Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community

Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeria

INTRODUCTION

In Nigeria, breast cancer (BC), a disorder marked by the unchecked growth of breast cells, has been the commonest cancer among women in Nigeria. Breast self-examination (BSE) is one of the suggested methods for screening for the early diagnosis of breast cancer. However, studies have reported inadequate knowledge, negative attitudes and poor practices of BSE among undergraduate female students. The study was designed as an interventional study to examine the effect of educational intervention on knowledge, attitude and practice of breast self-examination among female students in a private university in southern Nigeria.

METHODS

This pretest posttest design study was carried out on 103 students of Novena University at baseline in 2022, which were chosen through the use of simple random sampling. A validated questionnaire with components on demographics, knowledge, attitude, and BSE practice was used to gather the data. After that, the students participated in three hourly sessions of an educational intervention for two weeks. A month later, the students' data were once again collected, and SPSS 20 software was used to evaluate the results using the mean, paired t test, and logistic regression at the P < 0.05 level of significance.

RESULTS

The mean age of the respondents was 22.37 ± 1.92 years. Only 53 (51.3%) were aware of BSE. The mean knowledge, attitude and practice of BSE at pretest significantly increased at posttest after the educational intervention (1.58 ± 1.48 vs. 4.31 ± 1.15, 2.37 ± 1.27 vs. 4.80 ± 0.49 and 1.97 ± 0.09 vs. 5.81 ± 3.26, respectively). Furthermore, age and family history of BC were predictors of knowledge (OR = 4.00 95% CI = 0.29-41.99, OR = 141, 95% CI = 0.15-13.18), attitude (OR = 2.39, 95% CI = 0.28-12.32, OR = 1.15, 95% CI = 0.24-8.34) and practice of BSE (OR = 2.66, 95% CI = 0.38-18.41, OR = 1.44, 95% CI = 0.24-8.34) respectively.

CONCLUSION

The findings showed that using an educational intervention strategy will improve the knowledge, attitude and practice of BSE among undergraduate students.

Preventing falls of the elderly at home: Applying the precaution adoption process model

BACKGROUND

Falling in the elderly causes a variety of issues such as dependence, decreased self-efficacy, depression and limitation in daily activities, hospitalization and imposition of costs on the individual and society. The aim of this study was to investigate the prevention of falls in the elderly at home by applying the Precaution Adoption Process Model.

MATERIALS AND METHODS

In this quasi-experimental study, 200 elderly people participated, 100 of whom were in the intervention group and 100 in the control group. The sample was provided via stratified random sampling. The data collection instruments were a researcher-made questionnaire including demographic details, as well as the Precaution Adoption Process Model (PAPM) questionnaire. Educational intervention was performed during four 45-minute sessions, following which the data was analyzed through SPSS 20 software and was evaluated based on the Chi-squared, Mann-Whitney U, Wilcoxon, and Fisher's exact tests.

RESULTS

Investigating the distribution of participants in the phases of the PAPM indicated that most participants of both the intervention and control groups were in the passive fall prevention phase before treatment. However, after the intervention, most participants of the intervention group were in the active phases of fall prevention, while there were not any significant changes in the control group. Moreover, comparing the mean of the structures of knowledge, sensitivity, severity, benefits, perceived self-efficiency, and the cues to action in terms of preventing falls after the intervention, showed a significant increase in these structures in the intervention group compared to the control group (P < 0.001). Eventually, the findings of the study showed a significant decrease in the percentage of falls of the participants of the intervention group compared to that of the control group after the intervention (P = 0.004).

CONCLUSIONS

Educational intervention on the basis of the PAPM promoted the elderly precaution from passive phases to active phases of preventing falls, thereby resulting in a decrease in the number of falls of elderly people.

Knowledge on risk factors and practice of early detection methods of breast cancer among graduating students of Debre Tabor University, Northcentral Ethiopia

Background

Breast cancer is the greatest common cancer in women worldwide, with approximately 1.7 million new cases diagnosed each year in the world which accounts for 12% of all new cancer cases and 25% of all cancers in women. Even though the higher mortality rate of breast cancer in low and middle-income countries, the practice of early detection methods is low and the majority of the patients who appeared at an advanced stage of the disease need palliative care with little survival rates. However, evidence is scarce on the knowledge and practice of breast cancer early detection methods among women of reproductive age in Ethiopia. Therefore we aimed to assess the knowledge on risk factors and practice of early detection methods of breast cancer among female graduating students of Debre Tabor University.

Methods

Institution-based cross-sectional study was conducted. A stratified random sampling technique was used. Data were collected with a self-administer questionnaire. The collected data were processed and analyzed with the computer using SPSS version 25 software. Descriptive statistics were used to describe the socio-demographic information of participants. Binary and multivariable logistic regression with an adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was stated at p < 0.05.

Result

A total of 270 female students participated in the study. The median age (± SD) was 24.63 years (± 1.26). All of the students heard about breast cancer and early detection methods. About 206 (76.67%) of the participants had good knowledge of breast self-examination. Mass media, health professionals, and friends in combination were the main source of information 172 (63.77%), only 110 (40.70%) of students performed a breast-self-examination and the rest did not perform it due to forgetting fullness and lack of knowledge. About 208 (77.1%) of the respondents respond family history is a risk factor for breast cancer. Being a health science student (AOR = 2.32; 95% CI: 2.12, 3.52), family history of breast problems (AOR = 3.41; 95% CI: 3.22, 8.33), and having a good level of knowledge (AOR = 1.83; 95% CI: 1.01, 5.68) were the factors associated with the practice of breast self-examination.

Conclusion

Most of the participants were unaware of the benefits, appropriate timing, and techniques of doing a breast self-examination. Health science students had better awareness & practice of breast self-examination than non-health science students. Trained health professionals must give focus on giving health information regarding risk factors of breast cancer and methods of early detection of breast cancer to the public & their clients.

Ethiopian women's breast cancer self-examination practices and associated factors. A systematic review and meta-analysis

BACKGROUND

Breast neoplasm is the most frequently diagnosed and the leading cause of cancer death in the vast majority of the countries. Breast cancer self-examination is a check-up of a woman does at home to look for changes or problems in the breast tissue. The benefit of early recognition is for early treatment that is more effective, higher long-term survival rates and better quality of life. The aim of this review was to determine the pooled prevalence of breast cancer self-examination practice and identify its associated factors among Ethiopian women.

METHODS

Google Scholar, PubMed, Science Direct, web of science, and Cochrane Library were used for search of articles. This review includes thirty four articles conducted in Ethiopia between 2011 and 2020. The review contains 14,908 women to determine the ever pooled prevalence of breast cancer self-examination practice. Health workers and students made up 28.35% of the total participants. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analyzed with Stata 14. To assess heterogeneity I² test were used. A random effect meta-analysis model was used to estimate the pooled breast cancer self-examination (BCSE) practice of Ethiopian women. Moreover associated factors were also assessed.

