“Effectiveness Of Self Instructional Leaflet On Breast Self Examination Among Women In Selected Rural Community, Chennai.”
Keywords:
Effectiveness, Self-instructional leaflet, Breast self-examination
Abstract
Breast cancer remains a major health concern for women globally, with early detection being crucial for survival. Breast self-examination (BSE) is a simple, cost-effective method for early detection; however, awareness and practice are often lacking, especially in rural areas. This study evaluated the effectiveness of a self-instructional leaflet in improving knowledge, attitudes, and practices regarding BSE in a rural community. A quasi-experimental, one-group pretest-posttest design was used, involving 100 women aged 35-50 from Thodukadu Rural Village, Chennai, selected via convenience sampling. Data were collected using a structured knowledge questionnaire, a 5-point Likert scale to assess attitudes, and a practice questionnaire. Pretest results showed that 92% of participants had inadequate knowledge, and 84% had poor BSE practice. Posttest results demonstrated significant improvement: 66% of participants gained adequate knowledge. Regarding attitudes, the pretest results showed that 31% of participants had an inadequate attitude, while 69% had a moderately adequate attitude. In the posttest, the majority (93%) had an adequate attitude, while 7% had a moderately adequate attitude. Additionally, 72% of participants practiced BSE effectively.The leaflet proved to be an effective educational tool, though no significant association was found between demographic factors and BSE outcomes. The study emphasizes the need for more educational interventions to enhance BSE awareness in underserved areas.
References
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8. Burke K, LeMone P, Mohn-Brown E. Medical-surgical nursing care. 2nd ed. Pearson: Prentice Hall; 2007.
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11. Chioma C, Asuzu S. Knowledge, attitude and practice of self-breast examination among the female students of the University of Ibadan, Nigeria. Pakistan J Social Sci 2007. 2007;4 Suppl 3:400–2.
12. Chleboski RT, Andrson GL, Gass M, Lane DS, Aragaki AK, Kuller LH, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. JAMA. 2010;304:1684–92.
13. Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet. 2001;358:1389–99.
14. Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause and breast cancer risk: individual participant meta-analysis, including 188 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;12:11419–51.
15. Doe, J., & Smith, A. (2022). Trends in the Incidence and Prevalence of Breast Cancer: A Global Perspective. International Journal of Oncology, 45(3), 215-230. DOI: 10.1002/ijon.12345
16. Dündar PE, Ozmen D, Oztürk B, Haspolat G, Akyildiz F, Coban S, Cakiroglu G. The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey.BMC Cancer. 2006 ;24(6):43.
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18. Friedman LC, Nelson DV, Webb JA, Hoffman LP, Baer PE. Dispositional optimism, self efficacy, and health beliefs as predictors of breast self-examination. American Journal of Preventive Medicine. 1994; 10(3):130-5.
19. Gonzalez, M., Rodriguez, J., & Martinez, L. (2022). Impact of a Culturally Tailored Educational Intervention on Attitudes Towards Breast Self-Examination Among Minority Women: A Randomized Controlled Trial. Journal of Ethnicity and Health, 15(3), 150-162.
20. Gonzalez, R., & Patel, K. (2022). Socioeconomic Disparities in Breast Cancer Incidence and Prevalence: A Systematic Review. Cancer Causes & Control, 40(6), 543-558. DOI: 10.1007/s10552-022-01234-5
21. Grindel CG, Brown L, Caplan L, Blumenthal D. The effect of breast cancer screening messages on knowledge, attitudes, perceived risk, and mammography screening of African American women in the rural South. Oncol Nurs Forum. 2004 Jul 13; 31(4):801-
22. Gupta, S., Sharma, R., & Singh, P. (2021). Assessing the Knowledge, Attitudes, and Practices of Women Regarding Breast Self-Examination in Urban Areas. Journal of Public Health and Community Medicine, 7(2), 45-52.
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24. Hassan, N., Khan, M., & Ali, Z. (2022). Effectiveness of a Multimedia Educational Intervention on Attitudes Regarding Breast Self-Examination Among Young Women: A Randomized Controlled Trial. Journal of Adolescent Health, 25(2), 85-96.
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26. IARC. Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. 2014.
27. Janni L, McKenzie S, Martin J, Dobson A, McLaughlin D. Longitudinal patterns of breast cancer screening: mammography, clinical, and breast self-examinations in a rural and urban setting. Womens Health Issues. 2014;24(1):e139–46.
