Understanding women's perspectives on breast cancer is essential for cancer control: knowledge, risk awareness, and care-seeking in Mwanza, Tanzania.

BACKGROUND: Breast Cancer is the most common cancer in women worldwide. Since 2008, Mwanza, Tanzania, has worked to provide comprehensive cancer services through its Zonal consultant hospital. New national guidelines focused on clinical breast exam requires that women be aware of and seek care for breast concerns. Therefore, this study aims to understand breast cancer awareness in Mwanza and describe women-level barriers, care-seeking behavior, and perspectives on breast cancer. METHODS: A community-based survey was administered to conveniently sampled women aged 30 and older to assess women's perspectives on breast cancer and care-seeking behavior. RESULTS: Among 1129 women with a median age of 37 (IQR: 31-44) years, 73% have heard of cancer and 10% have received breast health education. Women self-evaluated their knowledge of breast cancer (from 1-none to 10-extremely knowledgeable) with a median response of 3 (IQR: 1-4). Only 14% felt they knew any signs or symptoms of breast cancer. Encouragingly, 56% of women were fairly-to-very confident they would notice changes in their breasts, with 24% of women practicing self-breast examination and 21% reporting they had received a past breast exam. Overall, 74% said they would be somewhat-to-very likely to seek care if they noticed breast changes, with 96% noting severity of symptoms as a motivator. However, fear of losing a breast (40%) and fear of a poor diagnosis (38%) were most frequent barriers to care seeking. In assessing knowledge of risk factors, about 50% of women did not know any risk factors for breast cancer whereas 42% of women believed long term contraceptive use a risk factor. However, 37% and 35% of women did not think that family history or being older were risk factors, respectively. CONCLUSIONS: The success of efforts to improve early diagnosis in a setting without population-based screening depends on women being aware of breast cancer signs and symptoms, risks, and ultimately seeking care for breast concerns. Fortunately, most women said they would seek care if they noticed a change in their breasts, but the low levels of cancer knowledge, symptoms, and common risk factors highlight the need for targeted community education and awareness campaigns.

Health Beliefs of Midwifery Students at Istanbul University about Breast Cancer and Breast Self-Examination Acknowledgements.

Knowing the attitudes and beliefs of midwifery students toward breast cancer and breast self-examination (BSE) practice may reduce breast cancer-related deaths by increasing breast cancer awareness. This study was conducted to examine the attitudes and beliefs of midwifery students toward breast cancer and the BSE practice. The study was conducted with 160 midwifery students at Istanbul University as a descriptive, cross-sectional study. Data were collected by a part of Champion's Health Belief Model Scale and a self-administered questionnaire. The descriptive characteristics were given as frequencies and percentages. The evaluation was done with Kruskal-Wallis test, a non-parametric test. It has been observed 70.0 % among midwifery students have knowledge of breast cancer. 90.0 % of midwifery students know about BSE, however only 14.4 % among them practice BSE regularly every month. The benefit, barrier and confidence sub-dimension scores were positively associated with BSE practice regularity (p ≤ 0.05). It has been determined that more than half of midwifery students have knowledge about breast cancer and BSE, and that only a fraction of those with knowledge about BSE practice BSE regularly every month. The perceived seriousness of breast cancer and knowledge about breast cancer affect the ability of individuals to perform BSE, initiating BSE and continuing to practice BSE for early diagnosis of breast cancer. The results from the study provide the midwifery students awareness of breast cancer and BSE both for themselves and for the women for whom they take responsibility.

Influence of sense of coherence, spirituality, social support and health perception on breast cancer screening motivation and behaviors in African American women.

Despite formidable barriers, some African American women (AAW) engage in breast cancer screening (BCS) behaviors. Understanding individual characteristics that allow AAW to overcome barriers to BCS is critical to reduce breast cancer mortality among AAW. A salutogenic model of health was used to evaluate the influence of sense of coherence, social support, spirituality and health perception on BCS motivation and behaviors in AAW, and to determine differences in these factors in AAW who participate in free BCS programs compared to AAW who do not. Findings revealed that greater levels of spirituality were significantly associated with greater motivation to practice BCS. Further, women who utilized free BCS programs reported significantly greater rates of both performing and of intent to perform breast self examinations (BSE) in the future, obtaining clinical breast exams and mammograms. Findings can inform the development of culturally specific programs to improve the utilization of BCS programs by AAW.

Do Turkish nursing and midwifery students teach breast self-examination to their relatives?