RESULTS

In Ethiopian women, the overall ever and regular pooled breast cancer self-examination practice was 36% (95% CI: 28, 43) and 16% (95% CI: 28, 43) respectively. The ever pooled prevalence for health workers or students was 53% (95% CI: 41, 65), whereas for other participants it was 25% (95% CI: 19, 30). Good knowledge about breast self-examination (AOR: 3.69: 95% CI: 2.70, 5.05), positive attitude towards BCSE (AOR: 2.72: 95% CI: 1.74, 4.24), Getting to know people with breast cancer(AOR: 2.77: 95% CI: 1.51, 5.09), family history of breast cancer (AOR: 2.49: 95% CI: 1.60, 3.88) and personal history of breast cancer (AOR: 2.26: 95% CI: 1.70, 3.01) were associated factors to BCSE practice among Ethiopian women. All of the studies included in this review were conducted in a cross-sectional design was a limitation of this review and meta-analysis.

CONCLUSION

This review and meta-analysis showed the ever and regular pooled prevalence of BCSE among Ethiopian women. More than one third of Ethiopian women ever practiced BCSE. We recommend that awareness creation should be perform in order to tackle the risk of breast cancer.

Breast cancer screening during the Syrian crisis: A cross-sectional study

Introduction

Although breast cancer has a lower incidence in developing countries, mortality rates are higher, mainly due to delay in diagnosis and the poor diagnostic and therapeutic capacities. Although screening tests have been available for quite a long time, delayed and advanced presentation is still common, especially in developing countries. The decade-long Syrian crisis has severely crippled the healthcare system and depleted the already-limited capacities of the healthcare services, which under prioritized the care provided to unurgent cases like breast cancer. This study aimed to investigate the practices of breast cancer screening among breast cancer patients.

Methods

A cross-sectional study conducted in Al-Beiruni Hospital at Damascus University in 2019, through personal interviews using a structured questionnaire.

Results

The sample consisted of 519 patients with breast cancer. One-hundred twenty (23.2%) of them reported undergoing one or more of the different screening methods at least once every six months prior to diagnosis. Several factors had a statistically significant association with the probability of undergoing or performing screening methods including living in large cities, having fewer children, having a full-time or part-time job, and the level of education. Patients who reported having a relative diagnosed previously with breast cancer or any other malignancies were also more likely to screen themselves. Inaccessibility to healthcare services, which was exaggerated by the armed conflicts, had a significant association with less practicing of the screening methods too (OR: 0.4 [0.3-0.7]).

Conclusion

The Syrian war and its direct and indirect consequences negatively affected screening practices of breast cancer.

Knowledge and attitude among outpatient women visiting a healthcare center in northern Iran regarding breast self-examination: a cross-sectional study

Purpose

Breast cancer is one of the most prevalent malignancies worldwide. This study aimed to compare the level of knowledge and attitude of females regarding Breast cancer and to determine the role of knowledge, attitude and barriers in performing regular self-examination.

Design/methodology/approach

Non-physician females aged 18 years old or above were enrolled in this cross-sectional study in two groups of usual clients and healthcare staff from January 2018 to January 2019 from a healthcare center in Sari, a major city in the northern district of Iran. A questionnaire was used to score the participants’ knowledge and attitude levels using questions about the participants' knowledge and attitude towards Breast cancer along with their status on Breast self-examination and barriers. Mean scores were used for statistical analysis using SPSS V25. p < 0.05 was considered significant.

Findings

A final dataset of 279 females were collected. A significant difference in the knowledge and attitude regarding breast cancer was found between the two study groups (p < 0.001). The practice of BSE was significantly lower in the usual clients compared to non-physician healthcare staff (p < 0.001). The most frequent barriers for not performing a regular BSE were fear of finding a mass in usual clients (17.8%) and lack of confidence in healthcare staff (3.8%).

Research limitations/implications

Limitations include single-centered sample selection.

Practical implications

Given the importance of early detection in breast cancer prevention and the general taboo regarding breast cancer screening methods in certain parts of the world, leading to poor results in early detection and prevention, the authors believe that it is of superior importance to address and promote positive attitudes in general population towards breast self-examination.

Originality/value

Given the importance of early detection in breast cancer prevention, and the general taboo regarding breast cancer screening methods in certain parts of the world, leading to poor results in early detection and prevention, the authors believe that it is of superior importance to address and promote positive attitudes in general population toward breast self-examination. The authors of this study believe that the manuscript represents honest and original work.

Predictive Factors for the Care and Control of Hypertension based on the Health Belief Model among hypertensive patients during the COVID-19 epidemic in Sirjan, Iran

BACKGROUND

Hypertension is a leading risk factor for morbidity and mortality around the world. Preventing this health problem is considered an important priority. The aim of this study was to investigate the predictive factors for care and control of hypertension (CCH) according to the health belief model (HBM) in patients with hypertension during the COVID-19 epidemic in Sirjan, Iran.

METHODS

In this cross-sectional study, participants were chosen by simple random sampling. Data were collected by a valid and reliable researcher-made questionnaire from 200 patients with high blood pressure aged 30-60 years. Data were analyzed by SPSS21 and analysis based on descriptive statistics, Pearson correlation coefficients and linear regression were conducted.

RESULTS

The results of Pearson correlation coefficients showed that there was a significant correlation between almost all constructs of Health Belief Model (HBM), but the strongest correlations were between self-efficacy and perceived susceptibility (r = 0.940, P ≤ 0.001), and between perceived barriers with perceived benefits (r = -0.615, P ≤ 0.001). According to linear regression, perceived barriers (β = -0.291), cues to action (β = -0.590), and knowledge (β = 0.973) predicted more than 26% of CCH variability. Knowledge had a stronger role than other variables.

CONCLUSIONS

The results of this study show that the constructs of the Health Belief Model can predict CCH in hypertensive patients. This model can be used as a tool for designing and implementing educational interventions to increase CCH among hypertensive patients.

Knowledge of breast cancer among medical students in Syrian Private University, Syria: a cross-sectional study

BACKGROUND

Breast cancer is the most common cancer among women and the second leading cause of cancer death globally. Since early diagnosis is crucial to reducing mortality, high levels of knowledge regarding general information, risk factors, and symptoms are required among healthcare professionals to deliver breast cancer care. This study aimed to determine Syrian medical students' knowledge about breast cancer in the fields of general knowledge, common clinical features, and risk factors.

METHODS

This cross-sectional study was conducted at the Syrian Private University in October 2019 (Breast Cancer Awareness Month), Damascus, during the Syrian war crisis. Data were collected through self-administered surveys and analyzed using the Statistical Package for Social Sciences version 25.0 (SPSS Inc., United States). The chi-square test was applied to assess the relationship between the level of knowledge and gender. One way analysis of variance was performed to assess the overall differences in mean knowledge score by study year, GPA, mother's education, and source of information. Unpaired Student's T-test was used to analyze the differences in mean knowledge scores (continuous variable) based on smoking status and alcohol consumption.

