How do nurses and teachers perform breast self-examination: are they reliable sources of information?

Application of Personalized Education in the Mobile Medical App for Breast Self-Examination

Introduction. Mobile apps are considered intelligent tools useful in various areas of public health. The social dimension of breast cancer and the current epidemic situation require tools that may increase knowledge and improve the skills in the field of breast self-examination. The study aims to assess the use of personalized education based on algorithms with conditions in the mobile medical app for breast self-examination. Materials and methods. In total, 500 women from the Podkarpackie Province were enrolled in the study, which was a representative group for the inhabitants of this province. The subjects were randomly divided into two groups (group I: the study group including 250 people; group II: the controls of 250 people). The study group was subjected to intervention, which was personalized education on breast cancer. The method was a proprietary mobile medical app based on algorithms with conditions. The study was carried out from March 2018 to February 2019. Results. The majority of women, 77.8% (N = 389), were under 30 years of age. Only a small amount of the breast area was marked in the tactile test in both groups. In the study group, the average number of selected points was 14.86 (7.43% of the area to be examined), while in the control group it amounted to 9.14 (4.57%). The area most commonly examined in Test I in both groups was the central area of the mammary gland with the nipple. After the intervention in Test II, women from the study group marked a significantly greater area in the tactile test than women from the control group (χ2 = 99.733; df = 6; p < 0.0001). The mean result in the study group was 22.10, while in the control group it amounted to 9.10. It was found that the breast area marked in both tests depended solely on the women’s knowledge about breast cancer (p < 0.001). It was also found that the higher the risk of developing breast cancer, the more points in Test I were indicated by the women in the tactile test (p = 0.0122). Conclusions. Educational mobile medical apps for breast cancer prevention may help to deal with breast cancer, which is an important public health issue. It is also important to broaden the possibilities of medical apps for breast self-examination with elements verifying the skills of the three-stage compression of the examined breast.

Breast Tumor Malignancy Classification using Smartphone Compression-induced Sensing System and Deformation Index Ratio

Smartphone-based compression-induced sensing system uses the light diffusion pattern to characterize the early-stage breast tumor noninvasively. The system is built on a smartphone and cloud platform to capture, transfer, and interface with the user. The compressed tissue's deforming pattern creates distinctive tactile images due to the size and hardness of the tumor. From the compression-induced images, we estimate the size of the tumor using projection analysis and the tumor's malignancy using the tissue deformation index ratio. Deformation index ratio is based on the changes of a healthy region over the tumorous region. By using the projection analysis, the human patient tumor size estimation resulted in 52.3% of the average error. For a small number (seven) of the feasibility test, the tumor's malignancy was classified based on the deformation index ratio with 67.0% of sensitivity and 100% specificity.

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.

Perceived barriers to breast cancer screening among Saudi women at primary care setting

Introduction

Screening for breast cancer (BC) is of low rate in Saudi Arabia; although it is provided in the country free of charge to the population. This cross-sectional study aimed at investigating the perceived barriers towards BC screening in Al Hassa, Saudi Arabia.Participants and methods. A total of 816 adult Saudi women aged ≥ 30 years attending for routine primary health services or accompanying patients at the selected primary health care centers (PHCs) were randomly selected from 12 PHCs (8 urban and four rural) using multi-stage sampling method. Participants were invited to personal interview using semi-structured data collection instrument including inquiries about socio-demographics, reproductive history, previous histories of diagnosed breast lesions and breast cancer. The perceived individual barriers towards screening, their attitudes, the reasons for not attending previously held screening campaigns in Al Hassa, were also included.

Results

Low utilization of BC screening being significantly positively associated with woman's age, higher educational status, higher family income, using hormonal contraception and positive history of previous breast as shown by the results of the logistic regression model. Exploratory factor analysis showed that personal fears (especially fear of doctors/examiners, fear of hospitals and health facilities and fear of consequences/results) were the major factors that hinder women from utilizing the free of charge BC screening with high loading eigenvalue of 3.335, explaining 30.4% of the barriers.

