Self-efficacy and rural women's performance of breast and cervical cancer detection practices

Self-efficacy has become an important variable in multiple areas of human performance, including health behavior modification (Bandura, 1997). This study explores variables that lead to women's perceived self-efficacy in performing regular detection practices for breast and cervical cancer. A sample of southeastern U.S. farm women (N = 206) completed surveys that assessed their perceived and actual knowledge of women's cancer detection practices, as well as their perceived social norms and perceived barriers related to obtaining these tests. Regression analyses of these data revealed that perceived peer norms and the barriers of time and embarrassment were significant predictors of women's confidence in their ability to follow through with cancer detection practices. Perceived knowledge and perceived family norms significantly predicted women's perceptions of difficulty associated with cancer detection practices as well as women's confidence in their skills to perform breast self-examination (BSE). Time was also a significant barrier to confidence in performing BSE. Implications for health communication campaigns are discussed.     

Knowledge,Attitudes and Practices of Breast Cancer Screening Among Women in Jordan

Enhancing breast cancer screening in developing countries is pivotal in improving women's health. We aimed at describing knowledge of and perceived reasons for performing breast cancer screening. We interviewed 1,549 population-based randomly selected women. We found that women share limited knowledge about breast cancer screening. Few women performed screening for early detection purposes. The influence of physicians was the main reason for performing mammography. Prevalence of breast cancer screening might be enhanced by integrating screening into other medical services. Health agencies need to invite women for screening and educate them regarding the importance of screening in the absence of symptoms.     

Breast self-examination in women in two primary care settings: an evaluation of the impact of insurance status

Breast cancer is one of the most common cancers diagnosed among women in the United States. Screening tools available for breast cancer detection include breast self-examination (BSE), clinical breast examination, and mammography. Various studies have indicated that women may inconsistently perform BSE. This investigation evaluated the potential impact of insurance status on BSE. Women with health insurance receiving primary healthcare at a health maintenance organization (HMO) and women without health insurance receiving primary healthcare at a free clinic completed anonymous questionnaires that obtained information about the frequency of BSE performance, whether instruction was given about performing BSE, age at learning BSE, and confidence in performing BSE. One hundred fifty-five (82%) of 200 questionnaires at the HMO and 92 (92%) of 100 questionnaires at the free clinic were completed. Thirty-five percent of women (32% at the HMO, 39% at the free clinic) reported performing BSE. There were no significant differences in the rate of monthly BSE, receiving instruction about performing BSE, age at learning BSE, or confidence in performing BSE in women at the HMO and free clinic. Insurance status did not affect BSE. However, further study is needed to evaluate factors that potentially influence performance of BSE and could encourage compliance with BSE recommendations.     

Breast cancer knowledge and practices among D/deaf women

BackgroundLimited scientific evidence is available regarding D/deaf women's breast cancer knowledge and early detection practices, as well as about how to increase D/deaf women's breast cancer control practices.Objective/hypothesisTo assess baseline breast cancer knowledge and practices among a sample of D/deaf women recruited into a randomized controlled trial of a breast cancer education program developed for this population.MethodsA written and signed (American Sign Language) survey was administered to a racially/ethnically diverse sample of 209 D/deaf women, 40+ years old, with lower levels of education, recruited in California between October 2008 and May 2009.ResultsThere were misconceptions about breast cancer risk factors, screening, and treatment; only 64.2% of respondents correctly identified the purpose of mammography. Mammography in the prior 2 years was reported by 57.3% of the sample, by 69.8% of White women, and by 43.5% of women from other racial/ethnic groups. Rates also varied by education, having seen a physician in the prior year, and type of insurance.ConclusionsThis study underscores significant gaps in breast cancer screening knowledge and practices, communication issues in health care settings, and unmet needs for tailored health information and materials in this population. Challenges faced in conducting the research needed to develop and test such programs are noted.     

Breast self-examination competency: an analysis of self-reported practice and associated characteristics

Of 308 Baltimore, Maryland women surveyed by telephone, 76.3 per cent reported having performed breast self-examination (BSE) during the last year, with only 35 per cent reporting monthly BSE. Four BSE ability scores showed that most women had little knowledge of the proper BSE technique. Utilization factors, socioeconomic status, and knowledge/attitude about cancer were not related to BSE competency. Higher BSE competency scores were related to performing BSE at the recommended interval, having been taught the procedure by a health professional, and perceived confidence in BSE practice were also related to proper performance.     

A profile of Australian women practicing breast self-examination.

