Evaluation of breast self-examination beliefs using a decision model

Predicting Testicular and Breast Self-examination Behaviour: A test of the Theory of Reasoned Action

One aim of this study was to describe attitudes, beliefs, and behaviours concerned with testicular and breast self-examination (TSE, BSE); the second was to test the efficacy of the Ajzen and Fishbein theory of reasoned action in predicting self-examination behaviour. Participants comprised 116 male adults with a mean age of 27.9, and 141 female adults with a mean age of 30.0 years. The sample was relatively well-educated, with over half having engaged in some tertiary studies. They completed a questionnaire assessing self-examination behaviours, intentions, beliefs, attitudes, and perceived norms. Results indicated low rates of self-examination for both TSE and BSE. Barriers to self-examination included embarrassment, perceived unpleasantness and difficulty, concern about reliability, and worries about what the tests might reveal. Respondents perceived only moderate levels of support from salient others for engaging in the self-examinations. The theory of reasoned action was strongly supported by the study, with intentions to perform self-examination being predicted by attitudes and subjective norms, and intentions in turn predicting self-examination behaviours.

Knowledge, Attitude, and Practice of Obstetric Nurses in Relation to Breast Cancer and Breast Self-examination

PURPOSE

This study aims to determine obstetrics nurses knowledge, attitude, and practice about breast cancer and breast self-examination (BSE), and to contribute to the early detection of breast cancer during breastfeeding periods.

METHODS

For the survey, 163 individuals (obstetric nurses) were chosen by convenience sampling and agreed to participate in the study. Their knowledge, attitude, and practice about breast cancer and BSE.

RESULTS

Knowledge and attitude averaged 70.45+/-10.90 (of 100) and 3.64+/-0.27 (of 5), respectively. While most nurses (99%) recognized the importance of BSE, only 58.9% experienced BSE. BSE practice level averaged 8.35+/-1.96 (of 12). Only 20.2% had recommended BSE to their clients. Practice level varied significantly for different marital status, breastfeeding experience, and education, while knowledge and attitude remained independent. Nurses who had experienced mammogram or breast ultrasonogram themselves scored higher in knowledge. Attitude was higher for nurses who received recommendation for BSE, performed BSE, received BSE education, or recommended BSE to clients. Practice level was higher for nurses who received BSE education or willing to perform BSE in future. Practice level had a positive correlation with attitude but no correlation to knowledge.

CONCLUSION

Obstetric nurses need continuing education for practicing BSE. Practical BSE education can not only promote preventive behavior of nurses, but it can also improve the breast health management of obstetrical clients.

The Effects of Breast Self-examination Program Enriched Environmentally among Healthy Women

PURPOSE

The purpose of this study was to determine the effects of an environmental enrichment program on barrier, benefit, confidence, and compliance of breast self-examination in women at 3 months after instruction.

METHODS

Nonequivalent control group pretest-posttest design was conducted among 62 healthy women. Data were collected through the self-reported questionnaires from December 2008 to March 2009. Women were assigned to one of two treatment groups: (a) no-support of environmental enrichment with the instruction control group; (b) the support of environmental enrichment with the instruction experimental group. All women received the same instruction on breast self-examination once a week for two weeks. Data were analyzed with paired t-test, McNemar test and ANCOVAs of controlling for age run using SPSS/WIN 17.0.

RESULTS

The experimental group was significantly lower than control group on perceived barrier (F=5.91, p=.02) and higher than control group on compliance of breast self-examination (F=4.57, p=.04) after environmental enrichment program. However the environmental enrichment program did not make significant differences on benefit (F=0.01, p=.91) and confidence (F=0.77, p=.38).

CONCLUSION

Findings suggest that the environmental enrichment should be needed to support women's breast self-examination and expanded for compliance of breast self-examination to promote the secondary prevention of women breast cancer.