Conclusions

Educational interventions aim at improving breast cancer knowledge and addressing barriers should be incorporated as core component of the screening program in Saudi Arabia.

Effect of structured training programme on the knowledge and behaviors of breast and cervical cancer screening among the female teachers in Turkey

Background

Breast cancer and cervical cancer are the most common cancers among women in the world. Many studies on the early detection of cancer have been conducted among women worldwide, but few studies have been performed in the world on female teachers regarding breast self-examination (BSE), mammography (MMG) and Pap smear test (PST). As teachers interact with students, this could play an important role in health education and in developing healthy behavior such as cancer screening. The main objective of this study was to evaluate the effect of a structured teaching program on breast and cervical cancer screening on the knowledge and practice of teachers. The other objective was to encourage teachers to transfer this knowledge to the women who attended their courses.

Methods

Semi –experimental designs with pre-intervention, post-intervention and six month follow-up tests were used in this study. The data were collected from 37 volunteer teachers and their 64 volunteer students with a sociodemographic form, a questionnaire form for breast and cervical cancer, and a Transtheoretical Model of behavior change for BSE, MMG and PST. Behavior of the teachers related to BSE, MMG, PST was evaluated in pre-training and in the first, third and sixth months post-training, and the behavior of the students was evaluated with point follow-up in the sixth month.

Results

In post-training, it was determined that the teachers’ knowledge of breast cancer increased from 11.70 ± 2.80 to 14.81 ± 3.22 and their knowledge of cervical cancer increased from 7.75 ± 5.60 to 17.68 ± 3.79. For BSE behavior, 47.8% of teachers were in the action and maintenance stage in pre-training, but this ratio was 81.1% in the sixth month post-training. For MMG behavior, all of the teachers were in the precontemplation stage in pre-training, and 38.9% of them were in the action and maintenance stage in the sixth month post-training. For PST, while 24.3% were in the action and maintenance stage in pre-training, this ratio was 45.9% in the sixth month post-training.

Conclusion

It was determined that the behavior change for BSE, MMG, PST was positive. Similarly, knowledge transfer from teachers to students was also effective.

Electronic supplementary material

The online version of this article (10.1186/s12905-017-0478-8) contains supplementary material, which is available to authorized users.

Perceived Barriers to Breast Cancer Screening among Saudi Women at Primary Care Setting

Background:

Screening for breast cancer (BC) is of low rate in Saudi Arabia; although it is provided in the country free of charge to the population. This cross-sectional study aimed at investigating the perceived barriers towards BC screening in Al Hassa, Saudi Arabia. It is crucial for increasing the rate of utilization of screening to identify the possible barriers for seeking BC screening in order to enhance early diagnosis and improve outcome.

Materials and Methods:

A total of 816 adult Saudi women aged ≥ 30 years attending for routine primary health services or accompanying patients at the selected primary health care centers (PHCs) were randomly selected from 12 PHCs (8 urban and four rural) using multi-stage sampling method. Participants were invited to personal interview using semi-structured data collection instrument including inquiries about socio-demographics, reproductive history, previous histories of diagnosed breast lesions and breast cancer. The perceived individual barriers towards screening, their attitudes, the reasons for not attending previously held screening campaigns in Al Hassa, were also included.

Results:

Low utilization of BC screening has being significantly associated with woman’s age (OR=2.55; 95% CI= 1.71-3.83), higher educational status (OR=2.98; 95% CI=2.05-4.34), higher family income (OR=1.96; 95% CI=1.31-2.93), using hormonal contraception (OR=1.46; 95% CI=0.99-2.13) and positive history of previous breast (OR=12.16; 95% CI=6.89-21.46), as shown by the results of the logistic regression model. Exploratory factor analysis showed that personal fears (especially fear of doctors/examiners, fear of hospitals and health facilities and fear of consequences/results) were the major factors that hinder women from utilizing the free of charge BC screening with high loading eigenvalue of 3.335, explaining 30.4% of the barriers.

