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Reddy H, Joshi A, Joshi SH, Gupta V, Mehendale AM. Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students. Cureus 2024; 16:e62151. [PMID: 38993420 PMCID: PMC11238611 DOI: 10.7759/cureus.62151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/08/2024] [Indexed: 07/13/2024] Open
Abstract
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.
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Affiliation(s)
- Himabindu Reddy
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Abhishek Joshi
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shiv H Joshi
- Department of Epidemiology and Public Health, World Health Organization, National Tuberculosis Elimination Programme Technical Support Network, Agra, IND
| | - Vatsala Gupta
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashok M Mehendale
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Geographic Variation and Factors Associated with Breast Cancer Screening in India Using a Spatial Durbin Approach. SPATIAL DEMOGRAPHY 2023. [DOI: 10.1007/s40980-023-00114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Gupta S, Bhardwaj A, Nadda A, Mittal A, Singh K. Predictors of Practice of breast self-examination among women in District Ambala (Haryana). INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Breast cancer is the most common cancer among women and its early detection is critical to improve survival. Breast self-examination is a cheap, basic and non-intellectual method to detect breast cancer. Aims and objectives: 1To determine the knowledge, attitude and practices regarding breast self-examination2. To explain the various factors which affect the practice of BSE Material and Methods: The present study was carried out among 300 women residing in rural and urban areas of district Ambala using a self-designed pretested semi-structured questionnaire. Results: In this study 127 (42.3%) of the participants had heard of BSE and 107 (35.7%) of the participants knew how to perform BSE. Overall, 47.7%, 30.3%, and 22% of the study participants had poor (<50%), medium (50–75%), and good knowledge (>75) on BSE, respectively. Educational qualification, knowing the three positions to perform BSE, knowing how often should BSE be done, taught how to do BSE, BSE is a useful tool to detect breast cancer were seen to be significantly associated with practice of BSE. Conclusion: This study elucidates that the knowledge as well as practice of BSE was significantly low in the population. This study provides insights into the various factors which affect the practice of BSE .
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Mukherjee Das A, Shrivastav KD, Taneja N, Awasthi AA, Rashid S, Gogia A, Janardhanan R. Knowledge and awareness of breast cancer and breast self-examination among college-going female students in Delhi-NCR: a cross sectional study. HEALTH EDUCATION 2022. [DOI: 10.1108/he-10-2021-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBreast cancer (BC) presents a major public health challenge world-over including India. While several risk-factors, early signs and symptoms of BC are known, the knowledge and awareness of this disease remains poor among the population. The present study aimed to determine the extent of knowledge and awareness of BC, its risk factors, early signs and symptoms and breast self-examination (BSE) practice as an early detection method among Indian college-going female students.Design/methodology/approachThe authors conducted a cross-sectional survey at a University in Delhi-NCR. Data on socio-demographic, knowledge and awareness of BC including BSE was collected using a pretested questionnaire. Chi-square test and logistic regression analysis was performed. All tests were two-sided and significance was set at p < 0.05.FindingsA total of 866 female students participated in the study with mean age of 22.32 (±0.146) years having mean body mass index (BMI) of 21.22 (±3.52). As high as 82.1% of the participants had heard of BC but while 74.8% thought early detection is possible, 70.7% believed BC cannot be prevented. Gene mutations (60.2%) were identified as a significant risk factor, while breast pain (61.4%) was commonly recognized as a sign of BC. Only 29.8% of students ever performed BSE. Increased odds of performing BSE (OR = 3.4) was found among students who recognized gene mutations as an important BC risk factor.Research limitations/implicationsKnowledge and awareness of BC including BSE among female college students were found to be below average. It is suggested that there is an urgent need for increasing BC awareness among young girls through workshops and mobile-health interventions.Practical implicationsThis study provides new information on the level of knowledge and awareness of BC risk factors, sign and symptoms and self-examination practice among young college girls. Moreover, this study advocates the need for design and implementation of a sustainable digital health model for active population BC screening, which is not being done currently.Social implicationsBC is a highly aggressive disease, which is now one of the leading causes of morbidity and mortality in India and world over. Although the knowledge of BC risk factors and its signs and symptoms have increased, the awareness of these elements among the general population at large is low and/or missing, especially in India. Furthermore, as a consequence of unorganized screening programs in the country, majority of women are presenting young with locally advanced disease. Understanding the existing level of knowledge and educating school, college and University students of the pertinent factors and screening practices such as BSE could drastically help in improving the self-screening and/or clinical examination rates. This could potentially lead to early detection and improved prognosis, thus ameliorating disease burden.Originality/valueThis study is one of the few studies conducted in India among young female college students belonging to non-medical backgrounds, delineating the level of knowledge and awareness of BC risk factors and signs and symptoms along with practice of early detection method such as BSE. The study has a considerable sample size and provides valuable evidence for a need to implement programs incorporating digital health models for accelerating awareness and screening of young girls in both rural and urban settings.
