Factors influencing registered nurses teaching breast self-examination to female clients

The effects of an educational program on knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives

AIM

To determine the effectiveness of an educational program concerning knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives.

BACKGROUND

Educational programs play an important role in breast cancer preventive behaviour.

DESIGN

The study was designed as an experimental post-test only, control group design. The educational program was applied only to the experimental group. The study group included 157,134 nurses and midwives respectively in the experimental and the control group.

METHODS

Participants in the experimental group received an educational program on the breast cancer. One year after the educational program was delivered, data were collected from the two groups using a personal data form and the Turkish version of Champion's Health Belief Model Scale. Descriptive statistics, paired samples t-test, chi-square test and Fisher's exact test were conducted in the course of the data analyses.

RESULTS

The mean total knowledge score was significantly higher in the experimental group than in the control group. The application percentage of mammography and clinical breast examination was higher in the experimental group. There were no significant differences between two groups in performing breast self-examination. The experimental group was significantly more likely to feel confident and motivated, and their total score on the health belief scale was much better than that of the control group.

CONCLUSIONS

The results of this study showed that educational intervention had a positive impact on knowledge of breast cancer, on practices related to breast cancer, on early detection and on the health beliefs in the experimental group.

RELEVANCE TO CLINICAL PRACTICE

The educational programs, including techniques to increase the motivation and skills for early detection of breast cancer, should be made widespread in nursing and midwifery. Health beliefs should be considered in planning educational programs about breast cancer. Interventions should be designed to enhance nurses' and midwives' confidence and motivation.

The problems encountered by midwives during breast self-examination training

The second leading cause of cancer death in Turkey, breast cancer accounts for 24% of female cancers, with a crude incidence rate of 7.2 per 100,000 women in 1999. It was determined that breast self-examination (BSE) is carried out effectively if it is taught by a physician or a midwife/nurse.

MATERIALS AND METHODS

This descriptive study was performed in 16 health centers found in the city center of Samsun between 01.09.2006 and 30.12.2006. A total of 124 midwives work in the health centers found in the city center of Samsun. It tried to cover the total population rather than sampling part of it. However, 11 midwives, where there was error detected in their data coding paper, and who did not accept to join the study, were excluded from the study. A total of 103 midwives (response rate=83.06%) were included in the study group. The data were collected using a questionnaire form and a problem definition list prepared according to the literature. Descriptive statistics and chi-square tests were used to evaluate the data.

RESULTS

While 90.3% of the midwives stated that they performed BSE, it was seen that 82.6% of the midwives performed BSE irregularly. While 97.1% of the midwives considered BSE as important, 78.6% of them stated that they had had on-the-job training about BSE. About 82.5% of the midwives stated that they educated women about BSE and 75.7% of them said that they did not feel as sufficient themselves for BSE training. The midwives stated that the most frequent problems encountered were that the women were not willing to apply BSE (43.7%), the women were not able to distinguish the masses from normal breast tissue (48.5%), the women did not feel confident in detecting the masses (49.5%) and the women were not willing to think about cancer (41.7%).

CONCLUSION

This study shows that multiple reasons are affecting women's BSE practices, which midwives should address when delivering their training sessions.

Health beliefs and breast cancer screening behaviors among female health workers in Turkey

The purpose of this study was to evaluate health beliefs and breast cancer screening behaviors in female health workers in Turkey. This descriptive study was conducted in various health centers located in Erzurum, Turkey. The sample consisted of 268 female health workers (physicians, n=51; nurses, n=169; and midwives, n=48). Data were collected by using a self-administered questionnaire and the Turkish version of Champion's Health Belief Model Scales (CHBMS). The mean age of participants was 31.31 (S.D.=6.89), and 49.9% of them were married. It was found that only 21.9% of the female health workers performed breast self-examination (BSE) regularly, and 12.5% of them had a mammogram. Physicians' health motivation and BSE self-efficacy perceptions were higher than the nurses and midwives. Susceptibility, health motivation to BSE, BSE benefits, BSE self-efficacy perceptions of female health workers who performed BSE were significantly higher than those who did not, and a result indicating that positive health beliefs are effective in stimulating performance of BSE of female health workers. Among the variables related with mammography, only susceptibility perceptions of female health workers who had a mammogram was significantly higher than those who had not had a mammogram.

Knowledge and practice of breast cancer screening among Jordanian nurses

PURPOSE/OBJECTIVES

To examine Jordanian nurses' knowledge of a and proficiency with breast self-examination (BSE) and early detection of breast cancer.

DESIGN

Descriptive.

SETTING

Seven governmental and three private hospitals in the country of Jordan.

