Breast Cancer; Knowledge, Attitude And Practice Among Female Secondary School Students In Mkpat Enin LGA In Akwa Ibom State

Project and Seminar Material for Public Health

Breast Cancer; Knowledge, Attitude And Practice Among Female Secondary School Students In Mkpat Enin LGA In Akwa Ibom State (Daniel)


Abstract


The study determined the breast cancer; knowledge, attitude and practice among female secondary school students in Mkpat Enin LGA in Akwa Ibom state. The Specific objectives of the study were; to determine the knowledge, to identify the attitude and determining practices of Breast Cancer Prevention Measures Among secondary school students. The study was conducted through a descriptive cross sectional study design qualitative in nature. The findings showed how lack of knowledge among secondary school students has hindered the practice of breast cancer screening they included; failing to do it in the right time, lack of self confidence in their ability to perform breast cancer screening correctly and embarrassment associated with manipulation of the breasts. The findings revealed that the negative attitudes among respondents towards breast cancer screening included; fear of detecting breast cancer and BSE is an embarrassment, some secondary school students thought they did not have any problem in their breasts therefore no need of breast cancer screening. The findings of the study recommended the benefits of the practices among secondary school students included; Diagnosis of breast cancer at an earlier stage, and being an inexpensive method of breast cancer screening.


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 Significance of the Study
  • 1.6 Scope of the Study
  • 1.7 Limitation of the Study
  • 1.8 Definition of Terms
  • 1.9 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

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background to the Study

Breast cancer is a global health concern and a leading cause of morbidity and mortality among women worldwide, posing a significant public health challenge. In Nigeria, as in many other countries, the incidence of breast cancer has been on the rise, warranting increased attention to understanding the knowledge, attitudes, and practices related to breast cancer among different populations. One crucial demographic that requires special consideration is the cohort of female secondary school students. Adolescence is a formative period, and fostering awareness and positive health behaviors during this stage can have a lasting impact on future health outcomes.

The World Health Organization (WHO) emphasizes the importance of health education and awareness programs in reducing the burden of breast cancer (WHO, 2021). Despite these recommendations, there is limited research focusing specifically on the knowledge, attitudes, and practices related to breast cancer among female secondary school students in Nigeria. This study aims to bridge this gap by investigating the current state of awareness, attitudes, and health practices concerning breast cancer within this demographic.

Globally cancer is among the top leading cause of death. It was estimated that 8.8 million people died of cancer in 2015 and prevalence estimates for 2012 show that there were 32.6 million people alive who had had a cancer diagnosed in the previous five years. Approximately 70% of deaths from cancer occur in low- and middle-income countries (WHO 2017). Among women, breast cancer (BC) is the most common cause of mortality accounting for 16% of cancer deaths in adult women (Ferlay et al. 2010).

According to Mary Kaye (2016) “Cancer is a group of diseases that cause cells in the body to change and grow out of control. Most types of cancer cells eventually form a lump or mass called a tumor, and are named after the part of the body where the tumor originates”. Cancer of the breast starts in the breast tissues which are consist of lobules, ducts and glands which are attached to breast nipples and the remaining parts are made up of connective, lymphatic and fatty tissues, (George, 2016). Knowledge and practice to the breast cancer prevention and early detection plays a significant part in decreasing morbidity of the illness.

Breast cancer is the leading cause of cancer related deaths among women worldwide. Diagnosis of breast cancer at an earlier stage allows women more treatment choices and greater chance of long term survival. In a bid to reduce the incidence of mortality from breast cancer there is need for an effective screening program. Empowering all health workers and creating awareness amongst them could go a long way in enhancing the screening program for breast cancer. Prevention or identification of breast cancer at an early stage is of paramount importance in saving lives as well as improving the quality of life. Breast cancer lends itself to early detection and subsequent early treatment if women use early detection measures, (Anderson, 2015). Breast cancer screening is one method of primary level of prevention of breast cancer, which should be adopted by all females started with age of 20 years and above. It does not improve mortality but decreases morbidity.

Understanding the knowledge levels among female secondary school students is essential as it forms the basis for promoting preventive measures and early detection strategies. Attitudes towards breast cancer, including perceived susceptibility and severity, influence health-related behaviors (Champion, 1984). Additionally, examining the practices related to breast health and cancer prevention is crucial for developing targeted interventions that can positively impact the health outcomes of this population.

Screening for early detection and diagnosis of diseases and health conditions is an important public health principle. breast cancer screening is a process whereby women examine their breasts regularly to detect any abnormal swelling or lumps in order to seek prompt medical attention. The procedure though simple, non-invasive and requiring little time, can only be practiced with the right attitude to sustain it and achieve the desired goal, of early diagnosis and treatment before metastasis, which is a prerequisite for better outcome, (Christmas & Nicholas 2015).

Breast cancer is the most common malignancy affecting women, with more than one million cases occurring worldwide annually. In India, it is the second commonest cancer among females.