Conclusion:

Educational interventions aim at improving breast cancer knowledge and addressing barriers should be incorporated as core component of the screening program in Saudi Arabia.

Knowledge, Attitudes, and Behaviors about Breast Self-Examination and Mammography among Female Primary Healthcare Workers in Diyarbakır, Turkey

Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% (n = 369) of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD) age of the female primary healthcare workers was 33.1 ± 6.8 (range, 20-54 years). The healthcare workers who practiced breast self-examination had significantly higher knowledge level (P = 0.001) than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education.

Using the health belief model to predict breast self examination among Saudi women

Background

In the Kingdom of Saudi Arabia, breast cancer (BC) usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination (BSE) for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model (HBM).

Methods

A convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia (n = 225), and their non-working adult female family members (n = 208), were subjected to the Arabic version of revised Champion’s Health Belief Model Scale (CHBMS) and the Arabic version of Breast Cancer Awareness Measure (CAM), to assess their knowledge and attitude on BC respectively. Percentage mean score (PMS) for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05.

Results

The majority of women heard about BSE (91.2 %), only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast (54.9 %), or untrusting themselves able to do it (24.5 %). Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures (PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively). They reported low scores of; perceived susceptibility, seriousness, confidence and barriers (PMS: 44.8 %, 55.6 %, 56.5 % & 41.7 % respectively), and high scores of perceived benefits and motivation (PMS: 73 % & 73.2 % respectively) to perform BSE. Significant predictors of  BSE performance were: levels of perceived barriers (p = 0.046) and perceived confidence (p = 0.001) to BSE, overall knowledge on BC (p < 0.001), work status (p = 0.032) and family history of BC (p = 0.011).

Conclusions

Saudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.

Evaluation of the Impact of Nurses' Healthy Lifestyle Behaviors on Utilization from Breast Cancer Early Diagnosis Methods

OBJECTIVE

This descriptive study was designed to determine the impact of nurses' healthy lifestyle behaviors on utilization from breast cancer early diagnosis methods.

MATERIALS AND METHODS

The study was carried out with 236 (41.7%) nurses who agreed to participate out of 565 nurses who work in a university hospital from February 12th to February 15th 2011. Healthy Lifestyle Behaviors Scale was collected by using a questionnaire consisting of 41 questions. The Healthy Lifestyle Behaviors Scale was improved by Walker, Sechrist and Pender (1987) and was adapted to Turkish by Esin (1997). The data was evaluated by percentage calculation, one -way ANOVA, t-test and Tukey's test.

RESULTS

The mean Healthy Lifestyle Behaviors Scale score was 129.09±19.82, the mean scores subscale scores of self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management were 38.52±6.28, 24.95±5.39, 9.41±3.24, 16.99±3.29, 21.22±3.39 and 17.99±3.66 respectively. It was found that Healthy Lifestyle Behaviors Scale total score was higher in nurses with sufficient level of breast cancer knowledge (F=13.115, p=0.000), who perform regular BSE (t=3.191, p=0.002) and who attended training on breast cancer (t=3030, p=0.003).

CONCLUSION

It was determined that although the mean total score of nurse's Healthy Lifestyle Behaviors Scale and their information on breast cancer prevention were above average, the utilization of breast cancer early detection services was not at the expected levels.

Do Saudi nurses in primary health care centres have breast cancer knowledge to promote breast cancer awareness?

BACKGROUND

Breast cancer is one of the leading causes of death among cancer patients in Saudi Arabia. It is known that nurses play a key role in promoting breast cancer awareness among women in any society. Nurses in primary health care centres (PHCC) have more direct contact with general population. This study aimed to investigate nurse knowledge of breast cancer and practice of early screening in PHCC in Jeddah city.

METHODS

A cross-sectional study was conducted using a self-administered questionnaire to assess the general knowledge of breast cancer, risk factors, and practice of 210 PHCC nurses. Data were analysed using SPSS v.16.