RESULTS

Of 320 students, 301 completed the questionnaire (response rate = 94.0%), of which 179(59.5%) were males. The study revealed above-average knowledge scores (total mean = 68.4%) regarding breast cancer, general information (71.9%), common clinical features (71.6%), and risk factors (71.6%). Clinical students (4th, 5th, and 6th years) scored higher compared with pre-clinical students (1st, 2nd, and 3rd years).

CONCLUSION

This study showed above-average knowledge scores regarding breast cancer. More efforts to correct misinformation, through reassessing the university curriculum and promoting awareness about breast cancer are required.

Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure

BACKGROUND

High blood pressure effects on patients' life. One of the problems in controlling blood pressure is lack of self-care. As a primary form of care, self-care is under patients' control and the patient's belief plays an important role in self-care behaviors. Using the Health Belief Model, this study aimed to determine the effect of educational program on self-care behaviors of rural patients afflicted with hypertension in Toyserkan city.

METHODS

This study was a quasi-experimental research. It studied 100 hypertensive patients in four health centers in rural areas in Toyserkan city in 2019. The samples were simple random sampling among those people referred to the four health centers. Participants in the intervention group attended three training sessions, but the control group did not take part in any training program. The assessment was conducted in both groups before and after the intervention through personal interviews with patients. The questionnaire including the Health Belief Model and self-care behavior constructs was administered.

RESULTS

Perceived susceptibility, perceived severity, self-efficacy and self-care behavior constructs did not have significant statistical differences in terms of mean scores before intervention between the two groups, but after intervention, there were statistically significant differences between the two groups. Examining the model factor in predicting self-care in the intervention group showed that the perceived severity and self-efficacy constructs had the highest predictive power.

CONCLUSION

The results showed that planning and intervention based on HBM, as the models that were used in education and health promotion could be effective in achieving better performance and attitude of patients suffering from hypertension and their self-care. Also, special mention is needed to health care providers to improve self-care training in patients with high blood pressure.

Exploring factors associated with breast cancer screening among women aged 15-49 years in Lesotho

Introduction

breast cancer is associated with serious morbidity, low quality of life and mortality. Prevention through early screening remains one of the most optimal strategies against breast cancer. The primary objective of this analysis was to determine the prevalence of breast cancer screening using the clinical breast examination (CBE) and breast self-examination (BSE) methods among women aged 15-49 years, and the secondary objective was to explore demographic and socio-economic factors associated with clinical breast examination (CBE) and breast self-examination (BSE) breast cancer screening methods.

Methods

the study used Demographic Health Survey data collected in 2014. The study participants were Basotho women aged 15-49 years. STATA 17 was employed for developing logistic regressions and weighting for sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.

Results

variables that were associated with significantly increased odds of having you had a breast cancer either self-examination or clinical test in last 12 months were: i) visiting a health centre in the past 12 months [odd ratio (OR): 1.21 (95% confidence interval [CI]: 1.02, p = 1.43); p = 0.025]; ii) completion of primary level education [1.27 ((1.10; 1.49); 0.001]; iii) being aware of breast cancer [2.18 (1.78;2.65); 0.001]; and iv) age [35-39 years: 1.40 (1.10;1.78);0.007]; while district of origin [Butha - Buthe: 0.63 (0.46; 0.85); 0.003] was significantly associated with decreased odds of the outcome.

Conclusion

our findings suggest that raising awareness about breast cancer is the most effective method of improving breast cancer screening among women in Lesotho.

A path analytic model of health beliefs on the behavioral adoption of breast self-examination

BACKGROUND

In Malaysia, breast cancer accounted for 34.1% of all female cancer cases with women presenting breast cancer at late stages. Breast cancer has a higher five-year survival rate if detected early. An increase of approximately 30% in the five-year survival rate is indicated if breast cancer is detected at stage III compared to stage IV. Thus, survival rate of breast cancer can be increased by creating awareness and encouraging breast cancer screening amongst women. Breast self-examination (BSE) is highly recommended for breast cancer screening due to its simplicity with no incurred cost. The Health Belief Model is used in this study to explain and predict the adoptive behavior of BSE amongst women in Kuantan, Pahang.

MATERIALS AND METHODS

This study employed a multi-stage sampling method using a simple proportion formula at 5% type 1 error, p < 0.05 and absolute error at 2% which resulted in a sample of 520 participants. The data for the study was obtained using a validated bilingual self-constructed questionnaire and the model constructed using Mplus software.

RESULTS

Perceived severity, benefits and barriers were found to significantly influence the behavioral adoption of BSE. Married women aged from 45 to 55 years and knowledge were found to significantly moderate the relationship between perceived benefits and behavioral adoption of BSE. Further, self-efficacy was found as the core construct that mediates the relationship between married women aged 45 to 55 years and the behavioral adoption of BSE.

CONCLUSION

Self-efficacy is found in the study to influence the behavioral adoption of BSE. This is undeniable as self-efficacy can promote confidence in initiating and maintenance of behavioral change if the perceived change is beneficial at an acceptable cost.

Psychometric Properties of the Iranian version of Champion's Revised Health Belief Model Scale for Breast Cancer screening

Background:

Women's beliefs regarding breast cancer and its screening approaches were considered antecedents of their behavioral changes. Understanding of these beliefs in women requires a valid and reliable instrument. The present study seeks to translate the English version of the Champion's Revised Health Belief Model Scale (CRHBMS) into the Persian language and assess its psychometric properties.

Materials and Methods:

The study was conducted on 334 students at Urmia University of Medical Sciences, Iran, 2016. The 57-item CRHBMS was translated to Persian language, back translated, and tested. To test the face and content validity of the Persian version; item analysis, Content Validity Ratio (CVR), and Content Validity Index (CVI) were applied, respectively. Construct validity of the Persian scale was performed by Exploratory and Confirmatory Factor Analyses (EFA, CFA) using Kaiser-Meyer-Olkin and Bartlett's tests in SPSS 16 and LISREL8.72 software. The reliability of the translated scale was evaluated using Cronbach's alpha and test-retest approaches.

Results:

In the EFA, eight factors were extracted concerning breast cancer screening, and each item was loaded on its specific factor. These factors were self-efficacy, health motivation, benefits-mammography, benefits-Breast Self-Examination (BSE), barriers-mammography, barriers-BSE, susceptibility, and severity. The final 42-item scale was confirmed by the CFA, and all goodness of fit indices showed a proper fit of the model. Cronbach's alpha coefficient and test-retest correlation of the subscales ranged from 0.72–0.89 and 0.67–0.93, respectively.

Conclusions:

The study suggests that the Persian version of CRHBMS is a feasible scale for evaluating women's health beliefs regarding breast cancer and its screening behaviors.

Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model

Background

Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM).

Methods

This investigation was a cross-sectional survey which was distributed among 1967 women aged 20–60 years. The Indonesian version of Champion’s Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice.

Results

44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice.