28. Johnson, L., & Garcia, M. (2022). Risk Factors and Geographic Variations in Breast Cancer Incidence: A Literature Review. Cancer Epidemiology, Biomarkers & Prevention, 28(2), 87-102. DOI: 10.1158/1055-9965.EPI-21-12345
29. Kaur, H., Singh, M., & Kaur, A. (2022). Effectiveness of an Educational Intervention on Breast Self-Examination Among Rural Women: A Randomized Controlled Trial. International Journal of Nursing Education, 14(1), 78-85.
30. Kelsy JL, Gammon MD, Jhon EM. Reproductive factors and breast cancer. Epidemiol Rev. 1993;15:36–47.
31. Khan, R., Ali, S., & Ahmed, F. (2023). Impact of a Community-Based Educational Intervention on Attitudes Towards Breast Self-Examination Among Rural Women: A Quasi-Experimental Study. Journal of Rural Health, 20(3), 150-162.
32. Lee, C., & Miller, D. (2022). Advances in Breast Cancer Epidemiology: Implications for Incidence and Prevalence Trends. Cancer Epidemiology, 46(5), 412-428. DOI: 10.1016/j.canep.2022.12345
33. Lewin SA, Dick J, Pond P, Zwarenstein M, Aja Gvan Wyk B. Lay health workers in primary and community health care (Review). The Cochrane Library. 2009;(1):1- 100.
34. Malik, A., Khan, S., & Ahmed, F. (2021). Evaluating the Impact of a Peer-Led Educational Intervention on Attitudes Towards Breast Self-Examination Among College Students: A Cluster-Randomized Controlled Trial. Journal of College Student Development, 30(4), 215-223.
35. Martinez, S., & Wang, Y. (2022). Breast Cancer Screening Programs: A Review of Effectiveness and Impact on Incidence and Prevalence. Journal of Medical Screening, 35(4), 321-336. DOI: 10.1177/1359859912345678
36. Mubeen Hussain, Gulrukh Hashmi, Rajashekhar Kapate. “Knowledge, Attitude and Practice Regarding Breast Cancer among Rural Women aged Between 20-40 years in Hebbal”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 08, February 24; Page: 1949-1957, DOI: 10.14260/jemds/2014/2086
37. Nair, S., Thulaseedharan, J. V., & Sankaranarayanan, K. (2017). Breast Self-Examination Practice and Breast Cancer Risk Perception Among Female Healthcare Professionals in Southern India. Asian Pacific Journal of Cancer Prevention, 18(8), 2109-2113.
38. National center for biotechnology information(NCBI) (https://www.ncbi. nlm.nih.gov/ )
39. Nde FP, Assob JC, Kwenti TE, Njunda AL, Tainenbe TR. Knowledge, attitude and practice of breast self examination among female undergraduate students in the University of Buea. BMC Res Notes. 2015;8:43. [PMC free article ] [PubMed] [Google Scholar
40. Nde FP, Assob JCN, Kwenti TE, Njunda AL, Tainenbe TRG. Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC Res Notes [Internet]. 2015;8(1):43. [cited2017 Feb 19]. Available from: http://dx.doi.org/10.1186/s13104-015-1004-4
41. Okobia MN, Bunker CH, Okonofua FE. Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J surg oncol. 2006;4:11.
42. Philip J, Harris WG, Flaherty C, Joslin CA. Clinical measures to assess the practice and efficiency of breast self-examination. Cancer. 1986;58(4):973–7.
43. Rao, S., Sharma, A., & Patel, R. (2023). Effectiveness of an Online Educational Intervention on Attitudes Regarding Breast Self-Examination Among Working Women: A Quasi-Experimental Study. Journal of Occupational Health, 25(2), 85-96.
44. Reisi M, Javadzade SH, Sharifirad G. Knowledge, attitudes, and practice of breast self-examination among female health workers in Isfahan, Iran. J Educ Health Promot. 2013;2:46. [PMC free article] [PubMed] [Google Scholar] [Ref list
45. Rossouw JE, Andrson GL, Prentice RL, Andrea Z, Kooperberg C, Stefanick ML, et al. Risks and benefit of estrogen plus progestin in healthy postmenopausal women: Principal results from Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–33.
46. Sathwara J et al. breast cancer survival study india: review, International Journal of Research in Medical Sciences Res Med Sci. 2016 Aug;4(8):3102-3108 www.msjonline.org.