AIM: To describe health beliefs and breast self-examination (BSE) practice of Turkish female nursing and midwifery students and extent of teaching the screening method to their mothers, sisters and relatives. DESIGN: In this definition survey, data were obtained from 113 nursing and midwifery students (n = 113) in third and fourth class and their mothers, sisters and other relatives in Turkey. METHODS: Data were collected using a personal data form, a knowledge evaluation form for BSE (Maurer 1997) and the Champion's Health Belief Model Scale. Number percentage, Chi-square test were used in the evaluation of the data. RESULTS: Students learned breast cancer and BSE in their lessons one or two years previously. Knowledge level scores of the students were 52.3 ± 9.6 (min:25,max: 75). Rate of having regular BSE was 32.7%. When health belief scale assessed; the average of susceptibility was 7.52 ± 2.62, seriousness was 21.8 ± 5.30, benefit was 16.7±4.45, barrier was 22.3 ± 6.44, confidence was 40.3 ± 6.67 and medical motivation was 26.6 ± 4.22. The rate of having regular BSE and benefit, barrier scores were compared, they were statistically significant difference(p < 0.05). The majority (106, 91.3%) gave BSE training to their mother and sisters, and 42.6% (48) to relatives, 6.2% (7) to friends, and 5.4% (6) to patients. CONCLUSIONS: Knowledge about breast cancer and BSE repetition training programs should be planned for nursing/midwifery students, to increasae their sensitivity, beliefs and attitudes, and medical motivation for BSE.

Black women and breast health: a review of the literature.

AIM: In the UK, it is known that screening inequalities exist involving ethnic minority groups such as Black women (Patnick, 2009). To date, there is limited UK data on Black British women and breast health awareness. Black British women appear to be an underrepresented group in breast cancer studies (Breast Cancer Care, 2004, 2005). This literature review aimed to explore Black women's perceptions of breast health and factors that influence breast cancer screening practices. METHODS: A literature search for the period 1994 to September 2009 was undertaken using BNI, CINAHL, PubMed, OSH-ROM, PsyInfo, Google scholar, and Scopus databases. Key words used included: breast cancer, breast health, African American women, Black British women, black women, breast cancer screening, qualitative studies. Hand-searching was also done, and reference lists of papers were examined for relevant studies. RESULTS: Black women hold a variety of views and perceptions on the risk that breast cancer poses. These perceptions are strongly related to existing knowledge, related stigmatization, spiritual and religious beliefs, all of which can adversely influence motivation to engage in self-breast examination and breast cancer screening. CONCLUSION: US based studies identified several influential factors: religion, educational awareness of breast cancer screening, breast health awareness. Breast health interventions and research are needed to increase breast health awareness in Black British women.

The effect of breast self-examination (Bse) education given to midwifery students on their knowledge and attitudes.

This study was conducted in a descriptive and half-experimental format in order to determine the effect of breast self-examination (BSE) education given to 103 midwifery students from Halic University Sciences of Health School Midwifery Department on their knowledge and attitudes. After legal permission was obtained from the institution and verbal participation consent from the students, data were obtained using demographic and knowledge surveys, applied twice before and after education by the researcher between May-June 2010 and evaluated with proportional calculations, Kruskal Wallis test, t-test and t-test for dependent groups. Mean age of the students is 20.2±1.52; 58.3% had no information about BSE and 73.8% were not doing BSE; 7.7% them stated that they had a family member with breast cancer. The knowledge level score was 43.2±10.6 before and 68.4±10.5 after the BSE education (p<0.05). A statistically significant difference persisted between the pre- and post-education scores taking knowledge, making BSE, and frequency of using BSE average scores of the students (p<0.05).

Breast self-examination among nurses and midwives in Odemis health district in Turkey.

BACKGROUND: The second leading cause of death due to cancer in Turkey is breast cancer, which accounts for 24% of female cancers. AIMS: To determine the practices of nurses and midwives and their attitude toward breast self-examination (BSE). SETTING AND DESIGN: The descriptive survey was conducted to determine the practices of nurses and midwives and their attitude toward BSE. It tried to cover the total population rather than sampling part of it. However, 15 nurses and midwives, where there were errors detected in their data coding papers, and who did not accept to join the study, were excluded from the study. A total of 80 nurses and midwives were included in the study group. MATERIALS AND METHODS: This survey was carried out at the State Hospital, all Public Health Cabins, and Family Health Centers, in the rural area of Izmir, a city located in the western region of Turkey. The data was collected between 15 March and 1 April 2004. STATISTICAL ANALYSIS: The analysis included descriptive statistics, to examine the association between BSE and medical history, knowledge of BSE, and attitude toward BSE. RESULTS: The results of the study indicated that 52% of the sample performed BSE. Approximately 35% of those who performed BSE reported that they acquired information regarding BSE during their work experience. A significant relationship was found between higher levels of work experience and BSE practice. Except for age, no significant relation was found between the sociodemographic factors and BSE practice. The sample showed a strong belief in the breast lump being the cause of breast cancer and it had a significant correlation with BSE practice. CONCLUSION: A positive correlation was found between nursing work experience and their practice alongside BSE medical professionals. Almost all the nurses and midwives knew how to conduct BSE, but did not prioritize practicing it.