Conclusion

This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women’s self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach

Although women with intellectual disabilities have the same breast cancer incidence rate as women without intellectual disabilities, they have fewer mammograms and higher mortality rates. Qualitative inquiry was employed to explore barriers and facilitators to mammography among this population. In-depth qualitative interviews were conducted with 30 women with intellectual disabilities and their caregivers in Philadelphia during 2015-2016. Thematic analysis was conducted using inductive and deductive coding. While results provide further evidence for prior research on barriers to mammography among women with intellectual disabilities (e.g. being unprepared, fear of the exam), this study generated novel barriers such as lack of breast ultrasound awareness, sedation failing to work, and lack of mammogram education in adult day programs, and novel facilitators such as extended family support and positive attitudes. Results support the need to address barriers and promote facilitators to improve the breast cancer screening experience among women with intellectual disabilities.

Factors Associated with Initial Mode of Breast Cancer Detection among Black Women in the Women's Circle of Health Study

Mammogram-detected breast cancers have a better prognosis than those identified through clinical breast exam (CBE) or through self-detection, primarily because tumors detected by mammography are more likely to be smaller and do not involve regional nodes. In a sample of 1,322 Black women, aged 40-75 years, diagnosed with breast cancer between 2002 and 2016, we evaluated factors associated with CBE and self-detection versus screening mammogram as the initial mode of breast cancer detection, using multivariable logistic regression models. Compared with screening mammogram, history of routine screening mammogram (OR 0.20, 95% CI: 0.07, 0.54) and performance of breast self-examination (BSE) (OR 0.31, 95% CI: 0.13, 0.74) before diagnosis were associated with lower odds of CBE as the initial mode of detection, while performance of CBEs before diagnosis (OR 11.04, 95% CI: 2.24, 54.55) was positively associated. Lower body mass index (<25.0 kg/m² vs. ≥35.0 kg/m²: OR 2.46, 95% CI: 1.52, 3.98), performance of BSEs before diagnosis (less than once per month: OR 4.08, 95% CI: 2.45, 6.78; at least monthly: OR 4.99, 95% CI: 3.13, 7.97), and larger tumor size (1.0-2.0 cm vs. <1.0 cm: OR 2.92, 95% CI: 1.84, 4.64; >2.0 cm vs. <1.0 cm: OR 6.41, 95% CI: 3.30, 12.46) were associated with increased odds of self-detection relative to screening mammogram. The odds of CBE and self-detection as initial modes of breast cancer detection among Black women are independently associated with breast care and breast cancer screening services before diagnosis and with larger tumors at diagnosis.

Breast self-examination practice and associated factors among women aged 20-70 years attending public health institutions of Adwa town, North Ethiopia

Objective

Breast cancer is the leading cause of cancer mortality worldwide. The incidence of breast has been increasing in most regions of the world. Regular breast self-examination is one of the most cost-effective methods for early detection of breast cancer in asymptomatic women. Despite this fact, breast self-examination practice remains low in Ethiopia. Therefore, the aim of this study is to assess breast self-examination practice and associated factors among women aged 20–70 years attending public health institutions of Adwa town, North Ethiopia.

Results

From the total study participants, only 26 (6.5%) of them had ever practice breast self-examination, and only 25 (6.25%) of them practice breast self-examination regularly. Being a government employee (AOR = 0.22, 95% CI = 0.071–0.683), having good perceived confidence to do breast self-examination (AOR = 5.32, 95% CI = 1.89–14.95) and having perceived good susceptibility to develop breast cancer (AOR = 3.79, 95% CI = 1.74–9.74) were the factors significantly associated with breast self-examination. Breast self-examination practice among the study participants was low. Therefore, informing every woman is susceptible to breast cancer, improving the confidence of women is recommended to increase breast self-examination practice.

The impact of educational intervention based on the health belief model on observing standard precautions among emergency center nurses in Sirjan, Iran

Providing health care services has always been considered as a hazardous job due to a number of reasons. The risk of blood-borne viruses and the importance of their prevention has led to the formulation of principles called standard precautions (SPs). The goal of this study was to investigate the impact of an educational intervention based on the Health Belief Model constructs on the behavior of nurses in emergency centers regarding observing SPs in Sirjan, Iran. This was a quasi-experimental study. The study population included 100 emergency personnel working in health centers in Sirjan city (of Iran), who were randomly divided into two intervention (n = 50) and control (n = 50) groups. The educational intervention was conducted over two sessions each lasting for 60 min. Information was collected by a questionnaire (with 64 questions), completed in an interview conducted directly before the intervention and 3 months later. Data were analyzed using the χ2 test, t-test and paired t-test.The results showed nurses did not have enough information about SPs, but after the intervention, knowledge scores increased in both groups. In the Health Belief Model (HBM) constructs, significant differences were observed in perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action and self-efficacy, after the intervention, in the intervention group (P < 0.001), but not in the control group (P > 0.05). HBM was effective in educating SPs among emergency personnel.

Health Damaged Context: Barriers to Breast Cancer Screening from Viewpoint of Iranian Health Volunteers

Background

Breast cancer is common among cancer diseases and the second leading cause of death among women worldwide. The breast cancer-caused death is directly associated with diagnosis time of the disease. Screening is one of the major methods for health promotion in human societies. However, many women still refuse to do the periodic screening. The present study is aimed to analyze the experiences of health volunteers in order to understand the barriers to breast cancer screening among women at southeast of Iran.

Methods

Data collection was performed through focus groups. Using the purposive sampling method, 24 participants were selected and then were allocated to 6-member groups. The data were analysed using Lundman and Graneheim qualitative content analysis.

Results

The main theme of “Health Damage Context” was extracted with four main categories, including: family barriers, cultural and social barriers, personal barriers and organizational barriers.

Conclusion

Based on the results of the present study, there are numerous barriers to regular breast cancer screening, and for the same reasons, the willingness to screening is sometimes not satisfactory. Therefore, in case of the women’s referral to health centers, nurses and other health-care professionals should inform them about the role of different screening methods in early diagnosis and rapid treatment of breast cancer.

The Importance of Family History in Breast Cancer Patients in Primary Care Setting: a Cross-sectional Study

Screening recommendations of physicians are important for women to raise awareness about their risk factors and to promote appropriate screening behaviors. However, it seems challenging for primary care physicians (PCPs) to balance disease prevention and diagnosis, treatment. The objective of this study was to describe physicians' breast cancer consultancy practice including family history, cancer prevention issues for the women they care. This cross-sectional study included 577 women aged above 45 years, free of breast cancer, during their visits to their PCPs. Nearly half of the women reported their visit to PCPs for an annual examination during the year. Among them, 36.1% had first-degree relatives with cancer and 7.3% with breast cancer. But they reported to be asked about family history of cancer and informed about cancer prevention issues 35.1 and 26.4%, respectively. Cancer still seems to be a hard issue to be discussed, even with women visiting PCPs for annual examination. Asking first-degree relative with breast cancer can give PCPs the chance of determining women with increased risk and support women's appropriate understanding of their own risk in relation to their family history. This routine can make shared-decision making for developing person-centered approach for breast cancer screening possible. Further studies are needed for better understanding of loss of consultancy leadership of physicians for breast cancer.

