Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory

Breast self-examination among female medical students at Damascus University: A cross-sectional study

Introduction

Breast cancer (BC) is the leading cause of death in Syria. In young females, it is a serious complication, making it crucial to raise awareness about the disease and its early detection methods. Given the challenging circumstances that Syrians face, regular visits to medical centers for mammography are often not feasible. Therefore, breast self-examination (BSE) is a valuable tool for detecting cancer. Educating girls in medical colleges is key to disseminating knowledge about BSE among women, as they will become future healthcare providers and can share accurate information with their families.

Materials and methods

A cross-sectional study was conducted in the medical faculties of Damascus University (medicine, dentistry, and pharmacy), Syria. The study utilized a structured questionnaire on Google Forms with four sections. The questionnaire was prepared electronically, and shared as an online link in formal university groups on social media. Data collection started on September 19, 2022, and ended on October 19 of the same year. Participation was accepted from female students in medical colleges, ranging from second to fifth year (for dental and pharmacy students) and sixth year (for medical students). Data from other students and incomplete data were excluded.

Results

589 female medical students from three faculties (medicine, dentistry, and pharmacy) filled out the questionnaire. Only 57 % of the students demonstrated a good attitude towards BSE, and 79.6 % of them agreed or strongly agreed that they avoid BSE due to fear of the consequences of breast cancer. Regarding BSE knowledge, 89.6 % of the participants reported previously hearing about BSE, and 55.7 % of them had performed BSE before. The factors that were accompanied by better knowledge about BSE were: a good attitude towards BSE; previously performed BSE; studying in a medical faculty; study years for medical and pharmacy students; and higher college average grades. Whereas, having a medical relative and having a family member with a history of BC surprisingly do not impact the knowledge.

Conclusion

The study, conducted at Damascus University in Syria, assessed the knowledge and practice of breast self-examination among female medical college students. The results indicate a moderate level of knowledge and limited practical experience in performing breast self-examination. These findings highlight the urgent need to emphasize the importance of promoting and teaching this method to a wider population of women in society.

Breast cancer preventive practices and associated factors among reproductive age women in Wadila District, North East Ethiopia: community based cross-sectional study

BACKGROUND

Cancer is one of the leading causes of morbidity and mortality worldwide. Among all cancer types, breast cancer stands out as the most common and is characterized by distinct molecular characteristics. This disease poses a growing public health concern, particularly in low and middle-income countries where it is associated with high mortality rates. Despite these challenges, there is a paucity of data on breast cancer preventive practices and associated factors among reproductive-age women in Wollo, Ethiopia. Hence, this study aimed to evaluate the level of breast cancer awareness, preventive practices, and associated factors among women of reproductive age residing in Wadila district, Wollo, Ethiopia in the year 2022.

METHOD

A cross-sectional community-based study involving 352 women of reproductive age in Wadila district was carried out between May and June 2022. Participants were selected using a systematic random sampling technique, and data analysis was conducted using Statistical Package for Social Science (SPSS) version 23 software. Logistic regression analysis was utilized to determine the odds ratio for variable associations, with statistical significance set at p < 0.05.

RESULT

The prevalence of breast-examination among women of reproductive age was determined to be 40.1% (95% Interval [CI]: 34.94-45.18). Factors such as educational status (Adjusted Odds Ratio [AOR]: 0.28, 95% CI: 0.13-0.6), income (AOR: 0.19, 95% CI: 0.11-0.33), and family history of breast conditions in reproductive-age women (AOR: 1.90, 95% CI: 1.08-3.34) were significantly linked to the practice of breast self-examination in this population.

CONCLUSION

The study highlighted a decline in regular breast self-examination among women of reproductive age. It revealed that the reduced frequency of regular breast self-examination was a prevalent concern among women in this age group and the broader community. Educational level, monthly income, and family history of cancer among women of reproductive age were identified as significant factors linked to the practice of regular breast examination.

Factors Affecting Breast Screening Behavior of First-Degree Relatives of Breast Cancer Patients in China: A Cross-sectional Study

BACKGROUND

Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear.

OBJECTIVE

The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs.

METHODS

A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior.

RESULTS

The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = -0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior.

CONCLUSION

Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior.

IMPLICATIONS FOR PRACTICE

Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.

Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students

INTRODUCTION

Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE).

METHODS

A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect.

RESULTS

Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump.