Women's approaches to decision making about mammography

Health professionals have an obligation to understand women's decision making about mammography and to advocate for their active participation in health care decision making. Although mammography is a major screening measure for the second largest cancer killer of women, only approximately half of women older than age 50 years, and fewer older than age 70 years, undergo mammography in accordance with American Cancer Society (ACS) guidelines. Therefore, the purpose of this study was to identify women's overall decision-making approaches when considering mammography. Subjects were a purposive, convenience sample of 50 women in the community who had made a decision about mammography; they included those who chose to have mammograms and those who decided not to have mammograms according to the pre-1997 ACS guidelines. Subjects participated in audiotaped interviews. Results indicated that women approached the mammography decision differently, regardless of the decision they made. Three overall decision-making approaches to addressing risk factors, issues about mammography, or other factors before their decision were evident. The approaches were (1) thoughtful consideration; (2) cursory consideration; and (3) little or no consideration. Each approach has implications for nurses who assist women in making decisions about mammography.

Health beliefs of rural Appalachian women and the practice of breast self-examination

The purpose of this study was to examine the relationship between health beliefs of rural Appalachian women and the practice of breast self-examination (BSE). The sample consisted of 130 women residing in rural Appalachia who were recruited from various groups. The mean age was 53. They completed Champion's Health Belief Scale, which consisted of six Likert subscales: Susceptibility, Seriousness, Benefits, Barriers, Health Motivation, and Confidence. The women were questioned if they did BSE and were asked to respond to the following statement: "If I had cancer, I would rather not know it." Only 34.9% reported that they did monthly BSE. Two of the six subscales correlated significantly with reports of doing monthly BSE. Women who reported more confidence in doing BSE and perceived more benefits from doing BSE were significantly more likely to do regular exams. Interestingly, 18% indicated that they would rather not know if they had cancer and another 17% had neutral feelings. The findings support the need for culturally sensitive education programs on BSE for rural Appalachian women. Consideration must be given to their health beliefs in relation to health promotion.

Factors affecting the decision of nursing students in Taiwan to be vaccinated against hepatitis B infection

Compliance with Hepatitis B vaccination for nurses has been reported to be low in Taiwan. Therefore, a study of nursing students' view was conducted in Taiwan to discover possible reasons. As complex decision-making was involved in taking the vaccine, a four-level utility decision model underpinned by the Multi-Attribute Utility theory was proposed to ascertain the relative contribution of the specific components of attitude and beliefs to the final decision and experience of being vaccinated against Hepatitis B infection. Results indicated that the 'personal value of Hepatitis B vaccination', in particular for 'concern about the efficacy of the Hepatitis B vaccine', 'fear of pain from repeated injections', 'time' and 'money', were the main determinants in relation to the uptake of the Hepatitis B vaccination. Such results were consistent with earlier findings based on the Health Belief Model. It appears that the greater the experience gained in nursing care the lower the rate of vaccination; the important items under the concept of 'Personal value of Hepatitis B vaccination' varied by 'experience in nursing care'. The overall predictive validity was 67%, based on the utility decision model. When stratified by 'experience in nursing care', the prediction improved, ranging from 89% to 100%. Based on these findings, a specific intervention programme should be provided to change behaviour and improve the vaccination rate.

THE EFFECTS OF EMOTION ON BREAST SELF-EXAMINATION: ANOTHER LOOK AT THE HEALTH BELIEF MODEL

Research examining the performance of breast self-examination (BSE) has been guided primarily by belief models (e.g., Health Belief Model (HBM)) that focus on cognition. In this paper it was hypothesized that emotional responses, in addition to beliefs, would have an important impact on BSE frequency. To test this hypothesis the participants' emotional states were measured after they had been required to think about BSE. Also, the participants' beliefs about the benefits of BSE, barriers to performing BSE, susceptibility to breast cancer, and severity of breast cancer were measured. The results indicated that the participants' emotional responses to BSE increased the ability of models containing the HBM variables to predict different types of self-reports about BSE frequency.