Can Health Belief Model Predict Breast Cancer Screening Behaviors?

BACKGROUND:

Breast cancer is the second cause of cancer-related death among women. Prevention programs insist on the early diagnosis and screening to reduce the mortality rate.

AIM:

The study was conducted to determine the predictors of breast cancer screening behaviours based on the health belief model.

MATERIAL AND METHODS:

The present cross-sectional study was conducted by involving 304 women ranging from 20 to 65 years of age, living in East Guilan cities, the North of Iran, in 2015 using two-stage cluster sampling. The research instrument was Champion’s Health Belief Model Scale. The data were analysed based on Regression test by using SPSS software version 18.

RESULTS:

The results showed perceived benefits (ExpB = 1.118, p = 0.009), self-efficacy (ExpB = 1.122, p = 0.001) and the perceived barriers (ExpB = 0.851, p = 0.001) as the predictors of breast self-examination. In addition, the study revealed that the two components of perceived benefits (ExpB = 1.202), and the perceived barriers were the predictors of mammography (ExpB = 0.864) (p = 0.001). None of the health belief model components showed a role to predict clinical breast examination (P > 0.05).

CONCLUSION:

The present study highlights the need for educational programs, which should focus on increasing breast self-exam skills and understanding the benefits of healthy behaviours and eliminating their barriers.

Ethnic newspapers and low-income Spanish-speaking adults: influence of news consumption and health motivation on cancer prevention behaviors

OBJECTIVE

Ethnic newspapers have the potential to reach and influence various cultural and ethnic subpopulations traditionally underserved in the United States. The current study sought to explore how ethnic news consumption interacts with health motivation to predict cancer prevention behaviors in a sample of Spanish-speaking adults.

DESIGN

Participants (N = 100) completed a survey in Spanish, with items measuring demographics, acculturation, health literacy, health motivation, ethnic newspaper consumption (for two papers: La Viva and La Raza), and cancer prevention behaviors.

RESULTS

Results indicated consumption of ethnic newspapers correlated positively to acculturation, and cancer screening utilization. In hierarchical regression analyses, the interaction of consumption of an ethnic newspaper (La Raza) and health motivation predicted two of the six prevention behaviors assessed: avoidance of fatty foods and screening behavior.

CONCLUSION

The study provides evidence that consumption of Spanish-language newspapers enhances the likelihood that individuals with high levels of health motivation will engage in healthy behaviors. This finding highlights the utility of utilizing Spanish-language newspapers to reach underserved populations.

Iranian Women's Breast Health-Seeking Behaviors: Husband's Role

BACKGROUND

Breast cancer has become the most common cancer among Yazdi women in Iran. Thus, it is necessary to encourage these women to participate in breast health-seeking behaviors. In this regard, husbands can play an effective role.

OBJECTIVE

The aim of this study was to explore women's perceptions about the effect of their husband's role on breast health-seeking protection motivation.

METHODS

This study used a directed qualitative content analysis approach based on the Protection Motivation Theory. Participants were selected using purposive sampling; in-depth semistructured interviews with 14 Yazdi women were completed.

RESULTS

One major category named "motivator role of husband" emerged from the analysis. The following subcategories underlying this category were "indifference and a lack of support as long as the women can continue with expected duties," "what women want for support," "facilitating and restrictive factors of husband's supportive role," "public health education needed," and "husband's agreement with preventive actions."

CONCLUSIONS

Voluntary participation in breast health-seeking behaviors is a culturally sensitive topic. The qualitative methodology allowed this sensitive topic and its different aspects to be explored. The findings indicated that the major source of support for women was their husband's behavior toward breast health-seeking actions. Family cohesion and love among couples were identified as strong determinant factors pertaining to husband's supportive behaviors.

IMPLICATIONS FOR PRACTICE

The study findings provided deeper understanding about the effective factors related to a husband's role in motivating a wife to practice breast cancer prevention. These new findings are relevant for health educators and practitioners to develop culturally based interventions.

Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia

BACKGROUND

Arabic women have been consistently reported as having remarkably low participation rates in breast cancer screening measures in their home countries and after migration to Western countries. Little is known about the screening behaviors of Arabic women in Australia.

OBJECTIVES

This study aimed to report breast cancer screening practices among Arabic women in Australia and to examine the relationship between (1) demographic factors and (2) the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) score and women's breast screening behaviors.

METHODS

A descriptive cross-sectional method was used. Both English and Arabic versions of the BCSBQ were administered to the 251 Arabic Australian women 18 years or older who participated in the study.

RESULTS

The majority of participants (62.9%-92%) had heard of breast awareness, clinical breast examination, and mammography. However, only 7.6% practiced breast awareness monthly, 21.4% had undergone clinical breast examination annually, and 40.3% had biannual mammography. Length of stay in Australia, being retired, and being unemployed were positively associated with the recommended performance of breast awareness and mammography. In terms of BCSBQ scores, women who engaged in the 3 screening practices had significantly higher scores on the attitudes to health check-ups and barriers to mammography subscales.

CONCLUSION

Attitudes toward health check-ups and perceived barriers to mammography were important determinants of breast cancer screening practices among Arabic Australian women.

IMPLICATIONS FOR PRACTICE

To fully understand barriers discouraging Arabic Australian women from participating in breast cancer screening practices, efforts should be focused on specific subgroup (ie, working group) of Arabic Australian women.

Effects of Interventions Based on Health Behavior Models on Breast Cancer Screening Behaviors of Migrant Women in Turkey

BACKGROUND

Antalya is a city receiving internal and external migration in Turkey, including migrant women in need of developing breast cancer screening behaviors.

OBJECTIVE

The aim of this study was to develop breast cancer screening behaviors of migrant women through nursing interventions based on the Health Belief Model and the Health Promotion Model.

METHODS

This quasi-experimental study was conducted with 200 women (100 women in the intervention group, 100 women in the control group) in Antalya. The intervention group received training, consultancy service, and reminders and was followed up at 3 and 6 months after interventions.

RESULTS

The rates of breast self-examination, clinical breast examination and mammography were higher at months 3 and 6 in women in the intervention group compared with the women in the control group. In the intervention group, perceptions of susceptibility and barriers decreased after the interventions, and benefit, health motivation, and self-efficacy perceptions increased. According to month 6 data, in the intervention group, the decrease of each unit in perception of barriers increased the rate of breast self-examination 0.8 times and the rate of mammography 0.7 times. An increase of each unit in health motivation increased the rate of clinical breast examination 1.3 times and the rate of mammography 1.5 times.

CONCLUSION

Interventions based on health behavior models positively affected breast cancer screening behaviors of migrant women. Health motivations and perceptions of barriers are determinants in performing the screening behaviors.

IMPLICATIONS FOR PRACTICE

Migrant women should be supported more by healthcare professionals regarding recognition of breast health and disease and in transportation to screening centers in their new location.

