Factors related to practice of breast self-examination in rural women

The purpose of this study was to examine variables related to breast self-examination (BSE) in rural women. The sample of convenience consisted of 347 women who were members of selected county-extension homemaker clubs. Champion's Health Belief Model Scale was used to measure susceptibility, seriousness, benefits, barriers, health motivation, sociodemographics, and knowledge variables and frequency of BSE. Multiple regression analysis indicated that the Health Belief Model concepts accounted for 26% of the variance in BSE practice. Women who perceived more benefits of BSE in reducing the severity of breast cancer were more likely to report more frequent BSE. Women who perceived fewer barriers to performing BSE and those who scored high on health motivation were also more likely to report performing monthly BSE. Pearson product-moment correlation indicated a significant positive relationship between the variables of BSE knowledge and BSE practice (r = 0.1216; p = 0.023). The lambda statistics showed weak or no association between the demographic variables of age, race, marital status, religion, education, personal experience with breast disease, and friend's experience with breast disease and BSE practice. These findings suggest that perhaps educational programs emphasizing benefits of BSE may be implemented for women represented in this sample in an attempt to increase the number of women practicing BSE. Assessment of women's perceptions of potential barriers would allow nurses to plan appropriate strategies that could reduce the barriers. Finally, assessment of women's general health practices may identify women motivated toward good health. These women may be likely to complete monthly BSE if encouraged to do so.     

Factors related to women's practice of breast self-examination

Factors related to women's practice of breast self-examination (BSE) were studied in a sample of upper-middle-class women attending meetings of voluntary women's groups. Factors found to relate directly to frequency of BSE practice were high perceived benefits of BSE, low perceived barriers to BSE, and high self-concept. Correlations with perceived susceptibility/seriousness of breast cancer, age, perceived level of social support, and social network properties were not significant. A multiple regression analysis was done with BSE frequency as criterion variable: perceived threat (susceptibility/seriousness) and perceived benefits minus perceived barriers were entered hierarchically; age, self-concept, and total social support were entered as a group. Perceived benefits minus barriers was the only significant predictor variable, R2 = .27. These findings underline the importance of assessing detective behaviors such as BSE as potentially different from preventive behaviors.     

Breast self examination: use of a visual reminder to increase practice.

1. Breast cancer, the most common type of cancer affecting women and the second leading cause of cancer death in women, will affect more than 10% of the female population of this country. 2. Breast self examination (BSE), known to be an effective component of a three part breast health program which includes physical examination and mammography, is not practiced consistently by American women. 3. A convenient memory aid serving as a visual stimulus, combined with appropriate educational materials, is effective in increasing both the knowledge of breast health and the frequency of BSE practice.     

Effectiveness of teaching breast self examination during office visits

In a randomized clinical trial a comparison was made of two BSE teaching interventions delivered by primary providers during office visits in a group nursing faculty practice. Patients who reported no regular BSE (n = 121) received either individualized teaching focused on reducing perceived barriers and reinforcing benefits of BSE, or routine teaching limited to usual instruction in BSE technique. Patients reporting frequent/monthly BSE during the past year were comparison subjects (n = 81). Self-reported data on BSE behavior were obtained in questionnaires administered before the interventions and via telephone interviews three months after the visit. Analysis using chi square showed that, contrary to expectation, individualized and routine teaching were equally effective: 61.4% of the individually taught and 63.5% of the routinely taught reported frequent or monthly practice at followup. Both groups were significantly more confident in technique and ability to detect change in the breast. The previously non-practicing women remained significantly less likely than comparison subjects to be performing BSE monthly at followup. The perceived benefit of BSE giving peace of mind predicted non-practicers most likely to change.     

Breast Self-Examination Beliefs: A Descriptive Study

Abstract 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.     

Breast self-examination and the health belief model: variations on a theme

Variables derived from the Health Belief Model (HBM) were studied in relation to breast self-examination (BSE) performance, which was measured in terms of both frequency and thoroughness. Data were collected from 202 adult women via self-administered questionnaires. Susceptibility and Seriousness were combined to form a "threat of breast cancer" variable, and two approaches were used to compute "net perceived efficacy of BSE." However, barriers and susceptibility in their original form explained more variance in BSE practice than did the combined variables. The negative relationship found between perceived barriers and BSE performance (r = -.44) is consistent with previous findings. Implications for research and practice are presented.     