SAMPLE

395 female nurses working in different healthcare settings. Their ages ranged from 21-51 years (X= 31); nursing experience ranged from 1-30 years (X= 16).

METHODS

Subjects completed a researcher-developed knowledge test consisting of 24 questions derived from the American Cancer Society's guidelines regarding risk factors associated with breast cancer and methods of early detection and from Jordan's breast cancer statistics. Responses to the knowledge test were summed for an overall knowledge score. Descriptive statistics were used to summarize data.

MAIN RESEARCH VARIABLES

Knowledge of breast cancer and early detection and practice of BSE.

FINDINGS

Nurses had low mean levels of knowledge about early detection and facts related to breast cancer in Jordan (X= 51%, SD = 19). Although 86% (n = 343) of the nurses reported performing BSE, only 18% (n = 62) reported doing so on a monthly basis.

CONCLUSIONS

Nurses had limited levels of knowledge about breast cancer and methods of early detection; few nurses practiced BSE monthly.

IMPLICATIONS FOR NURSING

Continuing education programs for nurses are urgently needed to improve nurses' knowledge about breast cancer and BSE. Additional studies to examine the impact of other variables on the practice of early-detection methods should be conducted, such as those that determine faculty knowledge and beliefs about early detection, those that assess curriculum content about breast cancer and its early detection, and those that assess other healthcare providers' knowledge and beliefs about early detection. Intervention studies that aim to increase nurses' knowledge of breast cancer and their practice of early-detection methods would be beneficial.

Breast cancer awareness and practice of breast self examination among primary health care nurses: influencing factors and effects of an in-service education

AIM

The purposes of this study were to identify the level of breast cancer and breast self examination practice knowledge of primary health nurses and the factors influencing breast cancer and breast self examination knowledge as well as to investigate the frequency of breast self examination practice of primary health nurses and influencing factors and to evaluate the effects of an in-service training program about breast cancer and breast self examination practice for primary health nurses.

BACKGROUND

An increased awareness among nurses about breast cancer prevention would most likely result in a higher number of better educated women about breast cancer and also motivate adherence to screening recommendations.

DESIGN AND METHODS

A pre-test and post-test design was implemented to evaluate the effectiveness of a Breast Cancer and Breast Self Examination Education Program for primary health nurses. The program was instructed to 192 of the 215 primary health nurses by two nurse trainers. Pre- and post-tests made available a quantitative evaluation of the level of improvement in breast cancer and breast self-examination knowledge.

RESULTS

Mean of total breast cancer knowledge score of primary health nurses prior to the program was 58.51 SD 15.63 whereas, it increased to 75.96 SD 9.53, revealing a statistically significant escalation (p < 0.0001). A significant increase was detected in the number of primary health nurses practising breast self examination as a result of the significant improvement in the mean of self breast self examination practice knowledge score which rose evidently from 71.09 SD 19.31 to 85.02 SD 12.92 (p < 0.0001).

CONCLUSION

The in-service education program improved the knowledge about breast cancer and practice of breast self examination in trained primary health nurses. The program model, which involved trained primary health nurse also represented an efficient use of the resources.

RELEVANCE TO CLINICAL PRACTICE

It is important that primary health nurses have adequate breast cancer knowledge and practice of breast self examination to contribute effectively to primary health care. Findings of this study can be used to guide the planning efforts on continuous education of primary health nurses about breast cancer and breast self examination issues.

Registered nurses' breast self-examination practice and teaching to female clients

Many registered nurses (RNs) do not regularly perform breast self-examination (BSE), and even fewer routinely teach the procedure. The aim of this descriptive survey was to investigate registered nurses' BSE practice and teaching to female clients. A systematic random sample of 171 female Australian RNs aged 20 to 65 who worked in acute or long-term care areas was surveyed. A questionnaire I developed and mailed to participants was used to collect the data, and descriptive statistics were used in data analysis. Ninety-three percent of participants reported performing BSE in the preceding 12 months. However, less than half (46%) had performed BSE monthly, and the major reason cited for not performing monthly BSE was "forgetting" (57%). Most participants (81%) stated they did not include the teaching of BSE in their nursing care; the major reason identified was "it was not relevant to their work context" (86%). However, 77% indicated feeling confident in teaching BSE, and most (94%) would teach BSE if they had the opportunity. Furthermore, participants were found to be more likely to teach BSE if they performed monthly BSE, felt confident with their BSE teaching skills, and had completed other nursing courses. The implications of this study are that nurses' teaching to clients may be increased if more emphasis on BSE occurs in the workplace and in undergraduate and postgraduate courses. Also, the provision of BSE educational programs is necessary to increase nurses' knowledge, confidence, performance, and teaching of BSE.