Knowledge, attitudes, and behaviors of nursing and midwifery students regarding breast self-examination in Turkey.

PURPOSE/OBJECTIVES: To investigate knowledge, attitudes, and behaviors of nursing and midwifery students regarding breast self-examination (BSE). DESIGN: Descriptive, cross-sectional. SETTING: Aydin School of Health at Adnan Menderes University in Aydin, Turkey. SAMPLE: 244 female students of nursing and midwifery. METHODS: Data were collected with a questionnaire. MAIN RESEARCH VARIABLES: BSE-related knowledge, attitudes, and behaviors. FINDINGS: More than half of the study participants stated they had sufficient information about BSE from varied sources, primarily from school curricula. The students were knowledgeable about who should perform BSE and its recommended frequency; however, their knowledge of BSE techniques was limited. First-year students had negative attitudes about BSE but became more positive as they progressed in their education. Half of the study sample stated they performed BSE at recommended times and intervals, but only one-fifth used recommended BSE positions and techniques. The main reasons for not performing BSE included not knowing how to perform it (57%), not having any history of problems in the breast (39%), and forgetfulness (18%). CONCLUSIONS: The results demonstrate that nursing and midwifery education has a positive effect on students' knowledge, attitudes, and behaviors regarding BSE. IMPLICATIONS FOR NURSING: The findings suggest that nursing and midwifery students should be thoroughly prepared to perform BSE on themselves so they can educate other women about this important preventive procedure.

Associations between the use of complementary and alternative medications and demographic, health and lifestyle factors in mid-life Australian women.

OBJECTIVE: To determine the prevalence and types of complementary and alternative medications (CAMs) used by menopausal women living in South-East Queensland, Australia; and profile the women who are using CAMs through sociodemographic characteristics, self-rated health status, lifestyle and preventative health strategies. METHOD: This study was a secondary data analysis of data collected by postal questionnaire from 886 women aged 48-67 years participating in the Queensland Midlife Women's Health Study. The outcome measure was CAM use, distinguished by three categories: herbal therapies, phytoestrogens and nutritional intake (supplements and healthy eating). RESULTS: The overall prevalence of CAM use among mid-life Australian women was 82% which included therapeutic techniques (83%), nutritional supplements (66.8%), phytoestrogens (55.8%), herbal therapies (41.3%), Evening Primrose oil (34%) and vitamin E (28.8%). CAM users, when compared to non-users, were more likely to be previous (p < 0.05) but not current users (p < 0.05) of hormone therapy (HT), higher educated (p < 0.05), low to middle income earners (p < 0.001) and have participated in self-breast examination (p < 0.01). They were also more likely to report good general health (p < 0.05) and improved physical functioning without limitations due to health (p < 0.05). CAM users were less likely to be aged over 55 years (p < 0.05) and smoke more than 20 cigarettes per day (p < 0.001). CONCLUSIONS/IMPLICATIONS FOR HEALTH RESEARCH: As prevalence of current CAM use in this population group is considerably higher than HT use, health education programs to assist mid-life women to understand the scientific evidence (or lack of it) for their efficacy is recommended.

Beliefs and behaviors about Pap and breast self-examination among Thai immigrant women in Brisbane, Australia.

Regular screening is an important preventive method in reducing morbidity and mortality from cervical and breast cancer. In 1998, a cross-sectional study was conducted in Brisbane, Australia, among 145 Thai immigrant women, to explore cultural and social factors related to their use of Pap smear tests and breast self-examination (BSE). The study aimed at describing women's beliefs and perceptions about the body, breast and cervical cancer, and their perceptions of the causes of the diseases. It explored the women's perception of the severity and the effects of both cancers on aspects of patients' lives, and their chance of developing both cancers. The Thai immigrant women explained the causes of breast and cervical cancer using both traditional beliefs and medical knowledge. They perceived that both cancers affect a patient's health and her daily activities. Some women believed that they would develop cervical cancer if their perineum or vulva was "dirty." Some believed that they would have breast cancer because they had a history of benign tumor or cyst of a breast. Forty-four percent of the women had biennial Pap smears in the past five years and only 25% conducted BSE monthly in the past two years. Information relating to perceived barriers to undertake regular cervical cancer and breast cancer screenings and other health beliefs can be applied by health care personnel to increase Thai immigrant women's preventive health behaviors.