Breast Cancer; Knowledge Attitude And Practice Of Female School Teachers In Enugu, Nigeria

Breast Cancer; Knowledge Attitude And Practice Of Female School Teachers In Enugu, Nigeria (Charles)
Abstract
This study was carried out to examine breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria. The study was specifically carried out to assess the knowledge level of female teachers towards the risk factors associated with breast cancer, ascertain the attitudes of female school teachers towards breast cancer, and ascertain female school teachers practices towards prevention of breast cancer. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of some selected secondary schools teachers in Enugu South LGA, Nigeria. In determining the sample size, the researcher conveniently selected 57 respondents and 50 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that the knowledge level of female teachers towards the risk factors associated with breast cancer is low. The study also revealed that female school teachers practices towards prevention of breast cancer includes: avoid birth control pills particularly after age 35, maintain a healthy weight and be physically active, get screening tests regularly, and avoid hormone therapy for menopause. Therefore, it is recommended that there is need of an intensive breast cancer awareness campaign which should also stress the importance of early detection and reporting is evident keeping in view the current status of breast cancer knowledge. To mention but a few.
Table of Content
- Title Page
- Certification
- Dedication
- Acknowledgement
- Table of Content
- List of Tables
- Abstract
Chapter One:
Introduction
- 1.1 Background of the Study
- 1.2 Statement of the Problem
- 1.3 Objective of the Study
- 1.4 Research Questions
- 1.5 Research Hypothesis
- 1.6 Significance of the Study
- 1.7 Scope of the Study
- 1.8 Limitation of the Study
- 1.9 Definition of Terms
- 1.10 Organisations of the Study
Chapter Two:
Review of Literature
- 2.1 Conceptual Framework
- 2.2 Theoretical Framework
- 2.3 Empirical Review
Chapter Three:
Research Methodology
- 3.1 Research Design
- 3.2 Population of the Study
- 3.3 Sample Size Determination
- 3.4 Sample Size Selection Technique and Procedure
- 3.5 Research Instrument and Administration
- 3.6 Method of Data Collection
- 3.7 Method of Data Analysis
- 3.8 Validity of the Study
- 3.9 Reliability of the Study
- 3.10 Ethical Consideration
Chapter Four:
Data Presentation and Analysis
- 4.1 Data Presentation
- 4.2 Analysis of Data
- 4.3 Answering Research Questions
- 4.4 Test of Hypotheses
Chapter Five:
Summary, Conclusion and Recommendation
- 5.1 Summary
- 5.2 Conclusion
- 5.3 Recommendation
- References
- APPENDIX
- QUESTIONNAIRE
Chapter One
Introduction
1.1 Background of the Study
After non-melanoma skin cancer, breast cancer is the second most common cancer in women aged 15–45 years, with an estimated 2.09 million new cancer cases and 626,679 deaths in 2018. It is also the most frequent malignancy among women in developing countries (Afolayan et al., 2012). Breast cancer (BC) is an important health issue all over the world, and based on the most recent Iranian National Population-based Cancer Registry survey,the age-specifc incidence rate for breast cancer is about 34.53 per 100,000 (El Saghir et al., 2011). Women aged 40–49 years form the group with the highest incident rate. In 2017, it was estimated that 351.3 (275.2–374.2) disability-adjusted life years (DALY) were attributable to BC in the world (Downing et al., 2007), where it is the fifth leading cause of cancer mortality. According to statistics, the probability of BC incidence for individuals aged 15–79 years has increased in the last 30 years (Jack et al., 2009).
The early detection and diagnosis of BC are ideal solutions for reducing mortality worldwide (Khokhar, 2009). BC prevention based on awareness and early diagnosis are crucial because of the worse consequences they experience. The Global Burden of Disease (GBD) report announced an alarming increase in BC incidence, highlighting the importance of establishing procedures for the early detection and improved prognosis of this disease (Montazeri et al., 2008). Breast cancer screening is conducted mainly through three methods: monthly breast self-examination, medical breast examinations, and breast imaging procedures under the direct supervision of a radiologist qualifed in mammography (Onwere et al., 2009). Breast self-examination (BSE) is the most infuential and feasible tool for the early detection of BC in developing countries (Islam and Aziz, 2012).
In general, increasing women’s awareness of BC can positively affect their better performance of BSE. Awareness is the recollection of the details and the general procedures (i.e. recognition and review), processes, patterns, structures, or situations (Peacey et al., 2006).
The importance of knowledge of these risk factors and the need for every woman to be aware of the need for surveillance on her breasts and the various ways to do this cannot be over emphasized. The poor knowledge and wrong beliefs about cancer breast prevention among women are responsible for a negative perception of the curability of a cancer detected early and of the efficacy of the screening tests.16 Studies that detect the awareness of breast cancer and the practice of BSE among women were few and pointed to a lack in breast cancer knowledge of females (Downing et al., 2007).
In order to increase BC awareness among women, it is imperative to target school teachers to be a source of campaign on knowledge of cancer symptoms, risk factors, attitude towards BSE, mammography and common misconceptions. About (376) teachers working in girl schools in Imo state were investigated to assess their knowledge about breast cancer risk factors, their attitudes and factors associated with the practice of BSE. The results of the study showed more than half of the women to have limited knowledge level. Among the respondents the most frequently reported risk factors were non-breast feeding and the use of female sex hormones as the possible etiological factors(Austoker et al., 2009).While the effect of school health education program on the knowledge of BC and BSE was investigated in 7663,secondary school students in Abia state. The outcome of the program was found successful in raising the awareness of secondary school girls and in helping them to practice BSE more effectively (El Saghir et al., 2011).Therefore, this study was designed to evaluate the knowledge, attitude and practice of breast cancer screening among female teachers. This study aimed to determine breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria.