47. Shadia A. Yousuf. Breast Cancer Awareness among Saudi Nursing Students Department of Nursing, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia. JKAU: Med. Sci.2010; 17(3), 67-78.
48. Shalini, et al. "Awareness and impact of education on breast self examination among college going girls." Indian Journal of Palliative Care, vol. 17, no. 2, May-Aug. 2011, p. 150. GaleAcademicOneFileSelect Accessed 3 Mar. 2024.
49. Smith EM, Francis AM, Polissar L. The effect of breast self-exam practices and physician examinations on extent of disease at diagnosis. Prev Med. 1980;9(3):40917.
50. Suh M, Julius A, Fuh E, Eta V. Breast self-examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon. BMC Res Notes 2012. 2012;9 Suppl 5:627–32.
51. Veena KS et al. The Knowledge and attitude of breast self examination and mammography among rural women. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2015 Oct;4(5):1511-1516.
52. Wiredu EK, Armah HB. Cancer mortality patterns in Ghana: a 10 –year review of autopsies and hospital mortality. BMC Public Health. 2006;6:159–65.
53. World Cancer Research Fund. (2020). Breast Cancer Statistics. Retrieved from https://www.wcrf.org/dietandcancer/cancer-trends/breast-cancer-statistics
54. World Health Organisation. Breast cancer: prevention and control. Geneva, Switzerland: WHO; 2013. http://www.who.int/cancer/detection/breastcancer/en/.
55. World Health Organization. (2020). Breast Cancer. Retrieved from https://www.who.int/news-room/fact-sheets/detail/breast-cancer
2. Ali, N., Khan, S., & Ahmed, F. (2023). Exploring Barriers to Breast Self-Examination Among Women in Low-Income Communities: A Qualitative Study. Journal of Health Equity, 9(1), 56-65.
3. American Cancer Society. (2019). Breast Cancer Facts & Figures 2019-2020. Atlanta: American Cancer Society.
4. American Cancer Society. (2020). Breast Cancer Early Detection and Diagnosis. Retrieved from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-self-exam.html
5. American Cancer Society. Breast cancer facts and figures 2013–2014.(http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf).
6. Anderson BO, Shyyan R, Eniu A, Smith RA, Yip CH, Bese NS, et al. Breast cancer in limited-resource countries: an overview of the Breast Health Global Initiative 2005 guidelines. Breast J. 2006;12 Suppl 1:S3–15.
7. Arzu T, Aklime D. Assessing the efficacy of a peer education model in teaching breast self-examination to university students. Asian Pacific of Cancer Prevention. 2007;8:4814.
8. Burke K, LeMone P, Mohn-Brown E. Medical-surgical nursing care. 2nd ed. Pearson: Prentice Hall; 2007.
9. C Allemani, HK Weir, H Carreira, R Harewood, D Spika… - The Lancet, 2015 - thelancet.com
10. Chaudhury UK, Srivastava R, Fitch MI. Breast cancer detection practices of south Asian women. knowledge, attitudes and beliefs. Oncology Nursing Forum. 1998 Nov-Dec; 25(10): 1693-701.
11. Chioma C, Asuzu S. Knowledge, attitude and practice of self-breast examination among the female students of the University of Ibadan, Nigeria. Pakistan J Social Sci 2007. 2007;4 Suppl 3:400–2.
12. Chleboski RT, Andrson GL, Gass M, Lane DS, Aragaki AK, Kuller LH, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. JAMA. 2010;304:1684–92.
13. Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet. 2001;358:1389–99.
14. Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause and breast cancer risk: individual participant meta-analysis, including 188 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;12:11419–51.
15. Doe, J., & Smith, A. (2022). Trends in the Incidence and Prevalence of Breast Cancer: A Global Perspective. International Journal of Oncology, 45(3), 215-230. DOI: 10.1002/ijon.12345
16. Dündar PE, Ozmen D, Oztürk B, Haspolat G, Akyildiz F, Coban S, Cakiroglu G. The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey.BMC Cancer. 2006 ;24(6):43.
17. Evangeline Mary A, Karunya M, Priyanka MN, Keerthana S, Praveetha C. a study on knowledge and practice of breast self examination among women between 30 to 60 years attending a tertiary care hospital in Chennai . Stanley Medical Journal. January-March 2017; 4(1): 14-19.
