Knowledge, And Practice Of Self-Breast Examination Among Staff In AU

Project and Seminar Material for Nursing (Science)

Knowledge, And Practice Of Self-Breast Examination Among Staff In AU

Chapter One


1.1 Background to the Study

Breast cancer is the leading cause of morbidity and mortality in women in most parts of the world, including Iran (Mousavi et al., 2009; Loh and Chew, 2011). According to recent statistics, the average age of breast cancer in Iranian women has been reduced by about 10 years and is between 40 and 30 years old (Fouladi et al., 2011). The incidence rate was 22 per 100,000 population (Mousavi et al., 2013). It is the most common malignancy and the leading cause of cancer mortality in women worldwide, with an estimated 11,314,155 new cases worldwide in 2014 (Ferlay J., 2014). Its spread throughout the world continues to increase, and breast cancer is now considered a growing public health problem in populations of low and middle income countries (LMIC). In a recent population study on cancer survival in Africa, Asia and Central America, African countries found unacceptably low survival rates in Africa, particularly in the Gambia, where the relative survival standardized by age at 5 years was no more than 12 years (Sankaranarayanan et al., 2015).

Breast cancer has been identified throughout the world as one of the leading causes of death worldwide (WHO, 2015). There are more than one million new cases of breast cancer that cause around 875,000 deaths each year and high mortality rates in developing countries (WHO, 2015). In Nigeria, it was reported that breast cancer accounted for 56.6% of all cancer diagnoses between 1995 and 2002 (Okafor, 2014). The burden of the disease has increased and affected women often arrive late to hospitals when they are at an advanced stage. Your healing at this time is seriously in danger; the low survival rate is related to late detection and diagnosis (Ejiro, 2016). Cancer is a disease process that begins when an abnormal cell is transformed by the genetic mutation of cellular deoxyribonulinic acid (DNA) (WHO, 2015: CDC, 2013). Breast cancer is not painful or uncomfortable at an early stage. Usually, it turns out to be a painless breast tumor. There are several risk factors that can affect the susceptibility of any woman to the disease (WHO, 2015).

In addition to poverty, low public awareness about breast cancer is an obstacle to combating breast cancer in LMICs, where women seek late medical help and cancers are often diagnosed in advanced stages when very little can be done with the healing treatment. The Global Breast Health Initiative Forum (BHGI) has recommended utiization strategies to optimize breast cancer management in LMICs in terms of health care systems, breast cancer diagnosis, treatment and early detection. Efforts should be made to improve the population’s awareness for early detection. Civil society, represented by non-governmental organizations (NGOs), can play an important role in the fight against breast cancer (Azenha G, 2013).

In Asia, staging is still poor in women, the majority of women (72%) were diagnosed with a 2-cm tumor and 63% had lymph node involvement at the time of diagnosis (Mousavi et al. , 2009, Fouladi) et al. al., 2011). The social and cultural perception of breast cancer in Iran is the most important contribution to further development of the presentation. Early detection of breast cancer plays an important role in reducing morbidity and mortality. In Nigeria, 2,062 new cases of breast cancer and 1,137 deaths from breast cancer were estimated each year (16.5% of all cancer deaths in women), with an incidence by age and mortality rates of 25.8 and 15.2 per 100,000 women, respectively (Globocan, 2012). 60% of the cases were detected in late stages (IIB, III and IV). The available data on the average age are limited and mainly on a hospital basis. Clegg-Lamptey et al. (2016) reported a mean age at diagnosis of 43 years in a sample of 66 women newly diagnosed with breast cancer. The age range was between 20 and 84 years (Clegg-Lamptey, 2013). Surgery is still the main form of breast cancer treatment in the country and, like in other African countries; it is surrounded by some cultural beliefs and mysticism (Clegg-Lamptey, 2013). Breast self-examination (BSE), clinical breast examination and mammography are recommended for the early detection of breast cancer (Ersin and Bahar, 2013, Yilmaz et al., 2013). There are discussions about the efficacy of routine BSE in the early detection of breast cancer (Giridhara et al., 2011). BSE continues to be an important screening tool for the early detection of breast cancer in developing countries, as it is cheap, widespread and does not require complex technical training (Giridhara et al., 2011). In general, the practice of BSE allows a woman to become familiar with her normal breast structure and help detect unusual changes in her breast tissue (Smith et al., 2015).

