乳腺增生症病人乳腺健康知识调查分析

目的 了解女性乳腺增生症病人乳腺健康知识及乳房自我检查的实施情况。方法 采用自行设计的问卷对850例女性乳腺增生症病人进行乳腺健康知识的调查及乳房自我检查实施情况的调查。结果 31．1％的乳腺增生症病人了解常见的乳腺疾病知识，58．5％的病人了解乳房自我检查知识，15．7％的病人掌握乳房自我检查的方法；不同职业、文化程度的乳腺增生症病人的乳房自我检查情况存在统计学差异（P〈0．01）。结论 加强妇女乳腺健康知识宣传，传授乳房自我检查的正确方法，有利于达到乳腺疾病早发现、早诊断、早治疗的目的。     

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.     

护理人员乳房自检实施及宣教情况的调查

目的了解护理人员乳房自检相关知识的掌握和实施情况,以及对周围人群的宣教情况。方法采用自制问卷对某医院140名护士进行调查,主要包括一般情况、乳房自我检查的相关知识、乳房自检的实施情况及对周围人群进行乳房自检相关知识的宣教情况。结果（1）被调查护士对乳房自检知识的平均掌握程度为59.1%;（2）51.4%的护士知道5个以上的乳腺癌高危因素;（3）50.7%的护士知道乳腺自检的频率和时间,36.4%的护士知道望诊的3~4个步骤,88.6%和61.4%的护士知道触诊手法和按压顺序;（4）仅5.7%的护士每月规律自检;（5）50%的护士曾接受过他人咨询,其中47.1%未给予咨询者指导。结论应加强护理人员乳房自检相关知识的培训,重点是乳腺癌高危因素、乳房自检频率和望诊方法等;同时,作为妇女健康的教育者和咨询者,护理人员应加强责任心,做好对周围人群乳房自检的宣传普及工作,积极维护自身及广大妇女的身心健康。     

Breast screening education at Australian and Thai worksites: a comparison of program effectiveness

To determine whether a nurse-led breast screening educational program in the workplace improved the breast screening practices and attitudes of women. Worksites are potentially cost-effective and convenient for breast cancer screening education due to their ability to educate several women at one time. This was a collaborative study between industry, university and health services in Australia and Thailand. This was a pre post test group comparative design. Three worksites in Australia and three in Thailand were assigned to one of three groups: treatment (group education), pamphlet only, or control. All groups were assessed pre-education and again 3 months post-education on breast screening attitudes and practices using a mail-out self-report questionnaire. Women were significantly more likely to practice breast self-examination (BSE) following group education, and were more confident in their ability to detect a breast lump. There was a significant increase in breast screening discussion on the workplace for the Thai group following the group education program. An increase of 25% more women saw having a mammography as a priority. The Thai women had less access to free mammographic screening. They also had more negative attitudes and poorer knowledge regarding BSE and physical breast examination (PBE) than the Australian group, with the education program having a more positive impact on them than the Australian group. Relative breast screening attitudes and practices for the treatment, pamphlet and control groups are also presented. This study provides educators and health promotion professionals with further information on the beliefs and practices of women working in both Australian and Thai industries about breast screening. Education programs such as this one can have a positive impact on attitudes and practices including increased likelihood and confidence in practising BSE, promoting women to have a PBE, and promoting discussion of breast screening at the workplace. The findings suggest that Australian women have greater opportunities to ensure their breast health than Thai women, and that there may be a greater need for programs such as this in countries such as Thailand.     