Hispanic women's beliefs about breast cancer and mammography

Although breast cancer rates are lower among Hispanic women than among White women, Hispanics are more likely to die from this disease if they do get it. This may be related to the fact that Hispanic women are less likely to participate in mammographic screening. This study used a two-stage decision model to describe a group of rural, Hispanic women's beliefs and attitudes about breast cancer and mammography. The first stage consisted of exploratory interviews to identify factors, both positive and negative, that affect the mammography decision. The second stage will use a survey to weigh the identified factors in order to determine their importance to the decision. This article presents the stage 1 findings of this study. Twenty-nine rural, Hispanic women between the ages of 38 and 74 participated in the interviews. The majority had annual incomes of < $10,000, and 30% completed < or = 8 years of education. The subjects identified 18 factors, which fell into three general categories: Knowledge and Attitudes (How Well It Works, Personal Risk, Other Ways of Knowing, Fear of Cancer and/or treatment, Belief in Fate, Cultural Issues), Issues Related to Participation (Language, Getting There, Time, Cost, Radiation Exposure, Pain), and Social Concerns (Role Model, Responsibility to Self, Responsibility to Others, Influence of Family/Friends, Influence of Doctors, Influence of Society). Verbatim description of each of these factors are presented. The implication of the findings to health professionals is discussed.

Toward a reliable measure of breast self-examination. Attitudes and performance barriers

Breast self-examination (BSE) attitude scales are typically administered as part of face-to-face interviews or telephone surveys. The purpose of this study is to test the reliability (i.e., internal consistency) of a newly developed BSE scale that can be self-administered. The scale is made up of 24 items, each rated on a 5-point Likert-type scale. The scale items cover such issues as perceived seriousness and susceptibility to breast cancer, perceived effectiveness of breast self-examination, and personal barriers. Preliminary results were encouraging. Results of an exploratory factor analysis suggest that six factors may underlie this scale (common variance = 53%). Areas of item and scale improvements and implications for the use of this scale in health evaluation research are discussed.

An evaluation of mammography beliefs using a decision model

The purpose of this study was to identify factors that contribute to a group of working women's decision related to mammography. The study was guided by a decision model called the Multiattribute Utility Model. Exploratory interviews were conducted among 36 women to identify positive and negative factors associated with the mammography decision. Eighteen factors emerged and were categorized into three broad areas: Knowledge and Attitudes (Confidence in Efficacy, Personal Risk, Other Means of Knowing, Fear of Cancer/Treatment, Belief in Fate, Embarrassment), Issues Related to Participation (Accessibility and Convenience, Difficulty Arranging, Time, Cost, Pain, Radiation), and Social Concerns (Role Model, Responsibility to Self, Responsibility to Others, Family/Friends' Influence, Societal Influences, Health Care Providers' Influence). This information served as the basis of a survey among 87 women to determine the importance of these factors. Seven factors emerged as significantly different between compliers and noncompliers. In order of significance, they were Difficulty Arranging, Fear of Cancer/Treatment, Cost, Accessibility and Convenience, Time, Other Means of Knowing, and Influence of Health Care Provider. The predictive validity of this analysis was 85%. Implications of findings are discussed.

Breast self-examination beliefs: a descriptive study

Breast cancer is a major cause of morbidity and mortality among American women. Evidence indicates that regular breast self-examination (BSE) may reduce breast cancer mortality by 18%, yet the majority of women do not practice it. This study used a decision model to examine the BSE-related characteristics, beliefs, and behaviors of 52 working women age 21 to 65 years (mean 44.05 yrs). Nearly 29% of the sample performed BSE. They were more likely than nonperformers to be white, to have a close relative who had breast cancer, and to believe that breast problems could be detected through BSE. Fears, particularly fear of cancer, were more likely to affect performers' than nonperformers' BSE decision. Nonperformers were more likely to think that the first symptom of breast cancer would be a sensation of some type, and that a healthy lifestyle protected them from the disease. They also were more likely to think reminders would encourage them to perform BSE. The most often reported sources of information about BSE were health care providers and friends or relatives.