CONCLUSION

This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

The practice of breast self-examination and associated factors among female healthcare professionals working in selected hospitals in Kigali, Rwanda: a cross sectional study

BACKGROUND

Breast self-examination (BSE) is considered one of the main screening methods in detecting earlier stages of breast cancer. It is a useful technique if practiced every month by women above 20 years considering that breast cancer among women globally contributed to 685,000 deaths in 2020. However, the practice of breast self-examination among healthcare professionals is low in many developing countries and it is not well known in Rwanda. Therefore, this research was intended to measure the level of breast self-examination practice and its associated factors among female healthcare professionals working in selected hospitals in Kigali, Rwanda.

METHODS

A cross-sectional study was conducted among 221 randomly selected female healthcare professionals in four district hospitals in Kigali, Rwanda. A self-administered structured questionnaire was used as data collection instrument. The predictor variables were socio-demographic and obstetrics variables, knowledge on breast cancer and breast self-examination as well as attitude towards breast cancer and breast self-examination. Sample statistics such as frequencies, proportions and mean were used to recapitulate the findings in univariate analysis. Multiple logistic regression analysis was employed to identify statistically significant variables that predict breast self-examination practice. Adjusted odds ratio with 95% confidence level were reported. P-value < 0.05 was used to declare statistical significance.

RESULTS

Breast self-examination was practiced by 43.5% of female healthcare professionals. This prevalence is low compared to other studies. Attitude towards breast self-examination and breast cancer was the only predictor variable that was significantly associated with breast self-examination practice [AOR = 1.032; 95% CI (1.001, 1.065), p-value = 0.042]. However, number of pregnancy and number of children were not significantly associated with BSE practice in the multi-variate analysis. In addition, there was a positive linear link between knowledge and attitude, with a correlation coefficient (r) of 0.186 (p = 0.005).

CONCLUSIONS

The breast self-examination practice among healthcare professionals was found to be low. Attitude towards breast cancer and breast self-examination was positively associated with BSE practice. Moreover, attitude and knowledge were positively correlated. This suggests the need for continuous medical education on breast self-examination and breast cancer to increase the knowledge & BSE practice level of female healthcare professionals.

The Sociocultural Influences on Breast Cancer Screening among Rural African Women in South Africa

The incidence of breast cancer in South Africa is increasing, with rural South African women presenting with advanced stages of the disease. A woman's breasts are a symbol of her womanhood; they also constitute a social definition of her femininity. Women with breast cancer in rural South Africa are heavily stigmatized and suffer from various sociocultural interpretations of the disease. Breast cancer is frequently interpreted in rural South Africa as a symbol of witchcraft, sin, and punishment, and traditionally, it is treated by offering animal sacrifices, consumption of herbs, and prayer to ancestors. Using care-seeking behaviour theory as the theoretical framework, we intend to explore the sociocultural factors influencing breast cancer screening practices among rural South African women. A qualitative exploratory study was conducted using semi-structured interviews with 22 rural South African women selected by purposive sampling. Thematic analysis was used to analyse the data. The study identified four sociocultural factors influencing women's practices of breast cancer screening in rural South Africa, including psychological factors, habits, beliefs, and perceptions of healthcare. Women in rural South African communities have deep-rooted traditional beliefs and practices regarding breast cancer. Consequently, this influences women's preventative health behaviours regarding breast cancer screening. The development of culturally appropriate health education programs involving traditional healers and influential community leaders is essential to increasing the number of women being screened for breast cancer in rural South Africa.

A concept analysis: Support for lay healthcare workers in HIV services, Bojanala District, North West

BACKGROUND

 Different lay healthcare workers play an important role in the retention of clients to human immunodeficiency virus (HIV) care. Retention to HIV care is crucial to promote treatment continuation, viral suppression and reduced risk of transmission. However, lay healthcare workers view and perceive support differently.

OBJECTIVES

 The aim of the study was to investigate perceptions of healthcare workers regarding support provided to lay healthcare workers in HIV services. This article is a report of a concept analysis of healthcare workers' support provided to lay healthcare workers in HIV services, that was collected during the study. A concept analysis was done to explore the support attributes, clarify meaning and to understand its use within the lay healthcare workers' context in Bojanala District, situated in the North West province of South Africa.

METHOD

 The initial phase was data collection from lay healthcare workers, their supervisors and clients on antiretroviral therapy. Thereafter, the eight concept analysis steps of Walker and Avant were followed. Peer-reviewed articles on the support concept were searched and guided by data saturation.