Breast self-examination and breast awareness: a literature review

Aim. To explore the literature on breast self‐examination and breast awareness. Objectives. To clarify the confusion surrounding breast awareness and breast self‐examination. To critique the evidence for breast awareness as a health promotion tool. Background. Over 41 000 women are diagnosed with breast cancer each year in the United Kingdom. Compared with other European countries, women in England have poor survival prospects, for breast cancer, due in part to advanced disease at first presentation. In the United Kingdom, women are encouraged to be breast aware from the age of 18. However, the evidence suggests that women do not engage in breast awareness and are frightened and confused about their role in breast health promotion. Methodology. Four databases were used: Medline, Ebsco including CINAHL and Sociological Abstracts and the Cochrane Database of Systematic Reviews. The search terms ‘breast awareness’ and ‘breast self‐examination’ were used and combined with ‘breast cancer’, ‘breast screening’ and ‘health promotion’. Conclusion. The evidence on breast self‐examination is clear, there is no benefit to breast cancer mortality and results suggest that breast self‐examination may do more harm than good. Breast awareness provides women with some acknowledgement of the part they can play in being empowered to fight breast disease, not in terms of statistics used for mortality but on the qualitative effects of reductions in morbidity. Relevance to clinical practice. The Royal College of Nursing of The United Kingdom is actively encouraging all nurses to promote breast awareness along with clear guidelines for doing so. The United Kingdom National Health Service Cancer Plan: a plan for investment, a plan for reform, encourages preventive care, information giving, good communication as well as evidence‐based practice. In breast care this can reduce confusion for women and encourage empowerment in breast health promotion.     

HIV/AIDS knowledge and risk behaviour in Hong Kong Chinese pregnant women

BACKGROUND: With the increase in HIV infection among childbearing aged women in Hong Kong, health department policy-makers are considering the implementation of antenatal HIV screening to identify infected mothers. However, little is known about women's understanding of HIV/AIDS, and their attitudes towards HIV screening. AIM: The aim of this study was to explore pregnant women's knowledge about HIV/AIDS, their perceptions of risk, risk behaviour and management, and their attitudes towards HIV screening. METHODS: A cross-sectional study was carried out, and all Chinese pregnant women who attended an antenatal clinic of a regional hospital in Hong Kong in the month of December 2000 were invited to complete a questionnaire. FINDINGS: Hong Kong pregnant women had fairly good general knowledge of HIV/AIDS (mean score = 4.8/6), but were less knowledgeable on specific mother-to-child HIV transmission (mean score = 3.6/6). There were statistically significant differences between those with different levels of education (chi2 = 19.81; P < 0.001) and between Hong Kong born residents and immigrants from the Chinese mainland (z = -4.03; P < 0.001). Over a third (36.7%) of all pregnant women perceived a risk of contracting HIV. If HIV infection were suspected, over 70% would have HIV screening together with their spouse. If HIV was confirmed, 24% would terminate the pregnancy. As many as 78.5% and 72.8% of women believed that HIV screening should be carried out before marriage and pregnancy respectively. Only 4.7% would choose universal opt-out antenatal HIV testing. RECOMMENDATIONS: Health educators should provide tailored-made education programmes for women at risk, particularly those at lower education levels and those who have come from the Chinese mainland, to enhance their knowledge about mother-to-child HIV transmission, and to promote awareness of safe sex. Health policy-makers should consider the possibility of providing pre-marriage and pre-pregnancy HIV screening for women.     

Health beliefs,perceived self-efficacy,and breast self-examination among Thai migrants in Brisbane

BACKGROUND: Women in Thailand have a relatively low risk of developing breast cancer; however, death rates from breast cancer are increasing. Rates in many migrant groups are also known to be on the increase. Little is known about breast cancer screening, particularly breast self-examination (BSE), among Thai migrant women in other countries. In Australia, non-English-speaking-background migrants are known to be low users of preventive health services. AIMS: To investigate, using the health belief model (HBM) and self-efficacy as a theoretical framework, the use of BSE in a recent migrant group, Thai women in Australia, and to identify sociodemographic variables that influence the women's regular use of BSE. METHODS: In 1998, a cross-sectional study was conducted among 145 Thai women in Brisbane recruited through a snowball-sampling method, which used personal contacts and key persons within the Thai community. The study was approved by the University Human Ethics Review Committee. Data were collected through designed closed-ended questions. RESULTS: Only 25% of the women performed BSE regularly. HBM indices were strongly associated with BSE. Beliefs in high personal susceptibility to breast cancer strongly increased the likelihood of BSE. After adjusting for potential confounding factors, cues or triggers to undertake BSE and self-efficacy, or the ability to do BSE were found to be important determinants of regular BSE. Study limitations, including data collection methods, are discussed. CONCLUSION: A low percentage of women practised BSE regularly. The HBM is a useful framework for identifying factors influencing the use of BSE. Strategies that increase the confidence of women to undertake preventive health behaviour or increase self-efficacy are likely to increase their regular screening for breast cancer.     