Handedness and the laterality of breast cancer in women

In a pilot study of 138 women with mastectomies that explored the consistent finding of more left breast cancer in American women, associations were found among handedness, initial breast cancer laterality, and age. To test these findings further, 889 subjects were added to the original sample. The resulting sample of 1,027 consisted of 861 right-handed, 94 ambihanded, and 72 left-handed subjects aged 21 to 84. A chi-square test showed a statistically significant association between ipsilateral breast cancer before age 45 and contralateral breast cancer after age 44 in right-handers, chi 2 (1, n = 861) = 4.169, p less than .05. The association was also significant for left-handers, chi 2 (1, n = 72) = 4.036, p less than .05. In addition, a chi-square test showed a statistically significant association between handedness and earlier development of breast cancer, chi 2 (1, n = 933) = 13.9, p less than .01. Almost twice as high a percentage of left-handers as right-handers developed breast cancer before age 45. Log-linear analysis demonstrated no significant associations of nodes with either handedness or age. Overall, there was no statistically significant association between the laterality of breast cancer and a history of breast cancer in a primary relative, chi 2 (1, n = 1,024) = 1.38, p greater than .05. In some presently unknown way, lateral asymmetries of neurotransmitters may contribute to an explanation of the findings.     

Using a community-based outreach program to improve breast health awareness among women in Hong Kong

OBJECTIVE: To evaluate the effectiveness of a community-based health education program via a mobile van to promote the awareness of breast cancer and breast self-examination (BSE) practice among women in Hong Kong. DESIGN: One group pretest/posttest design. SAMPLE AND MEASUREMENTS: Seven hundred and seventy-seven women in Hong Kong completed a self-administered questionnaire before and after a breast health education program from May 2002 to March 2003. RESULTS: About half were aware of breast health and breast diseases (53.7%) and breast screening methods (48.6%) before the intervention. It was found that women who had received instruction on BSE practice, and those who were aware of breast screening methods, breast health, and breast diseases were more likely to have had prior BSE practice. Most indicated their willingness to practice BSE regularly (93.3%) and to pass on the BSE knowledge to their relatives and friends (92%) in the posttest. CONCLUSIONS: The outreach health education program has successfully reached women living in the 18 districts in Hong Kong. It appears to be useful in raising the awareness of breast health and BSE practice among the women, but longer term follow-up is required to ascertain its sustainability.     

Knowledge, barriers, and facilitators of Korean women and their spouses in the contemplation stage of breast self-examination

The aim of this study was to identify the knowledge, barriers, and facilitators of breast self-examination (BSE) in Korean couples in the contemplation stage. The study design was based on assumptions from the Health Belief Model and Transtheoretical Model that contemplators perceiving benefits as greater than barriers are likely to move to the next stage. Participant couples, with wives having never practiced BSE but with an intention to do so, were drawn from churches. Qualitative research was conducted with focus group methodology including both husbands and wives in the groups. Data transcribed from audiotapes were analyzed to identify common themes. Knowledge of breast cancer and BSE included "perceiving risks of getting breast cancer," "behaviors used to stay healthy and detect breast cancer," and "skills in BSE"; barriers to BSE included "lack of sensitivity to breast cancer," "fear of getting bad news," "lack of information," and "shortage of time"; and facilitators of BSE included "making BSE a monthly routine," "continuous systematic interaction from healthcare professionals reaching out to the community," and "encouragement and help from husbands." To improve compliance with BSE, women in the contemplation stage need specific and correct knowledge delivered by diverse materials, reminders, and the inclusion of husbands as facilitators.     

Factors involved in nurses' teaching breast self-examination

It has been demonstrated that breast self-examination (BSE) is a reliable method for early detection of breast abnormalities when practiced regularly and correctly. In addition, it has been found that a woman is likely to be more proficient if she has been taught BSE by a physician or nurse. In a hospital-based study, nurses were surveyed regarding both their personal practice and their teaching of BSE to patients. Although the nurses revealed themselves to be highly compliant in terms of performing the procedure themselves, only 40% included BSE in their patient teaching. The nurses' teaching of BSE was found to be unrelated to their age, BSE practice, or personal risk for breast cancer. Nurses agreed that BSE was a valuable tool in the prevention of deaths from breast cancer. They also believed themselves to be susceptible to breast cancer despite good health and low-to-medium risk sources. We suggest that nurses' ambivalent attitudes towards breast cancer and BSE may influence their teaching behavior.     

