Predicting breast self-examination using the theory of reasoned action

The personal and normative influences on breast self-examination (BSE) behavior in older women were examined using the Theory of Reasoned Action. The sample consists of 93 volunteers ranging in age from 52 to 90 years. A structured questionnaire was used for data collection. Direct and indirect measures of attitude and social norm were used to predict intention to perform BSE and BSE frequency. Contrary to the model assumptions, indirect measures accounted for more variance in both intention and behavior, and explained actual behavior better than intention to perform. Both the indirect and direct measures of attitude and social norm explained a significant amount of the variance in intention and BSE frequency. There were significant differences on all the model components (direct and indirect measures of attitude, social norm, and intention) between frequent and infrequent BSE performance groups. Discriminant analysis using the indirect measures of attitude and social norm correctly classified 76% of the women into frequent and infrequent performance groups.     

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.     

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.     

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.     

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.     

Health beliefs and self breast examination in black women

The relationship between health beliefs and practice of breast self examination (BSE) in a sample of 179 black women, 20 to 49 years of age, was investigated. Health beliefs were operationalized by employing Champion's revised Health Belief Model Scale (1993) to collect data. Data analyses included multiple regression analysis to examine BSE behavior in relation to selected demographic attributes and health beliefs. Results indicated that health beliefs were much stronger in determining BSE performance for a given individual than were demographic characteristics. The frequency of BSE was related to increased perceived seriousness of breast cancer, benefits of BSE, and health motivation. Frequency of BSE was inversely related to perceived barriers.     

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.     

Determinants of exercise intention and behavior in survivors of breast and prostate cancer: an application of the theory of planned behavior

The purpose of this study was to evaluate the theory of planned behavior as a framework for understanding exercise intention and behavior in survivors of breast and prostate cancer. Participants were 83 survivors of breast and 46 survivors of prostate cancer who were diagnosed within the previous 4 years and had completed treatment. Each participant completed a mailed self-administered questionnaire that assessed exercise during the previous week, demographic and medical variables, and the theory of planned behavior. For survivors of breast cancer, regression analyses indicated that attitude, subjective norm, and perceived behavioral control explained 45% of the variance in exercise intention with attitude, subjective norm, and perceived behavioral control each uniquely contributing to intention. Furthermore, exercise intention explained 30% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. For survivors of prostate cancer, attitudes, subjective norm, and perceived behavioral control explained 36% of the variance in exercise intention, but only perceived behavioral control made a significant unique contribution. Furthermore, intention explained 36% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. Results suggest that nurses may use the theory of planned behavior as a model for understanding the determinants of exercise intentions and behavior in survivors of breast and prostate cancer.     

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.     

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.     

Psychosocial adjustment to breast cancer in unmarried women

Breast cancer is a significant health problem that can affect many aspects of a woman's life. Although there is growing evidence that women with supportive husbands seem to adjust reasonably well, little is known about the impact of breast cancer among unmarried women. Relationships among primary treatment alternatives, symptom distress, perceived social support, and psychosocial adjustment to breast cancer in 101 unmarried women were investigated using data collected during the late postoperative recovery phase. The women experienced relatively low levels of psychosocial adjustment problems and perceived moderately high levels of social support. Social support and symptom distress each accounted for significant proportions of the variance in psychosocial adjustment, whereas primary treatment alternatives did not. Symptom distress emerged as the variable accounting for the most variance in psychosocial adjustment to breast cancer. Implications for health care providers to facilitate positive adjustment to breast cancer in unmarried women and directions for future studies are suggested. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 155–166, 1998     

Perceived social support, uncertainty, and quality of life of younger breast cancer survivors.

This study investigated the relationship between perceived social support, uncertainty, and quality of life among younger breast cancer survivors. Proposed hypotheses predicted a significant positive correlation between perceived social support and quality of life, a significant negative correlation between uncertainty and quality of life, and that perceived social support and uncertainty, considered together, will explain more of the variance of quality of life than either variable considered independently. A sample of 101 breast cancer survivors below age 50 completed the Social Support Questionnaire, Mishel Uncertainty in Illness Scale--Community Form, and Ferrans and Powers Quality of Life Index--Cancer Version. Data were analyzed using Pearson product-moment correlation and stepwise multiple regression. All three hypotheses were supported. Additional findings revealed a significant positive correlation between support and network size, and between network size and the socioeconomic domain of quality of life. Significant negative correlations were found between perceived social support and uncertainty, between network size and time since diagnosis and treatment, and between network size and uncertainty. Study results demonstrated that although perceived social support and uncertainty accounted for a significant amount (27.2%) of variance of quality of life, a large amount of variance remains unexplained. Further research is needed in this area.     

An evaluation of comparative strategies for teaching breast self-examination

This study compared the effects of three alternative methods of breast self-examination (BSE) instruction (booklet, film and group discussion, individual teaching) on nurses' personal BSE practice A pre-test and follow-up questionnaire were administered to a convenience sample of 166 nurses from Western Australian hospitals The results demonstrated that each method of BSE instruction produced a significant improvement in the technique of BSE ( P < 0 0001) However, the nurses involved in the film and discussion had the greatest improvement in BSE proficiency Findings were analysed in terms of the Health Belief Model The variables 'barriers to action' and 'perceived susceptibility'(in this case, to breast cancer) were found to be predictive of BSE practice,'perceived barriers' at pre-test and 'perceived susceptibility' at follow-up The incidence of BSE was significantly higher in the older nurses A reminder to practice BSE was significantly associated with an effective BSE technique Implications for nursing practice are discussed     

Instructional information and breast self-examination practice

The effects of four interventions on frequency and thoroughness of breast self-examination (BSE) were compared. The interventions provided different types of information, as derived from a self-regulation framework, to promote BSE practice. Women seeking BSE instruction (N = 204) were randomly assigned to interventions. No intervention effects on frequency were observed. However, exam frequency increased from pre- to postintervention and remained constant over 3 and 6 months follow-up. Interaction effects observed on thoroughness suggested that a positive effect of sensory information about the breast was conditional upon having had prior experience with BSE. Implications for research, theory, and practice are drawn.     

Review of Research Studies That Evaluated the Impact of Treatment for Childhood Cancers on Neurocognition and Behavioral and Social Competence: Nursing Implications

ISSUES AND PURPOSE. Given the increasing incidence of childhood cancer, increasing survivor rates, and documented incidence of sequelae, nurses need evidence on which to base interventions for families at risk. The authors review and critique research studies that evaluated the impact of treatment for childhood cancers. Implications for nursing practice are discussed.
CONCLUSIONS. Research to evaluate the effects of treatment on neurocognition and behavioral and social competency of children with cancer has produced conflicting results. Most studies found deleterious effects on all three areas associated with childhood cancer treatment. Some studies, however, found no differences between childhood cancer survivors and children on therapy compared to normative data or healthy controls.
PRACTICE IMPLICATIONS. Knowledge of the short-and long-term impact of treatment for childhood cancer on neurocognition and behavioral and social competence allows nurses to design interventions that mitigate neurocognitive effects, decrease behavioral problems, and improve social competence.     

Teaching employees breast self examination. Factors that may influence practice

Breast self examination is a widely known technique used for detection of breast lumps. Many women do not practice monthly breast self examination, although it has been proven that with early detection the prognosis of breast cancer can be improved greatly. When tend to be taught, or learn about, breast self examination at an early age. The educational techniques used during the instruction can influence the practice of BSE later on. Health professionals can make a difference in the practice of BSE by communicating the value of this detection technique. BSE is a viable breast cancer detection technique that employees can be taught easily in employee wellness programs by health professionals.