Breast self-examination (BSE) and medical breast examination practices were studied in a group of 1,103 women without diagnosed breast cancer, randomly sampled to conform in age and social status with breast cancer cases from the population of Brisbane, Australia between 1981 and 1985. Relationships between these practices and sociodemographic factors, breast cancer risk indicators, health related behaviors and source of knowledge about BSE were analyzed. Overall, 63% of women reported performing BSE. BSE was practiced frequently (monthly or more). BSE frequency was only weakly associated with breast cancer risk indicators. It was more strongly linked with age, the 20-44 year group being more likely to examine their breasts occasionally and the women 65 years and over being less likely to examine their breasts. Married women were the most likely to practice BSE frequently and widowed or single women most likely never to practice. Women who underwent cervical smear testing were more likely to perform BSE than those who did not have smear tests. Women who learned BSE from their doctors as opposed to other sources practiced BSE more frequently and were more likely to practice BSE exactly as taught.     

“I Have No Time for Potential Troubles”: Russian Immigrant Women and Breast Cancer Screening in Israel

The author's earlier study of Russian immigrant women's attitudes and practices related to the early detection of cancer has shown their low participation in breast screening activities, from BSE to mammography. Most respondents were educated women who acknowledged their personal risk, understood the role of screening, but still avoided preventive action. In this qualitative research, the gap between cognitions and behavior is explored further by means of in-depth interviews and focus groups with 34 women aged 50–74 who moved to Israel after 1990. All Israeli women of this age are entitled for screening mammography free of charge once every 2 years. The findings point to a low place of preventive health concerns in the personal agenda of female immigrants, loaded by the more immediate survival needs (income, housing, support of other family members, etc.). Other barriers include the lack of referral from primary care providers, fear of cancer diagnosis, apprehensions of irradiation and pain involved in mammography, fatalist general attitude towards health and illness, and mistrust of current cancer therapy. Many older women (60+), whose risks are actually higher, shared a false belief that breast cancer strikes younger women and they are already past the age of concern. Older informants avoided gynecological clinics because of male gender of most gynecologists, their poor command of Hebrew, and a belief that gynecological checkups are irrelevant and even shameful in their age. It is concluded that female immigrants, especially older ones, must be a special target group for preventive health interventions.     

Breast cancer diagnosis: biographical disruption,emotional experiences and strategic management in Thai women with breast cancer

In this article we draw on Bury's theory of biographical disruption to discuss the meanings of, and emotional experiences related to, being diagnosed with breast cancer among southern Thai women. Qualitative methods, including in‐depth interviewing and drawing methods, were used to collect data from 20 women with breast cancer. The women perceived breast cancer to be a rhok raai; an evil or dread disease. They believed that breast cancer would lead to death. The disruption in their biography occurred when they detected abnormalities indicating breast cancer. The women's narratives revealed their chaotic lives upon this diagnosis and the news precipitated in them shock, fear, anxiety and loss of hope. Although they experienced chaos and disruption, the women cultivated strategies that helped them cope with their experiences by accepting their fate and adhering to Buddhist beliefs and practices. Through their narratives of biographical disruption, the women in our study offer healthcare providers knowledge that could lead to an appreciation of their needs and concerns. This knowledge is crucial for health professionals who wish to provide emotional support to women who have been diagnosed with breast cancer in Thailand and elsewhere.     

Breast self‐exams: Are health professionals doing their part?

Although breast cancer cannot be prevented at this time, early detection is the single most important factor in recovery. Early detection is largely dependent on discovery of the breast cancer by women through self breast examinations. This study indicates that health professionals either neglect to teach breast self‐exam (BSE) or fail to document teaching it in the patient's record. One hundred eight records of hospitalized clients who had identified risk for breast cancer were reviewed for documentation of teaching of BSE by the health professional. Even though all clients had multiple risk factors, no documentation of teaching BSE was present. These findings indicate a need for some structure in the health care system to assure that health professionals are fulfilling their obligations to teach BSE and to document it in the patient's records. Including it as part of nursing history, a standard nursing care plan, or as a part of audit criteria would assure more consistency in the teaching of BSE.     

Breast screening and health issues among rural females in Malaysia: How much do they know and practice?

ObjectiveThis study investigated rural women's knowledge of breast cancer and screening methods by ethnicity and examined the predictors of breast screening methods.MethodsA cross-sectional survey was conducted in 2011 in five rural districts of Perak; 959 women were interviewed using a semi-structured questionnaire. ANOVA and regression analysis were used in data analysis.ResultsWomen below 50 years old, of Malay ethnicity and who had secondary education scored better than those older, of Chinese ethnicity and had primary education (p < 0.001). The uptake of breast self-examination (BSE), clinical breast examination (CBE) and mammogram was 59%, 51% and 6.8%, respectively. Multivariate analysis revealed knowledge of breast cancer and CBE as top predictors of BSE, being married and knowledge of breast cancer as top predictors for CBE; and CBE as the top predictor of mammography uptake. Support from husbands and family members for breast cancer screening was a predictor for CBE and BSE.ConclusionKnowledge of breast cancer and its screening uptake varies by ethnicity, location and the type of support received. Efforts and approaches to improve the women's knowledge of breast cancer and its screening uptake therefore should be customized to address the different influencing factors.     