Health Beliefs of African American Women on Breast Self-Exam

PurposeInvestigate the relationship between African American women's health beliefs in regard to breast cancer screening behaviors.Data sourcesA sample of 131 African American women, age 20–65, from a family practice clinic and 3 rural churches in Southeast.ConclusionsOne-hundred and nine of the participants reported practicing breast self-exam (BSE) within the past 12 months. However, 21 women had never practiced BSE. Fear of not doing it correctly was a main barrier.Implication for practiceSteps should be taken to increase confidence and resolve barriers of African American women through the development of culturally sensitive educational training on BSE and cancer prevention.     

Acculturation and breast self-examination among immigrant Latina women in the USA

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.     

Predictors of breast self-examination practice among elderly women

The purpose of the study presented in this article was to examine predictors of breast self-examination (BSE) practice among elderly female subjects in selected senior citizen centers. The health belief model served as the theoretical framework for the research study. Both the frequency of BSE performance and the technique subjects used to examine their breasts were measured by a questionnaire. Subjects who perceived few barriers to BSE had higher BSE technique scores. The findings also indicated that receiving instruction through a class on BSE was related to improved BSE technique. Perceived susceptibility to breast cancer and perceived benefits of BSE were not found to be significantly predictive of BSE practice.     

Nurses as Agents for Change in Teaching Breast Self-examination

The purpose of this quasi experimental, one-group pretest-post-test study was to determine the role of the nurses as agents for change in teaching breast self-examination (BSE) to healthy women in the community. The goals were to promote women's factual and proficiency knowledge in the areas of (1) signs and symptoms of breast cancer, (2) proper steps of BSE, and (3) frequency of BSE. Data were collected over four years in a large university teaching hospital. The sample was made up of 223 women. Teaching was provided by nurse clinicians. A 21-item written questionnaire was administered to all subjects three times: before BSE education session (treatment), immediately after education, and six months later. The questionnaire included four subscales: demographics, factual knowledge regarding signs and symptoms of breast cancer, proficiency of BSE practice, and frequency of BSE. Findings indicated that nurses influence positively the factual and proficiency knowledge base of clients and the frequency of BSE practice. Based on these findings and those of previous studies, the authors believe that nurses can be agents for change in promoting BSE.     

Who needs more psychosocial oriented rehabilitation -- women after breast cancer or women after genital cancer? -- A sociopsychological study of 308 women (author's transl)

A standardised questionnaire and personality test were used to study whether women after breast cancer treatment, or women treated for genital cancer need psychosocial counselling more frequently. The interview was given to 308 women during the author's tumor after-care consultations. 1. Repercussion on their marital lives were reported three times more often by women treated for genital cancer than by women after mastectomy (p less than 0.01). There was not significant difference with regard to their family status. 2. As epidemiologically expected -- mastectomy patients had born less children than women treated for genital cancer (p less than 0.05). 3. A reduced self-confidence was reported more often by patients treated for breast cancer than by the other patient group (p less than 0.01). 4. No decrease in working performance was observed by 50% of the women treated for genital cancers as against one third of the masectomy patients. 5. Work resumption was reported more often to be strenuous for masectomy patients than for women treated for genital cancer (p less than 0.05). 6. Woman after mastectomy experiences 50% less sexual repercussions than genital cancer patients (p less than 0.05).     

Evaluation of a breast examination facilitation device

Breast self-examination (BSE) is recommended in order to help women detect possible breast cancer early in its development Correct BSE performance has been shown tobe positively associated with breast lump detection ability Few women, however, report practising BSE, citing reasons such as dislike of touching one's own breasts, fear of finding a lump, lack of confidence in their-ability to perform BSE The purpose of this study was to test a breast examination facilitation device (BEFD) for women, which would provide a teaching/screening tool, as well as a shield between breast and fingers for women who are reluctant to touch their breasts A sample of 36 registered nurses in the United States was asked to perform BSE on three separate occasions using a BEFD made of latex, paper or cloth on which a wedge pattern for BSE had beenimprinted Subjects found the BEFD to be a useful tool for teaching/learning BSE, and expressed a clear preference for the latex material One size of BEFD is not adequate for all women A smaller size for women who wear A and B cup-size bras, and a larger size for women who wear C cup size and above, would be more acceptable     

The effect of training on the knowledge levels and beliefs regarding breast self-examination on women attending a public education centre.