住院女患者对乳腺疾病知识需求的调查

目的了解住院女患者对乳腺疾病知识需求的情况。方法采用自行设计的调查问卷进行调查,内容包括患者一般情况、乳腺癌高危因素、乳房自我检查情况、对开展乳腺疾病知识教育必要性、对乳腺疾病知识教育内容和形式的需求。结果143名住院女性患者中,7．0％经常做乳房自我检查,32．7％有患乳腺癌的高危因素,21．0％接受过乳腺疾病知识教育,93．0％认为有开展乳腺癌健康教育的必要。结论住院女患者对乳腺疾病知识了解较少,有较高的需求,应采取多种形式的健康教育方法。增强女性患者预防乳腺疾病的风险意识。     

Relationship of self-concept, health locus of control, and perceived cancer treatment options to the practice of breast self-examination

Breast cancer remains one of the most prevalent forms of cancer for women in the United States. Recognition of the fact that no more than 40% of women practice breast self-exam (BSE) is of major concern in that BSE has been identified as one method of early detection. The factors that encourage or discourage women to perform BSE need to be identified. The current study investigated the relationships between women's practice of BSE, self-concept, locus of control, and knowledge of treatment options for breast cancer. One mammogram screening center provided the 235 subjects who completed the questionnaires. Subjects who practiced BSE more frequently had a slightly higher self-concept score and were more aware of breast cancer treatment options (r = 0.16, p less than 0.05). Weak correlations were found between chance locus of control and BSE frequency of practice (r = 0.22, p less than 0.05). The majority of subjects reported irregular BSE practice, both as to whether they practiced BSE on a monthly basis and as to the time of the month for BSE.     

Ethnic differences in breast self-examination practice and health beliefs

Thirty-two African American nurses (AAN) and 78 Caucasian nurses (CN) were compared on breast self-examination (BSE) practice and health beliefs. Relationships between these variables were also examined. The Health Belief Model provided the framework for the study. The sample is a subset of 269 women from a larger study. AANs were recruited from a professional nurses' group. CNs were recruited from a list of female employees of a university medical centre. The results of t -tests revealed no significant group differences on BSE frequency ( P =0·06) or BSE proficiency ( P =0·10). Noted was that 42% of AANs compared to 20% of CNs examined their breasts 12 or more times during the year. AANs were more likely to consider BSE beneficial ( P =0·002) and to feel confident ( P =0·006) about doing BSE; CNs perceived more barriers ( P =0·001) to BSE. For AANs, BSE frequency and proficiency were positively related to confidence and inversely related to barriers; BSE frequency was also related to health motivation. For CNs, BSE frequency and proficiency were inversely related to seriousness. Implications include additional research to validate findings and to increase the knowledge base of all nurses regarding BSE.     

Response to breast health screening program at a not‐for‐profit clinic for working poor,uninsured, ethnically diverse women

Aims and objectives. Examine the effect of an ongoing breast health screening program, at a not‐for‐profit, non‐government assisted, volunteer clinic, specifically examining mammography usage and to discover variables to improve the rate of mammography. Background. Detection of breast cancer in women of low socio‐economic status, lacking health insurance, can be improved by increasing annual mammography rates, yet little is known about their screening behaviour. Design. Quantitative, retrospective subject‐controlled study. Methods. Subject‐controlled, longitudinal study of English and Spanish‐speaking women 40 years old and over, working poor, and uninsured, who participated in a comprehensive screening program that included a 7‐minute breast health educational DVD (n = 223). Results. Radiology records, breast health behaviours and beliefs indicated 76% of women invited for a second test completed it over a year after viewing the educational DVD. Chi‐square and t‐test indicated two significant findings for completing annual mammography in the 12th month: receiving a reminder postcard and scoring lower on perceptions of breast cancer susceptibility. Two significant findings for completing annual mammography even if late are knowledgeable about screening recommendations and ethnically identifying as Hispanic. Conclusions. This study shows statistically significant actions that can be undertaken to strengthen programs: reminder postcards, assessing susceptibility score and screening recommendation education. Relevance to clinical practice. Simple, inexpensive interventions encourage working, uninsured, Hispanic women to complete mammography.     