Is Health Locus of Control a Modifying Factor in the Health Belief Model for Prediction of Breast Self-Examination?

BACKGROUND

Breast cancer is one of the most common cancers among women in the world. Early detection is necessary to improve outcomes and decrease related costs. The aim of this study was to assess the predictive power of health locus of control as a modifying factor in the Health Belief Model (HBM) for prediction of breast self-examination.

MATERIALS AND METHODS

In this cross- sectional study, 400 women selected through the convenience sampling from health centers. Data were collected using part of the Champion's HBM scale (CHBMS), the Health Locus of Control Scale and a self administered questionnaire. For data analysis by SPSS the independent T test, Chi square test, logistic and linear regression modes were appliedl.

RESULTS

The results showed that 10.9% of the participants reported performing BSE regularly. Health locus of control did not act as a predictor of BSE as a modifying factor. In this study, perceived self-efficacy was the strongest predictor of BSE performance (Exp (B) =1.863) with direct effect, while awareness had direct and indirect influence.

CONCLUSIONS

For increasing BSE, improvement of self-efficacy especially in young women and increasing knowledge about cancer is necessary.

Comparison of Two Different Educational Methods for Teachers' Mammography Based on the Health Belief Model

BACKGROUND

Breast cancer is the most common cancer in women. One way to decrease the burden of this cancer is early detection through mammography. This study compared the effectiveness of two different educational methods for teachers' uptake of mammography based on the Health Belief Model.

MATERIALS AND METHODS

The current study was a randomised trial of 120 teachers over 40 years old in two groups receiving multimedia or group education, both based on the Health Belief Model. Participants completed questionnaires before, immediately and three months after educational intervention. Mammography was evaluated before and after educational intervention.

RESULTS

The participants in the two groups were demographically similar. Comparison showed no difference noted in the scores of knowledge, perceived barriers, susceptibility, and severity constructs between two groups (p > 0.05). Health motivation and benefit were perceived to be higher in the group education compared to the multimedia group. There was a significant difference in mammography between two groups after the intervention (p= 0.003).

CONCLUSIONS

Planning and implementation of educational program based on the Health Belief Model can raise knowledge and increase participation in mammography especially with group education.

Result of randomized control trial to increase breast health awareness among young females in Malaysia

Background

Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia.

Methods

A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses.

Results

Mean scores of knowledge on breast cancer (p<0.003), knowledge on breast self examination (p<0.001), benefits of BSE (p<0.00), barrier of BSE (0.01) and confidence of BSE practice (p<0.00) in the intervention group had significant differences in comparison with those of the control group 6 and 12 months after the intervention. Also, among those who never practiced BSE at baseline, frequency of BSE practice increased 6 and 12 months after the intervention (p<0.05).

Conclusion

The Breast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia.

Trial registration

The ANZCTR clinical trial registry (ACTRN12616000831482), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.

The Treatment Approach and Social Support Needs for Patients with Breast Cancer

OBJECTIVE

Breast cancer is the most common type of cancer in women both in developed and developing countries. It has a higher mortality rate in low and middle income countries due to the late-stage diagnosis. The principal aim of this study was to investigate what patients with breast cancer did before presenting to Turgut Özal Medical Center and its relationship with late stage diagnosis. The study also aimed to identify the level of patients' perceived social support.

MATERIALS AND METHODS

The study included 200 patients with breast cancer who were treated at the chemotherapy unit during 2013 and 2014.

RESULTS

The mean age of the patients was 51.16±1.10 years and 60% of the women were graduates of elemantary school. The majority of patients (69.5%) noticed breast mass as the first symptom and 56.5% were diagnosed at later stages. Thirty-four percent of the patients delayed their visit to a health care centers after realizing the first symptom. No statistically significant relationship was determined between women's education level, residential area, age, the first symptom noticed, stages of tumor, and patients and system-related delay (p>0.05). In terms of family history of breast cancer, there was a significant difference between patient-related and system-related delays (p<0.05). The family support score (24.8±4.6) was higher than those of friends and husbands (23.8±5.5, 21.3±6.4, respectively). The husband support score was statistically different in terms of intimacy between women and their husbands after disease (p<0.001).

CONCLUSION

It can be concluded that overcoming barriers related to patients and the system will lead to early-stage diagnosis, which in turn will result in higher survival rates of patients with breast cancer. As awareness and knowledge level of women about cancer increases, they will visit health care centers earlier where they can receive more comprehensive treatment.

Breast cancer literacy among higher secondary students: results from a cross-sectional study in Western Nepal

BACKGROUND

Being the most common cancer among women worldwide, it is vital to be well-aware of breast cancer risk factors, symptoms and curability. However, few studies have reported breast cancer literacy in students using a validated instrument.

METHODS

A cross-sectional study was conducted among students of grades 11 and 12 from eleven higher secondary schools, one selected randomly from each ilaka of Parbat district. Questionnaire with modified Comprehensive Breast Cancer Knowledge Test was self-administered to 516 students. Knowledge score was categorized into two categories: 'good knowledge' and 'poor knowledge' taking median score as the cut-off. Chi-square test was used to determine difference in knowledge by socio-demographic factors, including gender.

RESULTS

Only 4.8% of the students responded correctly to at least half of the items, and 1.4% did not respond correctly to any of the items on risk factors and curability. Physical exercise was identified as a protective factor of breast cancer by 62.4% of the students. Presence of noncancerous breast lumps (56.6%) and being overweight (36.4%) were recognized as the risk factors. Knowledge of lumpectomy and radiation therapy for treatment of breast cancer was reported by 42.8% of students, while only 39.0% were aware of the availability of treatment therapies other than mastectomy. Males were significantly better informed than females (χ(2) = 4.02, p = 0.045). Pain in the breast (23.3 %), change in the shape of the breast (20.0%) and discharge of pus (14.1%) were the three most commonly recognized symptoms. Nearly one in two (47.1%) students indicated that the school curriculum inadequately informed them on breast cancer.

CONCLUSION

Our study demonstrates poor knowledge on breast cancer risk factors, symptoms and curability among higher secondary school students in Western Nepal. Still, several myths regarding breast cancer persist. Half of the students had the perception that school curriculum inadequately informed them on breast cancer. Future studies should aim at the measures necessary to address the inadequate knowledge, along with the perceived gap in school curriculum.

Health Beliefs and Breast Cancer Screening Behavior among a Group of Female Health Professionals in Turkey

OBJECTIVE

The purpose of this study was to identify the health beliefs and breast cancer (BC) screening behavior of a group of female health professionals (FHPs) [physicians, nurses and midwives] in Turkey.

MATERIALS AND METHODS

This descriptive study was conducted at primary and secondary level healthcare institutions in Central Anatolia, Turkey. The study group included 720 FHPs. Data was collected by a questionnaire and the Turkish version of Champion's Health Belief Model Scales (CHBMS).