The aim of this study was to evaluate the effect of subject training on the level of knowledge about breast self-examination (BSE) and breast cancer in women attending a public education centre. This research was structured according to pre-test-post test, one group research design principles. The study involved 91 course attendees at the Erzincan Public Education Centre (73.4%). The average age of study subjects was 21.4+/-5.4. Of the 91 participants in the study, 3.3% (n=3) had a family history of breast cancer and 5.5% (n=5) have had a lump in their breasts. In pre-test questions, the rate of correct answers was between 13.2% and 68.1%. After training, the rate of correct answers increased to between 79.1% and 96.7% and attendees demonstrated an increase in the accuracy of their beliefs about breast cancer (health risk, susceptibility). The perception of self-efficacy, an important variable in the process of behaviour change, is a necessary component of changing and maintaining the practice of BSE. The results of this work and others demonstrate that education administered by nurses can increase positive perceptions about BSE self-efficacy. Education in BSE is easily administered, requires no special tools, could lead to early diagnosis of breast cancer if performed regularly and should be taught to all women aged 20 years and above.     

Effects of a Cognition-Oriented Breast Self-Examination Intervention for Korean Women and Their Spouses

ABSTRACT Objective: This study evaluated the effectiveness of a cognition-oriented breast self-examination (BSE) intervention program that is based on the Transtheoretical Model and reflects individual characteristics according to BSE stage among Korean women and their spouses.
Design: A time-series nonequivalent control group design was used.
Sample and Measurement: Twenty-four couples in each of 2 groups completed a preintervention test and were evaluated 1, 3, and 6 months later for their knowledge of breast cancer and BSE, spousal encouragement for BSE, perceived confidence in BSE methods, change in BSE stage, and perceived benefits and barriers to BSE. The intervention involved husbands as well as women, and consisted of lectures on breast cancer and BSE, demonstrations and practice with models while being videotaped, and feedback.
Results: There were significant differences between the control and experimental groups for all variables. Change of BSE stage in experimental group showed significantly advancement over time.
Conclusions: This intervention program was effective in promoting regular BSE practice and in enhancing confidence in BSE. The intervention also raised awareness among husbands of the importance of breast health for their wives. Educational interventions for breast cancer prevention should be specified to an individual's stage of BSE.     

Effectiveness of breast self-examination nursing interventions for Taiwanese community target groups

BACKGROUND: Because of the increasing morbidity and mortality from breast cancer, the Health Department in Taiwan in 1992 has identified early detection of breast cancer as one of the national health objectives. The effectiveness of Breast Self-Examination (BSE) in detecting breast cancer depends not only on frequency, but also on accuracy. This study explored the effects of nursing intervention on the BSE intention, BSE frequency and BSE accuracy among beauticians as community target groups. DESIGN: This study was comprised of two stages. In the first stage, 198 beauticians in Taipei County were surveyed. Those women with perceived barrier scores > or =15 points in the first stage were selected for the second stage with the quasi-experimental design. The experimental group was provided with BSE instruction for the enhancement of BSE competence, personalized strategies to reduce barriers to BSE and monthly telephone reminders after BSE instruction class for 3 months. The study instruments were Champion's BSE questionnaire, Lashley's 15 BSE steps and BSE items of social norm referenced Lierman et al. RESULTS: The mean age of the 198 beauticians was 28 (+/-8.6), the mean year of education was 10 (+/-2.4) and 60% of participants were married. The results of the study indicate that the program significantly increased BSE frequency, BSE accuracy, perceived benefit of BSE, perceived competence in BSE and decreased perceived susceptibility to breast cancer and perceived barriers to practice BSE. Multiple regression analysis indicated that the perceived competency, susceptibility and social normative influence accounted for 25% of the variance in BSE intention. Perceived competency and social normative influence accounted for 15% of the variance in BSE frequency, while intention, social normative influence and perceived competency accounted for 21% of the variance in BSE accuracy.