RESULTS

 Responsiveness, provision, reciprocity and integration are key characteristics of support.

CONCLUSION

 Despite support being an interpersonal process, it is perceived subjectively. Support is necessary to continuously promote growth or endurance during adverse times.Contribution: The concept analysis will provide common understanding of support and information that is responsive to the needs of different lay healthcare workers.

Predicting preventive travel behaviors under the COVID-19 pandemic through an integration of Health Belief Model and Value-Belief-Norm

This study developed a conceptual framework for a preventive travel decision-making process amidst the COVID-19 pandemic, combining the Health Belief Model (HBM) and Value-Belief-Norm (VBN). Analyzing 409 responses collected from an online survey, this study verified the integrated model as a salient theory addressing the importance of social components and health belief factors in affecting behavior. The model revealed that altruistic value influences the HBM variables, whereas personal norms mediate preventive behaviors and beliefs in both VBN and HBM. These findings offer new theoretical insights into decision-making process and provide practitioners with effective crisis management strategies concerning pro-social and health beliefs.

Determinants of Intention to Participate in Breast Cancer Screening among Urban Chinese Women: An Application of the Protection Motivation Theory

Despite the significance of early detection of breast cancer through screening, the screening uptake in China remains relatively low. Protection motivation theory (PMT) suggested by Rogers is one of the theories concerning threat appeal. This study aimed to apply the protection motivation theory (PMT) in predicting breast cancer screening intention. In this cross-sectional study, a sample of Chinese urban women was recruited using the convenient sampling method from five communities in Wuhan. Data were collected using a self-report questionnaire that included demographic variables, knowledge about breast cancer, six PMT subconstructs, and screening intention. We used the structural equation modeling (SEM) to identify the predictor factors associated with screening intention. Of the total sample (n = 412), 86.65% had intention to participate in screening. Our data fit the hypothesized SEM model well (Goodness of fit index (GFI) = 0.91, adjusted GFI (AGFI) = 0.89, comparative fit index (CFI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, standardized root mean residual (SRMR) = 0.06, and Chi-square/df = 2.01). Three PMT subconstructs (perceived severity, response cost, and self-efficacy) were significantly associated with screening intention. Knowledge, social status, and medical history had significantly indirect associations with screening intention through the mediating effect of PMT subconstructs. Considering the utility of PMT, intervention programs might be more effective based on the subconstructs of PMT, especially to improve self-efficacy, perceived severity, and knowledge, reduce response cost, as well as targeting specific demographic groups.

Knowledge and Practice of Breast Cancer Screening Methods among Female Community Pharmacists in Jordan: A Cross-Sectional Study

Objectives

Our study is aimed at exploring the knowledge and personal practice of breast cancer screening among female community pharmacists in Jordan.

Methods

A cross-sectional survey was carried out using a nonrandom sample selection method for pharmacists in community pharmacies.

Results

A total of 551 female pharmacists completed the questionnaire. The mean age of pharmacists was 29.1 ± 7.3 years (range 21–67), and most have bachelor degrees in pharmacy (89.1%). The mean score of knowledge of breast cancer signs and symptoms was 4.2 ± 1.5 out of 6 points (range 0–6). The mean score of knowledge of risk factors was 7.6 ± 1.9 out of 12 points (ranging from 2–12). The mean score for knowledge of screening guidelines was 2.8 ± 0.9 out of 4 points (range 0–4). Overall, 452 pharmacists (85.8%) had acceptable knowledge while 75 pharmacists (14.2%) had poor knowledge of breast cancer. Pharmacists surveyed were aware of the different screening methods of breast cancer. The percentage of pharmacists who has performed breast self-examination (BSE), clinical breast examination (CBE), and mammography was 46.6%, 16.5%, and 5.4%, respectively. The most common reason for the lack of BSE and CBE performance was the absence of breast symptoms. Not being at the age recommended for mammography was the most common reason for not undergoing this screening method. Knowledge and practice of screening methods were influenced by age, years of experience, geographic region, personal history of breast cancer, and educational level among community pharmacists.

Conclusions

This study revealed some gaps in the knowledge of breast cancer among female community pharmacists. The practice of the different screening methods was suboptimal, and variable reasons were indicated for the low uptake of these screening methods. Community pharmacists need to practice preventive behaviors to a satisfactory level to encourage women in the community to adopt similar behavior.