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Breast cancer awareness and knowledge assessment among men and women in Malaysia. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Breast Self-Examination Knowledge and its Determinants among Female Students at Addis Ababa University, Ethiopia: An Institution-Based Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2870419. [PMID: 35677100 PMCID: PMC9170413 DOI: 10.1155/2022/2870419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/30/2022] [Accepted: 05/14/2022] [Indexed: 12/03/2022]
Abstract
Introduction Breast self-examination is a noninvasive, low-cost screening method for breast cancer detection. A thorough awareness of breast self-examination enables the early detection of breast abnormalities and dramatically lowers breast cancer complications and mortality. The purpose of this study was to investigate the level of knowledge about breast self-examination and its associated factors among female students at Addis Ababa University, Ethiopia. Methods An institution-based cross-sectional study design was employed. The final calculated sample size was 407, and participants were recruited using a proportionate stratified random sampling approach. For data entry and coding, EPI Data 3.1 statistical software was utilized, and for data analysis, SPSS version 18 was employed. The data was described using descriptive analysis. Bivariate and multivariate logistic regression analyses were performed to determine the strength of the association between the predictor and the outcome variables. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance. Results The findings of this study revealed that 49.9% of respondents possessed good breast self-examination knowledge. Previously, urban residents were about two times more likely to have good knowledge of BSE than their rural counterparts (AOR =2.16, 95% CI (1.18–39.91), p =0.011). The odds of having good BSE knowledge were about three times more likely among those who had a good attitude than those who had a poor attitude (AOR =3.17, 95% CI (2.02–4.74), p <0.001). Those who knew someone with a diagnosis of breast cancer were almost three times more likely to have good knowledge than those who did not know (AOR =2.95, 95% CI (1.77-4.91), p <0.001). Conclusion According to the findings of this survey, less than half of the students who participated had good knowledge of breast self-examination. This justifies raising awareness about breast self-examination among female students.
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Sisodia G, Kumawat P, Gupta A, Gaur K, Meena S, Jahan I. Awareness and practice of breast self-examination (BSE) with its socio-demographic associates: a cross-sectional survey in the capital of Rajasthan, India. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gupta R, Gupta S, Mehrotra R, Sodhani P. Risk factors of breast cancer and breast self-examination in early detection: systematic review of awareness among Indian women in community and health care professionals. J Public Health (Oxf) 2021; 42:118-131. [PMID: 30608560 DOI: 10.1093/pubmed/fdy228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/19/2018] [Accepted: 12/20/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This review aims at evaluating the awareness of risk factors for breast cancer (BC) and the knowledge of breast self-examination (BSE) among Indian women and health care professionals (HCPs). METHODS Literature search was conducted on multiple bibliographic databases with restrictions applied to English peer-reviewed journals. RESULTS We reviewed 37 published articles on this topic. The mean level of awareness for risk factors such as age at menarche (22.3%), age at menopause (27.1%) and late first pregnancy (34.6%) was low in community. The awareness was better among HCPs; however, there was still room for improvement.Knowledge of BSE varied from very poor (2%) to good (69.8%) in the community setting. The practice was similarly negligible (0%) to moderate (34.9%). Mean knowledge and practice of BSE in HCPs were 77.1 and 55.5%, respectively. A significant difference was noted in knowledge and practice of BSE between community and HCPs (P < 0.05). CONCLUSIONS The present review highlights the low level of awareness regarding risk factors for BC and BSE in the community as well as HCPs. Though BSE is not the ideal modality, this seems to be the best alternative for resource-limited settings.
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Affiliation(s)
- R Gupta
- Division of Cytopathology, National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida, UP, India
| | - S Gupta
- Division of Cytopathology, National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida, UP, India
| | - R Mehrotra
- National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida, UP, India
| | - P Sodhani
- Division of Cytopathology, National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida, UP, India
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Ranganath R, Muthusami J, Simon M, Mandal T, Kukkamulla MA. Female medical and nursing students’ knowledge, attitudes, and skills regarding breast self-examination in Oman: a comparison between pre- and post-training. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2020; 17:37. [PMID: 33264826 PMCID: PMC7803588 DOI: 10.3352/jeehp.2020.17.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE Breast cancer is one of the most common cancers in women worldwide. Educational and awareness programs impact early practices of breast self-examination, resulting in the early detection of cancer and thereby decreasing mortality. The study aimed to assess the levels of knowledge and awareness of breast cancer and breast self-examination among medical and nursing students in Oman and to compare their knowledge, attitudes, and skills after a training program. METHODS This quasi-experimental study was carried out for female 90 medical and 80 nursing students in Oman in November 2019. A pre-test questionnaire was given before the training program and a post-test questionnaire was administered after the training program. Students’ knowledge, attitude, and skills regarding breast cancer and breast self-examination were compared. Scores for skills of practicing breast self-examination were compared between lecture and activity group and lecture-only group. RESULTS Pre-test and post-test data were collected from 170 female students. Significant improvements were observed in the post-test scores for students’ knowledge, attitude, and skills after the intervention (P<0.001). The mean scores for skills of practicing breast self-examination after the lecture and the activity were higher than those obtained after the lecture only (P=0.014 for medical students and P=0.016 for nursing students). CONCLUSION An educational training program on breast cancer and breast self-examination with an emphasis on skills can motivate participants to perform breast self-examination regularly, and may therefore help students to train other women to perform breast self-examination for the early detection of breast cancer.
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Affiliation(s)
- Rajani Ranganath
- Department of Pathology, College of Medicine & Health Sciences, National University of Science & Technology, Sohar, Oman
| | - John Muthusami
- Department of Surgery, College of Medicine & Health Sciences, National University of Science & Technology, Sohar, Oman
| | - Miriam Simon
- Department of Psychology and Behavioral Sciences, College of Medicine & Health Sciences, National University, of Science & Technology, Sohar, Oman
| | - Tatiyana Mandal
- Department of Pharmacology, Melaka Manipal Medical College, Manipal, India
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