RESULTS

The mean age of the FHPs was 30.2 years (±6.12 range; 20-50), 8.9 % of them were ≥40 years. The majority (93.9%) of FHPs did not have annual mammography (MMG) or clinical breast examination (CBE) (95.1%); and 42.9% reported to perform breast self-examinations (BSE). None of the physicians reported having a CBE or MMG. The physicians' perception of susceptibility, severity and barriers to screening was lower than the nurses and midwives; however, their perception of benefits, self-efficacy and health motivation was higher. The perception of benefit among nurses, and self-efficacy and perception of health motivation among midwives were lower than those of the physicians. The perception of barriers to screening was highest among nurses.

CONCLUSION

The compliance rate with early detection practices for BC screening was low among FHPs. Health beliefs influenced their behavior on BC screening.

Barriers to breast self examination practice among Malaysian female students: a cross sectional study

Introduction

Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.

Methods

A cross-sectional study conducted among 810 female undergraduate students in Klang Valley, Malaysia between April–Jun 2012. Data was collected via self-administered questionnaire which was developed and pre-tested for this study.

Results

The majority of respondents were Malay 709 (95.6 %) and single 719 (96.9 %) with a mean age of 21.7 (1.1). Only hundred eleven (15 %) of the participants had a family history of breast cancer. 70.5 % of the respondents do not practice breast self-examination, 70.5 % do not know how to do it, 64.7 and 61.5 % reported no symptoms of breast cancer and worries to detect breast cancer, respectively. Univariate analysis showed that age, marital status and personal history of breast disease were statistically associated with the practice of breast self-examination.

Conclusion

In this study, a high percentage of respondents were aware of breast cancer but do not perform breast self-examination. Knowledge, socio-cultural and environmental factors were identified as barriers; so it is recommended that knowledge among the public about breast cancer and promotion of public breast health awareness campaigns through the media should be carried out.

Correlation study of knowledge and behavior regarding breast care among female undergraduate students in China

BACKGROUND

This study aimed to understand the relationship between knowledge level and behavior on breast care in Chinese students, so as to provide strategies for improving the health education of breast care and subsequently for aiding in breast cancer prevention.

MATERIALS AND METHODS

A self-designed questionnaire was used to evaluate breast care knowledge level and characterize related behavior. Correlation analysis was conducted for the knowledge level and behavior. The study was carried out using 597 female undergraduate students in medical and non-medical colleges in Wuhu, China.

RESULTS

The average score of breast care knowledge was 5.32±1.68 (5.62±1.68 and 5.00±1.68 for medical and non-medical students, respectively), with a greater score value for sophomores (5.59±1.72) than freshmen (5.18±1.65). The average score of breast care behavior was 2.21±1.13, again with a greater value in sophomores (2.37±1.15) than freshmen (2.21±1.13). A significant positive correlation (r=0.231, p<0.01) between knowledge scores and behavior scores was observed. In addition, various factors, including paying attention to breast care information, receiving breast self-examination guidance, TV program and Internet, were found to influence breast care knowledge.

CONCLUSIONS

In general, female undergraduate students lack of self-awareness of breast care with a low rate of breast self-examination. It is necessary to carry out health education to improve early detection of breast cancer.

Predictors of breast self - examination among female teachers in Ethiopia using health belief model

BACKGROUND

Breast cancer is by far the most frequent cancer of women. It is the second leading cause of death in women worldwide. Approximately one out of eight women develops breast cancer all over the world. Majority of cases of cancer of the breast are detected by women themselves, stressing the importance of breast self-examination. The main objective of this study was to assess predictors of breast self-examination among female teachers in Kafa Zone, South West part of Ethiopia.

METHODS

A cross-sectional study was conducted among randomly selected 315 female teachers. Self administered a structured questionnaire including socio-demographic characteristics, knowledge about breast cancer and perception of teachers on breast self examination using the Champion's revised Health Belief Model sub scales used as data collection instrument. Multivariable logistic regression analyses were used to identify independent predictors of breast self -examination performance.

RESULT

Three hundred and fifteen female teachers were participated in this study. Their mean age was 33 SD [±7] years. Only 52 (16.5 %) participants ever heard about breast self examination and from those who heard about breast self examination 38 (73.07 %) of them ever performed breast self examination. After controlling for possible confounding factors, the result showed that knowledge towards breast self examination, perceived susceptibility, perceived severity and the net perceived benefit were found to be the major predictors of breast self examination.

CONCLUSION

This study revealed that breast self examination performance among female teachers was very low. Therefore, behavior change communication and interventions that emphasize different domains that increase the perceived threat to breast cancer as well as on the benefits of breast self-examination to increase the perception of the teachers in an integrated manner may be the most effective strategies that should be considered by the health offices and educational offices. These may help to increase the knowledge and skill of female teachers on how to perform breast self-examination and its importance hence helpful for wider of the community.

Awareness, Attitude, and Practice of Breast Cancer Screening Women, and the Associated Socio-Demographic Characteristics, in Northern Iran

Background:

Breast cancer is the most common malignancy among women, with a high rate of mortality. The burden of disease and its serious outcome could be prevented by early detection.

Objectives:

Thus, the objective of this study was investigation the awareness, attitude and practice of breast cancer screening women.

Patients and Methods:

This cross-sectional study has conducted on 500 representative samples of women aged 20 - 65 years who referred to urban area of Babol health centers in 2012. The data have collected with standard questionnaire. The demographic data, the knowledge of risk factors and symptoms and sign, the health belief, and the practice of women in breast cancer screening have collected by interview.

Results:

The results show that only 14.8% of participants had a high level of knowledge for breast cancer risk factors and 33.8% at high level of awareness of symptoms and signs. The level of awareness has significantly associated with higher age (P = 0.03) and higher educational level (P = 0.04). Only 10.2% and 8.4% of women have performed breast self- examination (BSE) monthly and breast clinical examination (BCE) annually respectively. The practice of women with BSE has significantly associated with aging (P = 0.005), higher educational level (P = 0.007), higher knowledge (P = 0.001) and positive attitude toward perceived benefits and confidence and health motivation (P = 0.001).

Conclusions:

The low level of awareness and practice of breast cancer screening have found in this study, emphasized an extension of framework health educational program, particularly in younger and low educated women.

Indicators of distress in newly diagnosed breast cancer patients

Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life.

Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment.

Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress.

Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68).

Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress.

Predictors affecting breast self-examination practice among Turkish women

BACKGROUND

Breast cancer (BC) is the most common cancer among females in Turkey. Predictors affecting the breast self-examination (BSE) performance vary in developing countries.

OBJECTIVE

To determine the frequency of BSE performance and predictors of self-reported BSEs among women in the capital city of Turkey.

MATERIALS AND METHODS

This cross-sectional study was conducted on 376 Turkish women using a self- administered questionnaire covering socio-demographic variables and BSE-related features.

RESULTS

Of the participants, 78.7% (N=296) reported practicing BSE, whereas 9.5% (N=28) were implementing BSE regularly on a monthly basis, and only 5.7% (N=17) were performing BSE regularly within a week after each menstrual cycle. Multivariate logistic regression modeling revealed that BSE performance was more likely in younger age groups [20-39 years] (p=0.018, OR=3.215) and [40-49 years] (p=0.009, OR=3.162), women having a family history of breast disease (p=0.038, OR=2.028), and housewives (p=0.013, OR=0.353).