1.2 Statement of Problem

Despite the relative benefits of BSE, its application remains low (Canbulat and Uzun, 2008). A study of 550 women in Turkey showed that less than half of the samples gave BSE, but only 16% experienced BSE each month (Yurdakos and Gulhan, 2013). Similar results were found among Malaysian women, who showed only 36.7% of BSE practices. A recent study found that a young woman from Malaysia did not know how to perform BSE (Akhtari-Zavare et al., 2011). Studies have shown sociodemographic characteristics and knowledge of breast cancer is linked to the practice of BSE (Giridhara et al., 2011, Yurdakos and Gulhan, 2013).

It is now a well-accepted fact that awareness and early detection can curb the growing burden of the disease and is the first step in the struggle against the BC. However, there are only a few studies that examine the various factors responsible for BC’s lack of knowledge in India. The main recognized detection methods include mammography, clinical breast examination (CBE) and breast self-examination (BSE). With respect to BSE, the American Cancer Society and other leading cancer agencies have recommended monthly BSE in women, and we have found that BSE in our studies is strongly associated with early presentation. Early diagnosis allows women more treatment options and, consequently, a better chance of survival and a better quality of life (Clegg-Lamptey, 2013).

The purpose of the current study is to assess the knowledge, and practice of self -breast examination among staff in AU. Understanding the women’s knowledge related to breast cancer and BSE practices will help health care professionals to choose more effective health education programmes and potentially to increase women’s screening practices.

1.3 Objectives of the Study

The broad objective of this study is to investigate the knowledge, and practice of self-breast examination among staff in AU.

However, this study specifically seeks to;

  1. Determine the knowledge of breast self-examination (BSE) among staff in AU
  2. Assess breast self-examination practice among staff in AU
  3. Determine the factors affecting practice of breast self-examination and measures to promote healthy behaviors among staff in AU

1.4 Research questions

The following questions will guide the study based on the problem identified and the research objectives;

  1. What is the level of knowledge of breast self-examination (BSE) among staff in AU?
  2. What is the breast self-examination practice among staff in AU?
  3. What are the factors affecting practice of breast self-examination and measures to promote healthy behaviors among staff in AU?

1.5 Hypothesis

  • HO1: There is no significant relationship between knowledge, and practice of self-breast examination among staff in AU
  • HA1: There is a significant relationship between knowledge, and practice of self-breast examination among staff in AU

1.6 Significance of the Study

The findings of this study will bridge the research and knowledge gap through the information provided that would be found useful for policy developers and administrators. The study shows the prevalence of breast cancer screening among female employees of Madonna University Teaching Hospital, especially through breast self examination. The Health institutions can use the results of this study as a basis for developing new strategies for mobilization and creation of awareness and sensitization for female workers and females generally on the need for breast self examination, as well as aid in the utiization of effective intervention and control measures to that regard. The public can also use the information to educate themselves on dangers of breast cancer and the benefits of early detection via constant breast self examination and employ the appropriate strategies to create awareness that would cause a change in behavior and eventually promote healthy behavior.

1.7 Scope of study

This study has its main focus on to investigating the knowledge, and practice of self-breast examination among staff in AU. Only staff in AU will be focused on in this study.

1.8 Limitation of the Study

In the course of this study, the researcher encountered some limitations. There was unwillingness of respondents to fill the questionnaires. Some of the copies questionnaires were also reported missing and it was severally replaced and this affected the researcher negatively finance wise. Also, the researcher faced time constraints and had to combine the research with other academic activities and coursework. Lastly, the researcher made use of staff in AUsince all the organizations could not be exhausted.

1.9 Definition of Terms

Breast Cancer:

Refers to a condition that starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body.

Breast Self-Examination (BSE):

Refers to a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.


These are male and female populations working in an organization. In this study, it refers to all workers in AU.

1.10 Organization of the Study

This study is organized into five chapters. Chapter one included the background of the study, research problem, research objectives and questions as well as limitation of the study. Chapter two contains the literature review. Chapter three includes the methodology. Chapter Four contains the results and discussion of key findings of the study. Chapter Five finally looks at the summary, conclusions, and recommendations based on the findings.


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Knowledge, And Practice Of Self-Breast Examination Among Staff In AU


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