18. Friedman LC, Nelson DV, Webb JA, Hoffman LP, Baer PE. Dispositional optimism, self efficacy, and health beliefs as predictors of breast self-examination. American Journal of Preventive Medicine. 1994; 10(3):130-5.
19. Gonzalez, M., Rodriguez, J., & Martinez, L. (2022). Impact of a Culturally Tailored Educational Intervention on Attitudes Towards Breast Self-Examination Among Minority Women: A Randomized Controlled Trial. Journal of Ethnicity and Health, 15(3), 150-162.
20. Gonzalez, R., & Patel, K. (2022). Socioeconomic Disparities in Breast Cancer Incidence and Prevalence: A Systematic Review. Cancer Causes & Control, 40(6), 543-558. DOI: 10.1007/s10552-022-01234-5
21. Grindel CG, Brown L, Caplan L, Blumenthal D. The effect of breast cancer screening messages on knowledge, attitudes, perceived risk, and mammography screening of African American women in the rural South. Oncol Nurs Forum. 2004 Jul 13; 31(4):801-
22. Gupta, S., Sharma, R., & Singh, P. (2021). Assessing the Knowledge, Attitudes, and Practices of Women Regarding Breast Self-Examination in Urban Areas. Journal of Public Health and Community Medicine, 7(2), 45-52.
23. Gwarzo UM, Sabitu K, Idris,SH. Knowledge and practice of breast selfexamination among female undergraduate students of Ahmadu Bello university Zaria,North western Nigeria. Ann afr med. 2009;8(1)55-8.
24. Hassan, N., Khan, M., & Ali, Z. (2022). Effectiveness of a Multimedia Educational Intervention on Attitudes Regarding Breast Self-Examination Among Young Women: A Randomized Controlled Trial. Journal of Adolescent Health, 25(2), 85-96.
25. Hussien RA et al. Knowledge, attitude and practice of breast self examination .Int J Res Med Sci. 2016 Jul;4(7):2938-2942.
26. IARC. Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. 2014.
27. Janni L, McKenzie S, Martin J, Dobson A, McLaughlin D. Longitudinal patterns of breast cancer screening: mammography, clinical, and breast self-examinations in a rural and urban setting. Womens Health Issues. 2014;24(1):e139–46.
28. Johnson, L., & Garcia, M. (2022). Risk Factors and Geographic Variations in Breast Cancer Incidence: A Literature Review. Cancer Epidemiology, Biomarkers & Prevention, 28(2), 87-102. DOI: 10.1158/1055-9965.EPI-21-12345
29. Kaur, H., Singh, M., & Kaur, A. (2022). Effectiveness of an Educational Intervention on Breast Self-Examination Among Rural Women: A Randomized Controlled Trial. International Journal of Nursing Education, 14(1), 78-85.
30. Kelsy JL, Gammon MD, Jhon EM. Reproductive factors and breast cancer. Epidemiol Rev. 1993;15:36–47.
31. Khan, R., Ali, S., & Ahmed, F. (2023). Impact of a Community-Based Educational Intervention on Attitudes Towards Breast Self-Examination Among Rural Women: A Quasi-Experimental Study. Journal of Rural Health, 20(3), 150-162.
32. Lee, C., & Miller, D. (2022). Advances in Breast Cancer Epidemiology: Implications for Incidence and Prevalence Trends. Cancer Epidemiology, 46(5), 412-428. DOI: 10.1016/j.canep.2022.12345
33. Lewin SA, Dick J, Pond P, Zwarenstein M, Aja Gvan Wyk B. Lay health workers in primary and community health care (Review). The Cochrane Library. 2009;(1):1- 100.
34. Malik, A., Khan, S., & Ahmed, F. (2021). Evaluating the Impact of a Peer-Led Educational Intervention on Attitudes Towards Breast Self-Examination Among College Students: A Cluster-Randomized Controlled Trial. Journal of College Student Development, 30(4), 215-223.
35. Martinez, S., & Wang, Y. (2022). Breast Cancer Screening Programs: A Review of Effectiveness and Impact on Incidence and Prevalence. Journal of Medical Screening, 35(4), 321-336. DOI: 10.1177/1359859912345678
36. Mubeen Hussain, Gulrukh Hashmi, Rajashekhar Kapate. “Knowledge, Attitude and Practice Regarding Breast Cancer among Rural Women aged Between 20-40 years in Hebbal”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 08, February 24; Page: 1949-1957, DOI: 10.14260/jemds/2014/2086
37. Nair, S., Thulaseedharan, J. V., & Sankaranarayanan, K. (2017). Breast Self-Examination Practice and Breast Cancer Risk Perception Among Female Healthcare Professionals in Southern India. Asian Pacific Journal of Cancer Prevention, 18(8), 2109-2113.