Breast self-examination. Knowledge and behavior of Greek female health care professionals working in primary health care centers.

A comparative correlational study was conducted to examine the knowledge and frequency of breast self-examination (BSE) by Greek health care professionals. A total of 268 women working in primary health care centers constituted the sample. The women were 22-64 years of age. Subjects reported low levels of knowledge about BSE and facts related to breast cancer. Multiple regression analysis showed significant relationships between level of knowledge and profession, number of years of health-related education, and frequency of BSE. The sample's frequency of practice of BSE was limited. Only 34.7% of the participants claimed to practice BSE on a monthly basis. Multiple regression analysis revealed statistically significant correlations between BSE behavior and marital status, professional experience with breast cancer, and level of knowledge. The level of knowledge of the participants is considered to be inadequate, taking into account that they work in settings where primary health care is offered. Courses of preventive medicine and health education should be incorporated in medical and nursing curricula.     

Evaluation of a community-based intervention to enhance breast cancer screening practices in Brazil

Objectives The primary aim of this study was to evaluate a programme called ‘Touch of Life’ (Toque de Vida in Portuguese) proposed to increase breast cancer screening awareness and provide free clinical breast examination (CBE) for asymptomatic women 40–69 years of age. Method Evaluation of the intervention used a before‐and‐after quasi‐experimental design without control groups. A total of 11 762 women, living in three cities in the State of Mato Grosso do Sul, Brazil, were submitted to breast cancer screening by CBE. The evaluation indicators were participation rate, abnormal call rate, cancer detection rate and rate of advanced‐stage breast cancers. Results Mean age was 42.6 years. Most women belonged to the 40–69‐year age group (56.7%) and had less than 8 years of formal education (60.9%). Mean age at menarche was 12.9 years (±1.7). The proportions of parous and nulliparous women were 85.1% and 14.8% respectively. Mean age of first pregnancy was 19.8 years (±4.4). Less than one‐third (29.3%) of the women had a history of abortion or miscarriage. History of breastfeeding was reported by 79.3% of the women, and 14.4% had used hormone replacement therapy at some time. For women between 40 and 49 years of age, the participation rate was 74.9%. The abnormal call rate for CBE was 10.7%. The main abnormalities found were breast lumps in 630 women (5.4%), thickening in 332 (2.8%) and other suspicious lesions in 316 (2.7%). The breast cancer detection rate was 1.3 per thousand, and only 20.0% of women were diagnosed with advanced‐stage disease (stages III and IV). Conclusions The intervention was effective in detecting new cases of breast cancer. A community‐wide screening approach based on CBE may be effective to enhance breast cancer detection in vulnerable populations, especially in areas where mammography screening is not available.     

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.     

乳腺癌患者一级亲属对乳腺癌早期筛查认知情况调查

目的了解乳腺癌患者一级亲属对乳腺癌早期筛查认知情况及探讨其影响因素,为临床针对性开展护理干预和健康教育提供理论依据和指导。方法选取2013年8月至2014年1月本院乳腺治疗中心乳腺癌患者一级亲属213例作为研究对象,采用问卷调查的形式分析乳腺癌患者一级亲属对乳腺癌早期筛查认知情况及其影响因素。结果乳腺癌患者一级亲属对乳腺癌疾病相关知识获取途径主要来源于亲属住院期间的健康教育(29.11%)和医护人员(24.41%);在乳腺癌高危因素认知上主要有认为其发病与乳腺良性疾病史(65.73%)、长期服用激素(64.32%)和家族史(61.03%)有关,在临床表现上,主要认为乳腺癌的临床表现为乳房肿块(88.26%);在早期筛查方法上,主要通过乳房临床检查(52.11%);乳腺癌相关知识认知程度与乳腺癌患者一级亲属居住地、有无职业和文化程度有关(P0.05),与年龄和婚姻状况无关(P0.05);乳腺癌患者一级亲属主要希望通过邮寄资料获取相关健康教育知识。结论乳腺癌患者一级亲属对乳腺癌早期筛查认知不足,应加大预防乳腺癌相关知识的健康教育,并注意不同居住地、职业和文化程度的宣传教育方式,努力提高防癌意识。