1.2 Statement of the Problem
Breast cancer affects women of all races equally, despite the severity and survival rates being widely disparate. Breast cancer is the second leading cause of cancer mortality among women worldwide, behind lung cancer (American Cancer Society, 2008). Breast cancer is also the leading cause of cancer mortality among women in low-and middle-income countries, with 269,000 fatalities (12.7 percent of all cancer deaths) in 2008. (Ferlay et al., 2008; Lancet, 2011). The burden of breast cancer varies by country and location, including differences in incidence, death, and survival rates (Coughlin and Ekwueme, 2009; World Health Organization, 2009). Breast cancer incidence varies widely across the globe, and Africa is no exception (Ojewusi and Arulogun, 2016). Breast cancer is found in 27 percent of cancer cases in North African nations (Algeria and Egypt) and 15 percent of cancer cases in Sub-Saharan Africa (Parkin et al., 2003). Although the exact prevalence of breast cancer is unknown (Boulos et al., 2005), many studies have shown that the illness is becoming more common in various areas of Africa (Onwere et al., 2009; Anyanwu et al., 2011). Breast cancer affects people of all ages, with the chance of developing the disease increasing as they become older (Omotara et al., 2012). And not all women are aware of the causes or symptoms of cancer.
The better health habits one has in adolescence, the better one’s health will be in adulthood. In other words, healthy habits, in particular BSE, may have profound and long-term effects on women’s health (El Saghir et al., 2011). Proper health practices should be developed as early as possible and should lead to the lifetime maintenance of good health. Given that BC is a growing health problem and the knowledge, attitude toward, and practice of BSE should be thought to students by their teachers. In author-conducted searches, no study was found that measured the breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria. Therefore, the present study aims to examine the level of breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria.
1.3 Objectives of the Study
The purpose of this study was to examine the breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria.
Specially, this study sought to:
- Assess the knowledge level of female teachers towards the risk factors associated with breast cancer.
- Ascertain the attitudes of female school teachers towards breast cancer.
- Ascertain female school teachers practices towards prevention of breast cancer.
1.4 Research Questions
The following research questions were formulated to guide this study:
- What is the knowledge level of female teachers towards the risk factors associated with breast cancer?
- What is the attitudes of female school teachers towards breast cancer?
- What are female school teachers practices towards prevention of breast cancer?
1.5 Research hypothesis
- Ho: The knowledge level of female teachers towards the risk factors associated with breast cancer is high.
- Ha: The knowledge level of female teachers towards the risk factors associated with breast cancer is low.
1.6 Significance of the Study
Breast cancer continues to spread despite intense preventative measures and broad public knowledge, presenting a public health issue. This research is important because it highlights breast cancer awareness and prevention among women, demonstrating the gap and assisting all interested parties in determining how to raise breast cancer awareness among women. As a consequence, the study will be helpful in providing breast cancer information. Policymakers and health-related groups may use this as a starting point for developing initiatives.
1.7 Scope of the Study
The research focused on breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria. Hence, the study will be delimited to some selected secondary schools teachers in Enugu South LGA, Nigeria.
1.8 Limitations of the Study
Limitation This review, like any other review article, is subject to bias, such as author bias, gaps in literature research that may lead to omission of relevant research, errors in data translation from primary literature to review summarization, and misrepresentation or misinterpretation of original data sources. By carefully analyzing the original data before examining the review items, efforts were taken to reduce the impact of these possible sources of bias. We were able to evaluate and enhance the review articles because of our knowledge of the topic. We’ve narrowed our search to only include articles published in English. Second, rather than clinical examination and mammography, the focus of this study is on breast self-examination practice.
1.9 Definition of Terms
Breast Cancer:
Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer.
1.10 Organization of the Studies
The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.
Chapter Five
Summary, Conclusions and Recommendations:
5.1 Introduction
This chapter summarizes the findings on breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was to examine breast cancer: knowledge, attitude and practice of female school teachers in Enugu, Nigeria. The study was specifically carried out to assess the knowledge level of female teachers towards the risk factors associated with breast cancer, ascertain the attitudes of female school teachers towards breast cancer, and ascertain female school teachers practices towards prevention of breast cancer.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 50 responses were validated from the enrolled participants where all respondent were some selected secondary schools teachers in Enugu South LGA, Nigeria.
5.3 Conclusions
Based on the findings of this study, the researcher concluded that;
- The knowledge level of female teachers towards the risk factors associated with breast cancer is low.
- Female school teachers has a negative attitudes towards breast cancer?
- Female school teachers practices towards prevention of breast cancer includes: avoid birth control pills particularly after age 35, maintain a healthy weight and be physically active, get screening tests regularly, and avoid hormone therapy for menopause.
5.4 Recommendations
Based on the findings of the study, the following recommendations are proffered.
- There is need of an intensive breast cancer awareness campaign which should also stress the importance of early detection and reporting is evident keeping in view the current status of breast cancer knowledge.
- Women must be taught self breast examination and mammogram to identify the breast cancer earlier
- The techniques of BSE should not only be taught, it should be demonstrated using the model of the breast. Women should be allowed to practice.
- Women need to be reminded and encouraged to perform BSE which should be done as routinely such as monthly. The nurse can also play advocacy role between the government and the people. They should encourage a sponsored periodic community sensitization and awareness activities by the local health authority on the general health of the women including breast awareness. Media programme including jingles which is presented in language that can be easily understood by people could also be used to provide necessary information.

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