Though it can be detected early by self and clinical breast examination or mammography, in Uganda only 15% patients present in the localized stage; and 75% regional lymph nodes are already involved while 10% have distant spread at the time of reporting (Rajvir .B 2009).
This is due to lack of awareness and non-existent breast cancer screening programs. Early detection and prompt treatment offer the greatest chance of long term survival and Breast cancer screening (breast cancer screening) seems to be an important viable optional substitute for early detection of cancer (Ertem & Kocer, 2009).Hence by knowing the situation in our community we can plan for awareness Programs involving our medical students, interns and post graduates. The data is also useful for policy makers for planning screening programs.

The available and advisable method for breast cancer screening worldwide are self- breast Examination (SBE), clinical breast examination (CBE) and mammogram. However, in most of developing countries the routine screening mammography are often unavailable (Coughlin & Ekwueme, 2009). Therefore, it is important to empower women on the SBE as a primary tool in screening the breast cancer. American Cancer Society did recommendations on SBE as option breast awareness and for early detection of breast cancer. It was reported that women who practicing SBE regularly were presented more often with clinically early tumors and had shorter patient delay in presentation.
Doctors recommend having physical breast exams every two or three years in your 20s and 40s, and an annual exam if you are 50 years or older; however, self-examination at home can bridge the gap in between check-ins with your ob-gyn.

This research is timely and relevant given the rising incidence of breast cancer in Nigeria and the potential for early education to contribute to its prevention and control. By shedding light on the knowledge, attitudes, and practices of female secondary school students regarding breast cancer, this study aims to provide valuable insights that can inform the development of targeted educational programs and interventions to enhance breast health awareness and promote positive health behaviors within this vulnerable demographic.


1.2 Statement of the Problem

Breast cancer is a significant public health concern globally, and its incidence has been on the rise in Nigeria, making it a pressing issue that requires targeted intervention strategies. Despite the growing awareness of breast cancer, there is a paucity of research specifically addressing the knowledge, attitudes, and practices regarding breast cancer among female secondary school students in Nigeria. This lack of attention is particularly concerning given that adolescence is a critical period for health education and behavior formation.

Studies conducted in other populations suggest that inadequate knowledge about breast cancer may contribute to delayed detection and treatment (Akhtari-Zavare et al., 2015). Furthermore, attitudes and perceptions towards breast cancer influence health-related behaviors, including preventive measures and screening practices (Champion, 1984). The specific challenges and factors influencing the knowledge, attitudes, and practices of female secondary school students in Nigeria regarding breast cancer remain poorly understood.

The limited existing research on breast cancer awareness among adolescents often focuses on high-income countries, and there is a dearth of literature addressing the unique socio-cultural and economic context of Nigeria. Consequently, there is an urgent need to investigate the factors that contribute to the knowledge gap, suboptimal attitudes, and inadequate health practices related to breast cancer among female secondary school students in Nigeria.

Understanding the challenges faced by this specific demographic is crucial for developing effective and culturally sensitive interventions. The lack of targeted research on this topic hinders the development of evidence-based educational programs and preventive strategies that could empower young women to adopt positive health behaviors and contribute to the reduction of breast cancer incidence and mortality..


1.3 Objective of the Study

To determine the breast cancer; knowledge, attitude and practice among female secondary school students in Mkpat Enin LGA In Akwa Ibom State. The specific objective of the study are;

  1. To determine the knowledge on Breast Cancer Measures Among female secondary school students in Mkpat Enin LGA In Akwa Ibom State
  2. To determine the knowledge on Breast Cancer Prevention Measures Among female secondary school students in Mkpat Enin LGA In Akwa Ibom State.
  3. To identify the attitude of Students towards Breast Cancer Prevention Measures in secondary school students in Mkpat Enin LGA In Akwa Ibom State.
  4. To determining practices for proper Breast Cancer Prevention Measures Among female secondary school students.

1.4 Research Questions

  1. What is the knowledge on Breast Cancer Among female secondary school students?
  2. What is the knowledge on Breast Cancer Prevention Measures Among female secondary school students ?
  3. What is the attitude towards Breast Cancer Prevention Measures Among female secondary school students?
  4. What are the practices for proper Breast Cancer Prevention Measures Among female secondary school students?

1.5 Significance of the Study

This study on breast cancer, focusing on the knowledge, attitudes, and practices among female secondary school students in Nigeria, holds considerable significance for several reasons.

Investigating the knowledge, attitudes, and practices related to breast cancer among female secondary school students is critical for developing targeted health promotion and prevention strategies. By understanding the factors influencing their awareness and behaviors, interventions can be designed to promote early detection, healthy lifestyle choices, and breast health.

Adolescence is a crucial period for health education and behavior formation. Providing accurate and culturally sensitive information about breast cancer during this developmental stage can contribute to the establishment of lifelong health-promoting habits. This study can inform the development of educational programs tailored to the specific needs and characteristics of female secondary school students in Nigeria.

