The Toronto Breast Self-Examination Instrument (TBSEI): its development and reliability and validity data

Translation, cross-cultural adaptation and validation of the Slovenian version of Harris Hip Score

INTRODUCTION

The Harris Hip Score is the most widely used outcome measure for the assessment of hip pathologies. An official Slovenian version has not been culturally adapted and validated. The aim of this study was to create a Slovenian valid and reliable version of the HHS.

MATERIALS AND METHOD

The HHS was translated and modified in Slovenian. The measurement properties of the Slovenian HHS were tested in 42 patients suffering from different hip pathologies. Reliability, responsiveness, construct validity, convergent/divergent validity and content validity of the Slovenian version of the HHS were tested.

RESULTS

Only minor adaptation was required in the translation process. The internal consistency of the HHS expressed by Cronbach's alpha was 0.94. The test-retest reliability expressed by the intraclass correlation coefficient was 0.983. The correlations of the HHS scale with the WOMAC scale (r = - 0.877) and the VAS scale (r = - 0.717) were statistically significant. The highest correlation between the HHS and SF-36 was with the General Health dimension (r = 0.61). while the lowest correlation was with the SF-36 Mental Health dimension (r = 0.43). MDC95% was 10.1. No floor or ceiling effects were found.

CONCLUSION

Slovenian version of HHS seems to has an acceptable level of reliability and validity. Slovenian HHS is short, comprehensible and easy to administer and interpret.

TRIAL REGISTRATION

Approved by the Slovenian National Medical Ethics Committee (0120-46/2019/19).

Impact of Health Education Intervention on Breast Cancer Awareness among Rural Women of Tamil Nadu

Background:

The most common cancer among Indian females is breast cancer. Limited access to early detection and treatment is responsible for more than half of the deaths, primarily in rural areas, where organized mammography screening is neither affordable nor feasible. Therefore, imparting awareness on breast health and breast self-examination (BSE) is highly recommended. This study aimed to assess the impact of a health education interventional program on breast health awareness and BSE among rural women of Tamil Nadu.

Methodology:

A quasi-experimental study was conducted among 266 women. A preinterventional survey was done using a pretested validated questionnaire. A multipronged breast health education intervention was administered and its effectiveness was measured after 3 months using the same tool.

Results:

There was a statistically significant (P = 0.0001) improvement in the knowledge of breast health, perceived susceptibility, and reasons for practice and proficiency of BSE practice of the interventional group from pre- to post-test. After the interventional program, 71.8% of increase in knowledge about breast health and BSE was observed. In addition, 64.7% of the women practiced BSE compared to 7.14% pretest.

Conclusion:

This study highlights the awareness needs by the women and application of extensive strategies to increase the acceptance of cancer screening programs.

A Randomized Trial on Breast Self-Examination in Faenza (Northern-Italy)

Aims and background

The aim of this randomized controlled trial was to compare two methods for teaching breast self-examination: theoretical and practical session versus mailed material.

Methods

A random sample of women aged 20-64 years was drawn from the demographic file of the city of Faenza (Northern-Italy). Of 825 sampled eligible women, 168 declined participation, 657 were randomly assigned, after completing a pretest questionnaire aimed at evaluating practice and quality of breast self-examination. Individualised instruction was administered to the treatment group invited to be taught breast self-examination in a medical practice setting. The control group received mailed information about breast self-examination. One year later, 443 women completed the posttest questionnaire.

Results

As far as concerns the first outcome of the trial (change in practice of breast-self examination) our study showed, after adjusting for lost-to-follow-up, no difference between the treatment and the control group. The analysis performed to evaluate the second outcome (change in quality of breast self-examination practice) showed that women of the treatment group improved the quality of breast self-examination practice more than the control group (Wilcoxon test, z=2.4, P<0.01). The same results have been confirmed by multiple regression analyses taking into account all potential confoun-ders. No selection bias affected these results.

Conclusion

Theoretical and practical sessions resulted in an improved quality of examination technique than did mailed material.