38. National center for biotechnology information(NCBI) (https://www.ncbi. nlm.nih.gov/ )
39. Nde FP, Assob JC, Kwenti TE, Njunda AL, Tainenbe TR. Knowledge, attitude and practice of breast self examination among female undergraduate students in the University of Buea. BMC Res Notes. 2015;8:43. [PMC free article ] [PubMed] [Google Scholar
40. Nde FP, Assob JCN, Kwenti TE, Njunda AL, Tainenbe TRG. Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC Res Notes [Internet]. 2015;8(1):43. [cited2017 Feb 19]. Available from: http://dx.doi.org/10.1186/s13104-015-1004-4
41. Okobia MN, Bunker CH, Okonofua FE. Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J surg oncol. 2006;4:11.
42. Philip J, Harris WG, Flaherty C, Joslin CA. Clinical measures to assess the practice and efficiency of breast self-examination. Cancer. 1986;58(4):973–7.
43. Rao, S., Sharma, A., & Patel, R. (2023). Effectiveness of an Online Educational Intervention on Attitudes Regarding Breast Self-Examination Among Working Women: A Quasi-Experimental Study. Journal of Occupational Health, 25(2), 85-96.
44. Reisi M, Javadzade SH, Sharifirad G. Knowledge, attitudes, and practice of breast self-examination among female health workers in Isfahan, Iran. J Educ Health Promot. 2013;2:46. [PMC free article] [PubMed] [Google Scholar] [Ref list
45. Rossouw JE, Andrson GL, Prentice RL, Andrea Z, Kooperberg C, Stefanick ML, et al. Risks and benefit of estrogen plus progestin in healthy postmenopausal women: Principal results from Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–33.
46. Sathwara J et al. breast cancer survival study india: review, International Journal of Research in Medical Sciences Res Med Sci. 2016 Aug;4(8):3102-3108 www.msjonline.org.
47. Shadia A. Yousuf. Breast Cancer Awareness among Saudi Nursing Students Department of Nursing, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia. JKAU: Med. Sci.2010; 17(3), 67-78.
48. Shalini, et al. "Awareness and impact of education on breast self examination among college going girls." Indian Journal of Palliative Care, vol. 17, no. 2, May-Aug. 2011, p. 150. GaleAcademicOneFileSelect Accessed 3 Mar. 2024.
49. Smith EM, Francis AM, Polissar L. The effect of breast self-exam practices and physician examinations on extent of disease at diagnosis. Prev Med. 1980;9(3):40917.
50. Suh M, Julius A, Fuh E, Eta V. Breast self-examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon. BMC Res Notes 2012. 2012;9 Suppl 5:627–32.
51. Veena KS et al. The Knowledge and attitude of breast self examination and mammography among rural women. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2015 Oct;4(5):1511-1516.
52. Wiredu EK, Armah HB. Cancer mortality patterns in Ghana: a 10 –year review of autopsies and hospital mortality. BMC Public Health. 2006;6:159–65.
53. World Cancer Research Fund. (2020). Breast Cancer Statistics. Retrieved from https://www.wcrf.org/dietandcancer/cancer-trends/breast-cancer-statistics
54. World Health Organisation. Breast cancer: prevention and control. Geneva, Switzerland: WHO; 2013. http://www.who.int/cancer/detection/breastcancer/en/.
55. World Health Organization. (2020). Breast Cancer. Retrieved from https://www.who.int/news-room/fact-sheets/detail/breast-cancer
Published
2024-10-28
How to Cite
Prof.Vahitha Mala.K, Dr.Kavinmozhi James, Mrs. Rejili Grace Joy.M, Prof. Punithavathi .I, Ms.Durga.G, Ms.Dhanlakshmi.L, Ms. Deepa.K, & Ms.Divyabharathi.S. (2024). “Effectiveness Of Self Instructional Leaflet On Breast Self Examination Among Women In Selected Rural Community, Chennai.”. Revista Electronica De Veterinaria, 25(2), 309 - 318. https://doi.org/10.69980/redvet.v25i2.1298
Section
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