Knowledge gaps and misconceptions about breast cancer may contribute to stigma and fear surrounding the disease. Addressing these issues among female secondary school students can help demystify breast cancer, reduce unfounded fears, and foster a positive attitude towards early detection and screening.

Enhancing the knowledge and fostering positive attitudes towards breast health among young women can empower them to take control of their own health. This empowerment is crucial for encouraging proactive health-seeking behaviors and fostering a sense of responsibility for personal well-being.

While breast cancer is a global health concern, research on this topic often lacks representation from diverse populations, including adolescents in low- and middle-income countries like Nigeria. This study contributes valuable data to the global understanding of breast cancer, filling a gap in the literature and offering insights that can inform broader public health initiatives.

The findings of this study can serve as a foundation for the development of policies and programs aimed at improving breast health education in schools. Policymakers can use this information to create evidence-based interventions that target the specific needs of female secondary school students, leading to more effective public health outcomes.

In conclusion, this study has significant implications for promoting breast health awareness, fostering positive attitudes, and influencing health practices among female secondary school students in Nigeria. The outcomes of this research can contribute to the overall effort to reduce the burden of breast cancer and improve the health and well-being of young women in the country..


1.6 Scope of the Study

This is a study on breast cancer, focusing on the knowledge, attitudes, and practices among female secondary school students in Nigeria. The study will be carried out among female secondary school students in Mkpat Enin LGA in Akwa Ibom state. The primary cause of breast cancer will be looked into alongside risk factors after which, suggestions will be provided to female secondary school students in mkpat enin LGA in akwa ibom state both those with breast cancer and those who do not have breast cancer.


1.7 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study..


1.8 Definition of Terms

Cancer:

Is a class of diseases characterized by out of control cell growth. These cells divide uncontrollably to form lumps or masses of tissues.

Breast Cancer:

This is the type of cancer that affects the breast part of women screening: This is the process of detecting cancer in women without signs or symptoms of breast cancer.

Attitude:

A settled way of feeling or thinking about something, typically reflected in a person’s behavior.

Clinical Breast Examination:

Is the physical examination done by a health care provider for example doctor, nurse or other medical staff.

Knowledge:

Facts, information and skills acquired by a person through experience or education.

Metastasis:

A medical term for cancer that spreads to a different part of the body from where it started.

Practices:

Performing an activity regularly in order to improve or maintain ones proficiency.

Self-Breast Examination:

Is a screening method used in an attempt to detect early breast cancer involving a woman her self-looking at and feeling each breast for possible lumps, distortion or swelling.


1.9 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

  • Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
  • Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
  • Chapter three deals on the research design and methodology adopted in the study.
  • Chapter four concentrate on the data collection and analysis and presentation of finding.
  • Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five


Conclusion and Recommendations

5.1 Introduction

This chapter discusses and concludes the findings of the study. An attempt is further made to highlight recommendations.


5.2 Conclusion

The findings showed the reasons why lack of knowledge among female secondary school students in Mkpat Enin LGA in Akwa ibom State has hindered them from practicing breast cancer screening as given by the respondents include; failing to do it in the right time, lack of self confidence in their ability to perform the technique correctly, embarrassment associated with manipulation of the breast, not knowing the procedures to be followed in examination, not knowing the necessity of examining the breasts and lack of information is a barrier to practice of breast cancer screening.

The findings revealed that the negative attitudes among female secondary school students in Mkpat Enin LGA in Akwa ibom State as given by all the respondents include; fear of detecting breast cancer, breast cancer screening is an embarrassment, some women thought they did not have any problem in my breasts, so there is no reason to examine my breasts, breast cancer screening is difficult, and some women perceived they had a low risk of developing breast cancer.

The study found out that the positive attitude among female secondary school students in Mkpat Enin LGA in Akwa ibom State as given by all the respondents include; it helps them to detect cancer at early age, it is a health practice among the women, inexpensive method of breast cancer screening, favors women with cultural attitudes that make them feel uncomfortable to receive information about breast cancer screening by male healthcare personnel and self-examination at home can bridge the gap in between check-ins with medical practitioners.


5.3 Recommendation.

The findings of the study recommended the practices for proper breast cancer screening among female secondary school students in Mkpat Enin LGA in Akwa ibom State include;

  1. Diagnosis of breast cancer at an earlier stage allows women more treatment choices and greater chance of long term survival
  2. Screening for early detection and diagnosis of diseases and health conditions is an important public health principle
  3. Women who examine their breasts should have their technique reviewed by their health care professionals regularly.
  4. The practice of breast cancer screening can help women to know the structure and composition of their normal breast thereby enhancing their sensitivity to detect any abnormality at the earliest time
  5. All female health professionals should adopt such preventive screening procedures and act as role models for the community.
  6. Screening methods for breast cancer should be included in the curricula of all health professionals so as to empower them to take up the challenge of breast cancer detection.

5.4 Nursing Implications

Nurses should always conduct health education talks to sensitize women on the benefits and practices of breast cancer screening for early diagnosis of breast cancer. All nurses should be welcoming, approachable, and non-judgmental in practice.


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