US female college students' breast health knowledge, attitudes, and determinants of screening practices: new implications for health education

OBJECTIVE

This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population.

PARTICIPANTS

A convenience sample of 1,074 college women from 3 universities participated in the research.

METHODS

Respondents completed an online version of the Toronto Breast Self-examination Instrument as well as questions developed by the authors.

RESULTS

Descriptive statistics showed gaps in college women's knowledge of breast health and negative attitudes toward screening that were relative to age. Multiple linear and logistic regression analyses revealed that knowledge, attitudes, and copay were significant predictors of screening, whereas family history and ethnicity were not.

CONCLUSIONS

This study supported previous smaller-sample studies that showed college women to be a priority population for breast health education and revealed new significant factors that should be addressed in health education for this group.

A comparison of two time intervals for test-retest reliability of health status instruments

Studies of test-retest reliability for health-related quality of life instruments have used varying intervals between test administrations. There is no evidence available to aid in the selection of the time interval between questionnaire administrations for a study of test-retest reliability for health status instruments. We compared the test-retest reliability at 2 days and 2 weeks for four knee-rating scales and the eight domains of the SF-36. Seventy patients with disorders of the knee who were in a stable state were randomly allocated to repeat the questionnaires at either 2 days or 2 weeks. There were no statistically significant differences in the test-retest reliability (intraclass correlation coefficient and limits of agreement statistics) for the two time intervals.

Knowledge, attitudes, and practices surrounding breast cancer screening in educated Appalachian women

PURPOSE/OBJECTIVES

To determine how and what women learn about breast cancer and screening practices and which factors influence women's breast cancer screening practices.

DESIGN

Descriptive analysis of questionnaire data collected at the time of enrollment in a clinical trial.

SETTING

Breast care center of a mid-Atlantic academic health sciences center.

SAMPLE

185 women in a predominantly Appalachian, entirely rural state.

METHODS

Participants completed the Modified Toronto Breast Self-Examination Inventory and questions related to personal mammography practices at the time of enrollment before randomization in a longitudinal clinical intervention study.

MAIN RESEARCH VARIABLES

Women's demographics, knowledge of breast cancer screening practices, adherence to breast cancer screening guidelines, and motivation, knowledge, and practice proficiency surrounding breast cancer screening.

FINDINGS

These educated women had knowledge deficits about breast cancer, breast cancer risk factors, and screening guidelines, particularly the timing and practice behaviors of breast self-examination. Women who had received healthcare and cancer-screening instruction by healthcare providers, including advanced practice nurses, had greater knowledge of breast cancer and detection practices.

CONCLUSIONS

Women still have knowledge deficits about breast cancer, breast cancer detection, and personal risk factors. In addition, some educated women in this study failed to practice breast cancer screening according to current guidelines.

IMPLICATIONS FOR NURSING

Practitioners must continue to remind and update women about breast disease, and women's cancer-screening practices must be reinforced. All levels of providers should improve their rates of performing clinical breast examinations with physical examinations. Nurses, who greatly influence women's health care, must remain current in their knowledge of breast disease, screening, and treatment.

The practise of breast self-examination over a six-year period following teaching

The null hypothesis is that there is no difference in the performance of breast self-examination (BSE) with respect to three teaching methodologies. A total of 614 women were randomly assigned to a group receiving content only, one receiving content plus supervised practise on a model with implanted lumps or one receiving content plus instruction on their own breasts. It has been established that all groups increased significantly their frequency of practise and level of confidence (Alcoe SY, Gilbey VJ. McDermot RSR, Wallace DG. The effects of teaching breast self-examination: reported confidence and frequency of practise over a six-year period. Patient Educ Couns 1994; 23: 13-21). This paper considers the steps undertaken during BSE and the changes likely to be noticed through factors labelled Technique, Observation, Inspection and Palpation. The factors have been created from 35 items reflecting multiple aspects of the procedure as reported at four follow-ups. The group wherein teaching involved practise on their own breasts achieved higher scores than the other groups. Scores for Technique and Inspection are better maintained over time than are those for Observation and Palpation.