RESULTS

The mean age of the PHCC Nurses was 36.9 (SD ±8.6). Only 11% percent scored <50% of the total score for general epidemiological knowledge on breast cancer, about 35% scored <50% of the total score for breast cancer risk factors. Sixty seven percent scored >75% of the total score on breast cancer signs. Majority of nurses 62.8% practiced BSE, but only 4% practiced regularly every month. Some 28% practiced once per year. About 81% of the nurses had not had a clinical breast examination and only 14% had had a mammography. The results of the study failed to show any correlation between the knowledge scores with age, education, year of experience, family history of BC and marital status of the nurses.

CONCLUSION

The results from the study reflect that there is a need to provide continuing nursing education programmes for PHCC nurses to improve their breast cancer knowledge and practice.

Health Beliefs Concerning Breast Self-examination of Nurses in Turkey

PURPOSE

The purpose of the study was to evaluate the health beliefs regarding breast self-examination (BSE) and their relationship with age, educational status and history of breast cancer in the family among nurses working in a university hospital.

METHODS

A cross-sectional design was used, with a convenience sample of 381 nurses at a military university hospital in Ankara in Turkey. Data were collected by using a personal data form and the Champion's Health Belief Model Scale. Descriptive statistics, logistic regression, Mann-Whitney U test and Kruskal Wallis Test were conducted.

RESULTS

The proportion of nurses reported doing BSE regularly is 47.2%. Controlling variables such as age, body mass index, the age at first birth, breast cancer in the family history and educational background, we found that the subscales of the health belief model, BSE benefit (OR = 0.782), self-efficacy (OR = 0.919), and risk perception (OR = 0.114) have statistically significant effects on the risk of not making BSE.

CONCLUSION

It is important to be aware of the health beliefs of nurses regarding BSE so that their own health can be protected and improved. Beneficial attitudes and behaviors of nurses regarding BSE will enable them to provide more effective services to women regarding breast cancer. Understanding the nurses' health beliefs, attitude and behavior that are influential to make BSE will guide nursing practices towards early diagnosis of breast cancer at the societal level.

Modern breast cancer detection: a technological review

Breast cancer is a serious threat worldwide and is the number two killer of women in the United States. The key to successful management is screening and early detection. What follows is a description of the state of the art in screening and detection for breast cancer as well as a discussion of new and emerging technologies. This paper aims to serve as a starting point for those who are not acquainted with this growing field.

The knowledge and practice of breast self-examination among healthcare workers in Kayseri, Turkey

Breast cancer is the most common cancer type and cause of death among women in many countries. Monthly breast self-examination (BSE) is an effective diagnostic method for breast cancer. This study aimed to determine the knowledge level and practice frequency of BSE among healthcare workers in Kayseri, Turkey. Data were collected via a questionnaire that was prepared based on information in the literature. The questionnaire was composed of 2 sections: sociodemographic characteristics and practice and knowledge related to BSE. The sample group included 246 healthcare workers. Mann-Whitney U, Kruskal-Wallis H, (post hoc) Dunn, and chi tests were used in the analyses of data. The mean (SD) age of the respondents was 29.0 (5.6) years. Most (58.1%) were married, and a family history of breast cancer was reported by 12.2%. Of the respondents, 35% stated that they did not know how to conduct an examination of their breasts. Although 52.4% (n = 129) of the women reported that they performed BSE, only 17.0% (n = 22) reported doing so on a monthly basis. The practice of BSE was significantly associated with older, more educated medical secretaries; a positive personal history of breast problems; and a positive family history of breast cancer (P < .05). Healthcare workers had a low mean level of knowledge about the practice of BSE (mean [SD] score, 11.70 [10.07]; range, 0-40). The scores of the women who stated that they practiced BSE were significantly higher (P = .000) than those who reported that they did not. Healthcare workers need to improve their knowledge of and sensitivity toward BSE.