Facteurs associés à la pratique de l'autoexamen des seins dans le cadre d'une enquête de population

A survey was carried out on the practice of breast self-examination (BSE) and attitudes related to this field by interviewing 382 women out of a representative sample from the canton of Vaud, Switzerland (response rate: 76.6%). In order to clarify the reasons which encourage or discourage the practice of BSE, the Health Belief Model was used as the conceptual frame and scores were built for each component: perceived threat of breast cancer (susceptibility and severity), perceived benefits and barriers to BSE, cues to action. A discriminant analysis shows that cues to action and barriers are the factors that are the most strongly associated with the practice or not of BSE. The main barriers are lack of perceived competence and passive dependence on doctors. The most important cue to action was the fact of having been informed about BSE by one's doctor.     

Breast cancer awareness,attitude and practices among female university students: A descriptive study from Jordan

The researchers' aim of this study was to assess breast cancer (BC) knowledge, attitude and practices of breast self-examination (BSE) among female university students. Data were collected from 236 participants using self-reported questionnaires. Participants reported inadequate knowledge (45.5%), fairly positive attitude (56.3%) and low BSE practice (37.5%). Analysis revealed significant differences based on participants' demographics. Results are in congruence with international literature, and support worldwide efforts aiming at increasing awareness of BC. In conclusion, raising students' awareness regarding BC and BSE is important for early detection of this increasingly alarming disease. Initiating BC educational programs among university students is highly recommended.     

Breast Cancer Prevention Knowledge, Attitudes, and Behaviors Among College Women and Mother–Daughter Communication

Although breast cancer prevention targets mostly women ages 40 and older, little is known about breast cancer prevention for young women and mother’s advice. The purpose of this study was to examine breast cancer prevention knowledge, attitudes, and behaviors among college women and mother–daughter communication. Hispanic and non-Hispanic students at a southwestern university completed a breast cancer prevention survey with items for mother’s advice, breast self-awareness and risk reduction knowledge, self-efficacy, susceptibility, family history, provider breast self-exam (BSE) recommendation, peer norms, BSE practice, and demographics. An openended item was also used to elicit types of mother’s advice. Logistic regression was used to assess predictors for receiving mother’s advice for breast cancer prevention and BSE practice. Self-reported data using a survey were obtained from 546 college women with a mean age of 23.3 (SD = 7.75). Nearly 36 % received mothers’ advice and 55 % conducted BSE. Predictors for receiving mother’s advice were age, self-efficacy, and family history of breast cancer. Predictors for BSE practice were mother’s advice, age, self-efficacy, and provider BSE recommendation. Family history of breast cancer and knowledge were not significant predictors for BSE practice. Findings support the need for clinicians, community health educators, and mothers to provide breast cancer prevention education targeting college women.     

Peer discussions of cancer among Hispanic migrant farm workers.

Hispanic migrant agricultural workers'' exposure to pesticides and other agrichemicals places them at increased risk for a variety of acute and chronic conditions, including cancer. As a socioeconomically disadvantaged group, migrant workers also face many barriers to effective cancer control. In 1992, a series of focus groups was held with 55 Hispanic migrant agricultural workers (22 women, 33 men) in central Wisconsin to gather information on their knowledge and attitudes regarding cancer etiology and treatment, their practices regarding cancer screening and early detection, and their concerns regarding occupational exposure to pesticides. Beliefs that pesticides are toxic and can cause health problems were common among participants. In addition, however, participants reported that they are reluctant to demand occupational protections to which they are entitled because they are afraid of losing their jobs. Study results also suggest that barriers to effective primary and secondary prevention of cancer in this Hispanic migrant agricultural worker population include knowledge and information barriers, cultural barriers, and socioeconomic barriers. A lack of knowledge and information regarding the causes of cancer, its prevention, and its early detection and treatment was evident among participants, which in turn was reflected in strong fatalistic attitudes toward the disease. Cultural barriers included attitudes of embarrassment and shame associated with physical examinations and women''s strong discomfort with male clinicians. Socioeconomic barriers to secondary prevention included the cost of obtaining health services, time constraints associated with the need to work and long working days, and a lack of transportation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Social factors associated with breast self-examination among high risk women.

A sample of 708 women, who by sociodemographic characteristics are high risk to breast cancer, were interviewed by telephone about their knowledge, attitude, and practice of breast self-examination (BSE). Reported frequency of BSE, knowledge of BSE and breast cancer, and BSE attitude in this sample are comparable to data reported by others. This report analyzes the associations between the frequency of a breast self-examination practice and the variables, age, education, detection confidence, social influence, modesty, preventive health behaviors, and memory. These relationships are discussed and several new hypotheses are proposed. Since the data were collected retrospectively, they are not able to describe causal relationships.     

