Abstract: The present descriptive survey was conducted to identify and describe breast self-examination knowledge and practice of nursing and midwifery students. The convenience sample consisted of 68 female students enrolled in the end year of the undergraduate program at Hamadan university in Iran in 2001. The data were collected using a questionnaire and observing form. The majority of participants (79.4%) reported that they had performed breast self-examination. Only 29.4% of participants described their breast self-examination practice as regular. The majority of participants (71.8% of midwifery students and 62.1% of nursing students) had average knowledge about breast self-examination. The majority of midwifery students (48.7%) had good practice and in nursing students majority of them (58.9%) had average practice. Significant differences were found between the knowledge and practice with kind of educational field (p<0.001). The implications of this study are the midwives and nurses` teaching to the clients may be increased if more emphasis on breasts self examination occurs in undergraduate courses. Also, the provision of breast self examination educational program is necessary to increase midwives and nurses` knowledge, confidence, performance and teaching of breast self-examination.
Introduction
Breast cancer is a feared disease, not only because it is life threatening, but also because it can affect a women’s sense of self her sexuality and feminity. It is most common malignancy in women and it is currently estimated that one in twelve women will develop this disease at some stage during their lives (Patkin 1995; Denton 1996). The national breast cancer center suggests that 1:14 women who live to the age of 75 will develop breast cancer. Thus strategies that raise breast awareness amongst women are highly relevant (Turnbull, 2004). The early diagnosis of breast cancer can lead to increased survival rates (Ellis et al., 1990). Since the degree of success in treating this disease is influenced primarily by the stage at which intervention is introduced, secondary prevention (early detection) is the mainstay (Morrison, 1996).
Changes in the breasts can be detected either by means of a clinical breast examination, mammography screening or breast self-examination, which is now known as breast awareness (Sortet and Banks, 1997). Breast awareness is more than just examining the breasts. It involves a women knowing how her breast look and feel normally, so that she will be able to detect any change which might be unusual (Breast Cancer Care, 1998).
Nurses and midwives are in a prime position to make use of the many opportunities that present themselves in their everyday work to encourage and influence women to be more breasts aware. They have the potential to make an impact on women’s health by encouraging women to become more involved in their own health and make use of the screening programs available (Bailey, 2000).
The aim of this study was to examine the knowledge and practice of breast self-examination in female Hamadan University Nursing and Midwifery Students.
Materials and Methods
This study utilized a descriptive approach. The convenience sample consisted of 68 female students’ enrolled in the end year of the undergraduate nursing and midwifery degree program (39 midwifery students and 29 nursing students) at the Hamadan University of Iran. The students had been previously exposed to information on breast cancer and health behaviors such as BSE in their course. The data were collected using a self-administered questionnaire containing 22 questions. The participants were asked questions designed to a licit the data about general and personal information such as age group, marital status, previous knowledge of breast self examination, place or person from whom breast self examination was obtained, adequacy of breast self examination information, necessity for breast self examination, personal history of a breast lump, personal and family history of breast cancer, performance of breast self examination, reasons for not performing breast self examination, performance of regular breast self examination. The content of instrument was validated from the current finding of breast self examination literature and a panel of five experts academic member of Hamadan Nursing and Midwifery University. An observing form was used to determine participant’s breast self-examination practice. Descriptive statistics were used to analyze the data.
Results
The majority of participants (79.4%) reported that they had performed breast self examination in the preceding 12 months. 37/9% of the sample corrected identified the time of breast self examination within 2 days of cessation of menstural bleeding. Significant differences were found between the recommended times for performing breast self-examination and the days of the menstural cycle when the participants performed breast self examination (p<0.0001).
Only 29.4% of participants described their breast self-examination practice as regular. All the participants knew about breast self-examination. The knowledge and practice of the samples were showed in Table 1.
| Table 1: | The rate of the nursing and midwifery Hamadan University breast self-examination knowledge and practice |
| Significant differences were found between the knowledge, practice and educational field (p<0.001) | |
Discussion
The number of participants found to have performed breast self examination in the preceding 12 months (79.4%) was lower than other studies (Budden, 1995; Hailey and Bradford, 1991; Lewis and Charney, 1988). This inconsistency can probably be accounted for by the sample that is, young women who enrolled in a health related course such as midwifery and nursing. A number of participants (29.4%) indicated that they would classify their breast self-examination practice as regular. This finding also contrasts with the results of a study by Redman et al. (1990). A little number (12.6% of midwifery students and 0% of nursing students) had good knowledge and the majority of participants (71.8% of midwifery students and 62.1% of nursing students) had moderate knowledge about breast self-examination. This finding is lower than the results of Elyasi and et al. (2000). The majority of midwifery students (48.7%) had good and in nursing student’s majority of them (58.9%) had moderate breast self-examination practice. This finding also contrasts with the results of the Budden study (1995).
Patistea et al. (1992). suggest that encouraging this self care practice is essential for increasing individual’s responsibility for their own health. Similar to other studies about midwives and nurses and breast self examination, this study illustrated a disparity between participants’ personal and professional breast self examination practices .If midwives and nurses do not believe in primary health strategies such as breast self examination, they could not effectively promote the look, touch and feel message of breast awareness to other women.
Conclusion
The nurses and midwives have a role for health and nature of the nurse client relationship facilitates opportunities for health education. Breast awareness will not necessarily translate into women becoming more familiar with their own breast tissue, unless they are encouraged to look at and touch their breasts as a normal part of self-care health behavior. To provide this message effectively to other women, nurses and midwives may need to internalize the concepts of health promotion more effectively so that opportunities to promote health awareness generally are seen as an integral part of their role. Midwifery and Nurses students require much information as possible about women’s health behaviors for development of effective health programs such as breast self examination.