Attitude and Practices of Breast Self Examination Among Female Undergraduate Students of Tertiary Institutions
Chapter One
Objectives of the Study
- To examine the impact of breast self examination
- To assess whether female undergraduates know the benefits of breast self examination
- To determine the level of attitude and practice of BSE among female undergraduate
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Overview of Breast Self Examination
Breast self-examination (BSE) should begin at age 20 and be performed monthly. The breast is usually easiest to examine on the days immediately following the menstrual cycle. BSE can be frustrating to patients, particularly when they have fibrocystic change because they are not certain what they are feeling or supposed to feel. The technique of BSE should be taught early and reinforced regularly. If a palpable tumor develops, women who regularly perform BSE present with tumors 1 cm or smaller more frequently than women who do not perform BSE. Improvement in survival from breast cancer has not been demonstrated, however. Some women should not practice BSE because of the psychological trauma they suffer from repetitive false-positive findings. Those women need to rely on their physician to do a breast examination once or twice a year.
In the past, many experts recommended that adolescents be taught breast self-examinations to establish the health habit and promote an understanding of its importance in adulthood. However, there are no data to support breast self-examination during adolescence and there is concern that it may produce unnecessary anxiety, testing, and surgery. There is consensus in the literature that breast self-examination should be encouraged for all adolescents with a history of malignancy, adolescents who are at least 10 years post-radiation therapy to the chest, and adolescents 18–21 years of age whose mothers carry the BRCA 1 or BRCA 2 gene.
Breast Self-examination: Background
Early diagnosis of breast cancer is of extreme significance in improving the survival rates and quality of life especially in low-income countries Rao, R. et al., (2005). Although awareness about breast cancer has long been advocated across the world, unfortunately studies have revealed that a major proportion of women are still not breast aware Kanaga, K.C. et al., (2011). As discussed earlier, techniques such as breast self-examination (BSE), clinical breast examination (CBE) and mammography have been advocated for bringing about a marked reduction in breast cancer associated morbidity and mortality Omar, S. et al., (2003), Humphrey, L.L. et al., (2002). As compared to CBE and mammography which require hospital visit and specialized equipment / technical expertise, BSE is helpful in the regard that it is cost-free, simple, non-invasive intervention carried out by women themselves Jemal, A. et al., (2011).
Studies conducted in developing countries have established BSE as one of the most reasonable and feasible approach in early detection of breast cancer Mittra, I. (2000). BSE not only familiarize women with the appearance/feel of their breast but also aids in early detection of breast cancer. Some of the studies have reported that BSE is highly effective in increasing sense of ownership about health, healthcare seeking behavior, encouraging adoption of preventive health behaviors and creating awareness about breast cancer among women. Multiple studies have concluded that women, who regularly perform breast self-examination present with smaller neoplasm and rare involvement of axillary lymph nodes Manasciewicz, R. et al., (2003). On the other hand, some researchers have seriously questioned the usefulness of BSE Thomas, D.B. (2002). while others have revealed no added benefits of BSE in improvement of survival rates.
Practice of Breast Self-examination
With the rising incidence of breast cancer and absence of any uniform breast screening strategy in most of the nations, it is important to assess the knowledge and practice of BSE in various age groups. Irrespective of the multiple benefits of BSE, various studies identified a wide knowledge application gap with regards to BSE, the practice of BSE remaining low and variable in different nations like 54% in England Parvani, Z (2011) varying from 19% to 43.2% in Nigeria Okobia, M.N. et al., (2006) and varying from 0 to 52% in India Gupta, S.K et al (2009). In a study done in Korea, 27% of students were engaged in BSE which was higher than what was observed in students (10.1%) from Nigeria Shin, K.R. (2012).
Among the health-care providers, around 90.3% women performed BSE in Sao Paulo; while in Turkey 28% of the nurses and 32% of physicians did not practice BSE. Similarly, in a cross-sectional study conducted in Iran it was revealed that most of the female health care workers (63-72%) did not practice BSE Haji-Mahmoodi, M. et al., (2002). Studies done with an aim to assess the knowledge about BSE among men have shown low level of knowledge. This was mainly because most of the pamphlets and information-education-counseling materials usually deals only with women’s breast cancer related issues Thomas, E. (2010).
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
The research design adopted description survey method for the study. This involves the collection of data from the study population in order to draw inference concerning the status of the problem investigated.
Population of Study
The population of this study consists of 100 female undergraduate students residing in Benson Idahosa University hostel.
CHAPTER FOUR
RESULTS AND DISCUSSION
Results
The total number of questionnaire given out was hundred (100), eighty (80) were found suitable for analysis after sifting and editing. The highest proportion of the respondents, 50 (62.5%) were in the age group 20 – 25 years and the mean age was 28 years. Most of the respondents, 60 (75%) were single while 20 (25%) were married.
Most of the respondents, 50 (62.5%) had heard about BSE at one time or the other. The commonest source of information about the topic was the television, 60 (70%); closely followed by information through friends, 24(30%). twenty-four (30%) of those who heard about it heard from multiple sources while only 40 (50%) heard from health personnel. One hundred and forty-six (42.8%) of those studied felt BSE should be done once monthly, 10(12.5%) indicated three-monthly, equal proportion of 10 each for twice yearly and once yearly respectively while 6 (7.5%) did not know how often BSE should be done.
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
Preamble
This chapter epitomized the whole study and gives suggestions to attitude and practices of breast self examination.
Conclusion
In conclusion, most of the respondents in the study were found to be aware of BSE. The attitude of teachers/lecturers to health information on BSE was positive, with a fairly high degree of acceptability of the idea. Despite the positive attitude to BSE, its practice was low. The electronic media were the major sources of information while the health workers were the least. Our study also has several limitations. The sample of the study population includes female undergraduate students; hence, the results of the study cannot be generalized to a larger population in Nigeria. Likewise, the survey was conducted on a health-care-providing team; hence, the study group might be better informed. Even though the questionnaire utilized in the study was pretested, it may limit the comparability of our results with other studies. Furthermore, the data were collected by self-report, which may be a source of bias. Also, since this study was limited to only female undergraduate students of the school, the sample size is relatively small and may not be representative of all females of that age group; hence, it is recommended to conduct further studies using larger samples at various institutions in Nigeria.
Recommendations
It is recommended that training of this kind should be implemented for all the public clubs of women. This issue should also be incorporated in the second school’s curriculum. It is also important to increase the information about breast cancer, early diagnosis, and BSE practice given by health care staff and especially through media (such as television, magazine, newspaper) which can provide information and raise awareness about BSE practices.
Secondary school teachers/lecturers should be educated – both in theory and practicals on BSE. The mass media should be used to disseminate information on BSE to enhance effectiveness particularly among the study group who has been found to be well educated enough for adequate impact.
Health workers should intensify health education on the importance of BSE when they come in contact with women such as Antenatal and Immunization clinic sessions.
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