Breast cancer detection behavior among urban women

Data from the ongoing Los Angeles Health Study were analyzed to determine women''s behavior and behavioral intentions regarding three modes of breast cancer detection behavior: breast self-examination (BSE), physician examination of the breasts, and mammography. Two questions were addressed: Are women who engage in one type of breast surveillance behavior likely to engage in all three? What are the social characteristics of women who engage in these breast cancer detection behaviors?The data indicated that women who had had a recent professional (physician) breast examination did not necessarily practice monthly BSE. Only 82 of a sample of 540 women had had mammography; thus, it was not possible to relate this type of surveillance to the other two types. However, 93 percent of the women interviewed indicated they would obtain a mammography examination if their physicians recommended it. There were few differences among the sociodemographic subgroups with respect to BSE and professional examination, with the exception that black women were more likely to report practicing monthly BSE than were white or Hispanic women.     

Knowledge and intentions of ninth-grade girls after a breast self-examination program

ABSTRACT: Breast cancer ranks as the second-leading cause of death for women. Until recently the American Cancer Society advocated teaching breast self-examination (BSE) procedures. The Susan G. Komen Breast Cancer Foundation, active in the fight against breast cancer, continues to support educational efforts to teach breast self-examination skills to adolescent girls. Funded by the Komen Foundation, a BSE education program was developed and delivered by health educators at the Hult Health Education Center. The 50-minute program consisted of a PowerPoint slide presentation of breast cancer and BSE facts, and a video demonstration of proper BSE technique. Using a quasi-experimental design, the program was evaluated for changes in knowledge and intention to perform BSE. Ninth-grade girls at four public high schools (n = 255) in Peoria, Ill, were given a pretest to determine their knowledge about breast cancer and breast self-examination. A delayed posttest was administered between five to six weeks later (n = 211). Using the Kruskal-Wallis nonparametric test, girls who participated in the BSE education program (treatment group) recorded a significantly higher overall mean knowledge score than girls who did not participate (comparison group). Those who participated in the program retained that knowledge over a five- to six-week period. Analyses of variance revealed that more girls in the treatment group reported performing BSE in the past month as well as a higher intention to perform BSE in the future. (J Sch Health. 2004;74(9):365–369)     

Knowledge and beliefs of breast cancer among elderly women in Puerto Rico

This is the first national study of breast-cancer knowledge, beliefs, and early detection practices among elderly women (65+) in Puerto Rico. Cancer breast examination (CBE) was the most common early detection practice, followed by the mammogram, with breast self exam (BSE) a distant third. The primary reasons most often cited for never having a mammogram related to both personal and external factors: not having symptoms, negligence or forgetfulness, and not having a physician's referral. No statistically significant difference (p < 0.05) was found between knowledge and early detection practices. Conversely, beliefs had an impact on preventive behavior. Those who had less misconceptions were most likely to have had a CBE or a mammogram. Bivariate analysis demonstrated that age was associated with performing a BSE once or twice monthly, ever having a mammogram, and having a mammogram in the past two years. A higher socioeconomic status was associated to performing BSE and ever having had a mammogram. Education correlated positively to ever having a mammogram or having a mammogram in the two years prior to the interview. Factors that explained compliance with a mammogram in the last two years included referral from a physician, owning a car, and receiving information after menopause on breast cancer from a health care provider. A gynecological visit increased the probability of having had a mammogram during the last two years. Logistic regression determined that a referral from a physician was the most important factor for mammogram compliance when a combination of variables were considered.     

Mammogram uptake and barriers among Palestinian women attending primary health care in North Palestine

BackgroundBreast cancer affects women''s lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers.ObjectivesOur study aims to assess mammography screening uptake and barriers among women attending primary healthcare centres (PHCs) in northern Palestine.MethodsUsing an interviewer administered questionnaire, we used a cross-sectional study design to determine mammography screening uptake, knowledge and barriers among 357 women attending PHCs in Northern Palestine between December 2018 and March 2019.ResultsThe mean age was 50 years. The majority (69.2%) were considered to have adequate knowledge about breast cancer and mammography screening. Mammography screening uptake among the participants was 37%. Almost 85% of the women had a positive attitude towards breastfeeding as a prophylaxis factor against breast cancer, while the most frequent barrier to mammography screening was that the participants believed they did not have any symptoms (28.6%), followed by 22.1% of them who did not want to know if they had breast cancer.ConclusionThe findings of this study highlighted the low mammography uptake among Palestinian women despite the adequate knowledge of those women and the fully accessible and free screening programme. Hence, interventional strategies should be implemented at several levels to enhance mammogram uptake.