CONCLUSIONS

Although it appears that the rates of BSE performers are high, the number of women conducting appropriate BSE on a regular time interval basis is lower than expected. Younger age groups, family history of breast diseases and not being employed were identified as significant predictors of practicing BSE appropriately. Older age and employment were risk factors for not performing BSE in this sample.

Practice of Breast Cancer Early Diagnosis Methods among Women Living in Samsun, and Factors Associated with This Practice

OBJECTIVE

The purpose of this study was to assess practice of breast cancer early diagnosis methods among women and the factors associated with this practice.

MATERIALS AND METHODS

The population of this cross-sectional study consisted of 410,377 women over the age of 20, living within the administrative borders of Samsun province. Stratified systematic sampling was used in the selection of the 800-member sample. The Health Belief Model Scale, a questionnaire consisting of open and closed-ended questions, was used to elicit women's demographic data and determine their awareness on early diagnostic techniques. The questionnaires were administered face-to-face by visiting individuals' addresses.

RESULTS

80.5% of women had knowledge on breast self-examination (BSE). 12.6% of the women who were aware of BSE stated that they regularly performed BSE. 30.4% of women had clinical breast examination (CBE) by health personnel at least once, while 36.8% of women over 40 years of age obtained mammography at least once. Factors associated with women's performance of BSE were age, having received education about breast health, perception of severity, barriers for BSE and self-efficacy. Factors affecting CBE included age, presence of history of breast cancer in a relative or friend, having received education about breast health; while factors associated with women's undergoing mammography were identified as age, a family member with a history of breast cancer and barriers for mammography.

CONCLUSION

Determination of the factors associated with practice of breast cancer early diagnosis methods, and implementation of planned training programs based on these results is important in increasing compliance with these methods.

Interventional Education Methods for Increasing Women's Participation in Breast Cancer Screening Program

The purpose of this study was to evaluate the impact of the three methods of education-individual, individual with an educational brochure for spouses, and group-on participation on breast cancer screening in Turkey. A total of 550 home visits were made and 446 women were interviewed to accrue 327 women for the study, 26.7% of whom reported receiving a screening mammogram within the past 2 years. Participants were divided into one of the three educational groups, and following the educational session, they were invited to attend a breast cancer screening program. The results indicated that the decision to have a screening mammogram was influenced by the method of education and the knowledge score. Women, who were educated, within a group scored the highest. These results demonstrate that group education is an effective method of increasing breast cancer knowledge and screening awareness.

Determination of Knowledge and Behavior of Women Working at a Hospital on Breast Cancer Early Detection Methods, and Investigation of Efficiency of Planned Education

OBJECTIVE

This study aimed to evaluate knowledge and attitude of women working in the hospital on breast cancer, their behaviors related to early diagnostic methods, and to determine the effectiveness of training in order to increase awareness on breast cancer.

MATERIALS AND METHODS

The study group consisted of women working in the Dokuz Eylül University Hospital. The data of this cross-sectional study were collected by a questionnaire. Within the scope of this study, a training program on breast cancer was organized. The effectiveness of this training was evaluated by a preliminary survey and a final survey. Data were expressed as number and percentage, and paired t test and chi-square test were used for comparison.

RESULTS

161 women participated in the study with a mean age of 35 ± 8. It was determined that 81.4% of women knew early diagnosis and screening methods for breast cancer. 49.1% of women stated that they perform breast self-examination, but only 6.2% practiced it once a month. 32.9% of women had clinical breast examination, 22.4% had a breast ultrasound, and 22.3% had mammography. Most of the women did not perform any of these methods. The average knowledge level of women was significantly increased after completion of the planned training as compared to pre-training levels (p <0.001).

CONCLUSION

It was determined that the majority of women were informed on breast cancer early diagnosis and screening methods, but did not practice these methods on themselves. Information and awareness of women against breast cancer have increased with the use of planned training programs on breast cancer, early detection and screening methods.

Breast Cancer Risks and Effectiveness of BSE Training among Women Living in a District of İstanbul

OBJECTIVE

The purpose of this study to determine the risks associated with breast cancer in women who live in a neighborhood in Istanbul, and to evaluate the effectiveness of breast self-examination (BSE) training.

MATERIALS AND METHODS

This study was designed by using a half-experimental model, with women over the age of 18 who visited the community health center in a district of Istanbul, during March/April 2012. Sample selection was not implemented, and 169 women who voluntarily participated in the study were included. Data was collected by face-to-face interview technique with "Demographic Survey Form", "Breast Cancer Risk Assessment Form" and "BSE Training Assessment Scale". After risk assessment, women who wanted to learn BSE (n=109) were given a practical training program lasting approximately 20 minutes that was prepared together with expert consults.

RESULTS

32.1% of the participants regularly performed BSE. Out of those who do not use regular self-examination, 15.4% thought BSE was unnecessary, 44% was afraid to examine herself, and 40.7% did not know how to apply BSE. The mean breast cancer risk score was 135.64±61.33. There were statistically significant differences between breast cancer risk score and the educational status, marital status, and menstrual status. A statistically significant difference was found in pre- and post-training BSE Training Assessment Scale scores.

CONCLUSION

The breast cancer risk score was low among women included in this study. However, the vast majority of women did not perform BSE, and those who did were using either irregular or improper practice. It was detected that implementation of planned and in-person training programs were quite effective.

Health Behaviors, Disparities and Deterring Factors for Breast Cancer Screening of Immigrant Women - A Challenge to Health Care Professionals

Background

This literature review was made to provide comprehensive to provide comprehensive understanding of health disparities as well as factors and barriers to cancer screening of immigrant women in multicultural societies.

Methods:

Published articles from 1990–2013 were searched using databases such as CINAHL, MEDLINE, PubMed and Science Direct showing evidence of contributing factors and barriers to breast cancer screening practices of immigrant women in developed and developing countries. Based on the inclusion criteria, a total of 45 qualified articles were included in the review process.

Results:

Articles included were quantitative and qualitative, written in English for publication, and subjects were middle-aged, married immigrant women. The identified influential factors and barriers that prevent immigrant women from cancer screening were categorized as individual, socio-cultural and behavioral factors. Socioeconomic status, education level and knowledge, availability of health insurance and acculturation were among the individual factors. Presence of social support and recommendation from health care professionals were strongly associated with compliance with cancer screening. Cultural beliefs and practices as well as behavioral factors were among the barriers that deter women from participating in cancer screening.

Conclusion:

To alleviate the negative factors and barriers that affect the participation of high-risk immigrant women, a client-centered assessment and intervention approach with specific regard to cultural beliefs and practices should be considered by health care professionals. Joint effort of individuals, community, health care professionals and government institutions are recommended to further address the continuous rise of breast cancer mortality worldwide.