Knowledge and Practice on Breast Self-Examination and Associated Factors among Summer Class Social Science Undergraduate Female Students in the University of Gondar, Northwest Ethiopia

Background

Breast cancer is a global health concern and a leading cause of morbidity and mortality among women. Early detection of breast cancer contributes to timely linkage to care and reduction of complications associated with breast cancer. In this context, breast self-examination is helpful to detect breast abnormalities particularly in settings with poor access to healthcare for clinical breast examination and mammography. Thus, all women in such settings are highly encouraged to perform breast self-examination regularly, and shreds of evidences are compulsory in this perspective. In the study setting, there was a scarcity of evidence on breast self-examination. Therefore, this study is aimed at assessing knowledge and practice on breast self-examination and its associated factors among summer class female students of social science at Maraki Campus, University of Gondar, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from July 01 to September 15/2018. A total of 398 female summer students were included in the study. A simple random sampling technique was utilized to select the study participants, and interviewer-administered structured questionnaires were employed to collect the data. The data were then entered into Epi info version 7.0, and analysis was done by SPSS version 20.0. A bivariable and multivariable logistic regression model was fitted, and the level of significance was declared based on adjusted odds ratio with its 95% CI and a p value ≤ 0.05.

Result

The proportion of students having a good knowledge and practice of breast self-examination was found to be 27.6% (95% CI: 22.9, 32) and 17.4% (95% CI: 13.8, 21.6), respectively. In the multivariable logistic regression analysis, urban residency (AOR = 2.50; 95% CI: 1.27, 4.94) and discussion with someone on breast self-examination (AOR = 4.57; 95% CI: 2.42, 8.65) were predictors of good knowledge, whereas family history of breast cancer (AOR = 7.14; 95% CI: 1.75, 25), discussion with someone on breast self-examination (AOR = 3.85; 95% CI: 1.82, 8.33), and good knowledge on breast self -examination (AOR = 12.02; 95% CI: 5.97, 24.20) had been significantly associated with breast self-examination practice.

Conclusion

In this study, the proportion of students with good knowledge and practice towards breast self-examination was lower than most of the studies done so far. The predictors of breast self-examination are related to lack of information. Thus, awareness creation on breast self-examination would be helpful in this context.

Structural equation modeling to detect predictors of breast self-examination behavior: Implications for intervention planning

AIM

Breast cancer is the most frequent malignant tumor among Chinese women. Breast self-examination (BSE) is a simple, effective method for early detection of screening and it is essential for the prevention and control of breast cancer. The aim of this study was to create a hypothetical model to determine the factors influencing women's BSE behavior in Eastern China.

METHODS

A survey was conducted using an online questionnaire and targeting 1200 women aged 18-70 years in Eastern China. Collected data were analyzed using ibm spss 25.0 and amos 24.0 software.

RESULTS

The final model showed a desirable fitness to sample data. A direct positive relationship exists between knowledge on risk factors and BSE. A direct positive association was found between positive attitudes and BSE, while negative attitudes have a direct negative impact on BSE. Objective factors not only had a significant direct impact on BSE, but also directly affected the positive attitudes. Positive attitudes play an intermediary role between objective factors and BSE.

CONCLUSION

Knowledge on risk factors about breast cancer, attitudes toward BSE and objective factors are new predictors which may influence BSE by using the structural equation modeling method.

Impact of Social Support and Social Trust on Public Viral Risk Response: A COVID-19 Survey Study

Public health has been under continuous threat worldwide in recent years. This study examined the impact of social support and social trust on the activities and efficacy of the public’s risk response in the case of COVID-19. We conducted an online survey over eight days with 620 Korean adult participants. Data were analyzed using structural equation modelling and K-means cluster analysis. Our results showed that public support had a positive impact on response efficacy, while response efficacy had a positive impact on sanitation, distancing, and purchasing activities. In addition, social support positively moderated the impact of public and individual support on response efficacy, while response efficacy negatively moderated the impact on sanitation activities. These results suggest that, first, amid viral risk, governments should proactively supply tools and information for infection-prevention, and deliver messages that encourage and support infection-prevention activities among the public. Second, when viral risk occurs, governments, along with all other members of society, must engage in aggressive risk response measures. Third, there is a need for risk communication that further emphasizes the importance of personal sanitation activities in the face of viral risk.