Purpose/Objectives: To examine health beliefs and sociodemographic and breast cancer-related variables influencing breast self-examination (BSE) practice.
Design: Descriptive, cross-sectional.
Setting: Two vocational training centers in Istanbul, Turkey.
Sample: 438 women were selected using a convenience sampling method. Participants had not had breast cancer and were not currently pregnant or breast-feeding. The mean age of participants was 33.51 years (range = 18-67).
Methods: Willing participants were asked to complete a self-administered questionnaire and the Turkish version of Champion's Health Belief Model Scale. The sample was categorized into two groups: performers (i.e., women who performed BSE at least occasionally) and nonperformers (i.e., women who had never performed BSE).
Main Research Variables: Perceived susceptibility to and seriousness of breast cancer, perceived benefits of and barriers to BSE, confidence in the ability to perform BSE, health motivation, and frequency of BSE practice.
Findings: Significant differences between performers and nonperformers correlated to age, marital status, health insurance, regular gynecologic visits, and education about breast cancer and BSE. The mean scores of perceived benefits and confidence were noticeably higher in performers. Stepwise logistic regression analysis yielded three significant predictor variables.
Conclusions: Women who had more confidence in their ability to perform BSE, had health insurance, and were informed about breast cancer were more likely to practice BSE.
Implications for Nursing: Women in Turkey are at great risk for advanced breast cancer and metastatic spread because of their lack of knowledge. Nurses must provide information on breast cancer etiology, risks, prevention, and detection. To promote BSE practice among Turkish women, tailored health education and health promotion programs should be developed based on a specific understanding of women's health beliefs.
Ali, N.S., & Khalil, H.Z. (1996). Cancer prevention and early detection among Egyptians. <i>Cancer Nursing</i>, <b>19</b>, 104-111.
Anderson, B.O., Braun, S., Lim, S., Smith, R.A., Taplin, S., Thomas, D.B., et al. (2003). Early detection of breast cancer in countries with limited resources. <i>Breast Journal</i>, <b>9</b>(2, Suppl.), S51-S59.
Apantaku, L.M. (2000). Breast cancer diagnosis and screening [Electronic version]. <i>American Family Physician</i>, <b>62</b>, 596-602.
Ashton, L., Karnilowicz, W., & Fooks, D. (2001) The incidence and belief structures associated with breast self-examination. <i>Social Behavior and Personality</i>, <b>29</b>, 223-239.
Champion, V., & Menon, U. (1997). Predicting mammography and breast self-examination in African American women. <i>Cancer Nursing</i>, <b>20</b>, 315-322.
Champion, V.L. (1993). Instrument refinement for breast cancer screening behaviors. <i>Nursing Research</i>, <b>42</b>, 139-143.
Champion, V.L. (1999). Revised susceptibility, benefits, and barriers scale for mammography screening. <i>Research in Nursing and Health</i>, <b>22</b>, 341-348.
Champion, V.L. (2003). Breast self-examination: What now? <i>Oncology Nursing Forum</i>, <b>30</b>, 723-724.
Champion, V.L., & Miller, T.K. (1992). Variables related to breast-self examination. <i>Psychology of Women Quarterly</i>, <b>16</b>, 81-96.
Champion, V.L., & Scott, C.R. (1997). Reliability and validity of breast cancer screening belief scales in African American women. <i>Nursing Research</i>, <b>46</b>, 331-337.
Chouliara, Z., Papadioti-Athanasiou, V., Power, K.G., & Swanson, V. (2004). Practice of and attitudes toward breast self-examination (BSE): A cross-cultural comparison between younger women in Scotland and Greece. <i>Health Care Women International</i>, <b>25</b>, 311-333.
Dundar, P.E., Ozmen, D., Ozturk, B., Haspolat, G., Akyildiz, F., Coban, S., et al. (2006). The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey [Electronic version]. <i>BMC Cancer</i>, <b>24</b>(6), 43.
Epstein, S.S., Bertell, R., & Seaman, B. (2001). Dangers and unreliability of mammography: Breast examination is a safe, effective, and practical alternative. <i>International Journal of Health Services</i>, <b>31</b>, 605-615.
Erblich, J., Bovbjerg, D.H., & Valdimarsdottir, H.B. (2000). Psychological distress, health beliefs, and frequency of breast self-examination. <i>Journal of Behavioral Medicine</i>, <b>23</b>, 277-292.
Fish, J., & Wilkinson, S. (2003). Understanding lesbians' healthcare behaviour: The case of breast self-examination. <i>Social Science and Medicine</i>, <b>56</b>, 235-245.
Foxall, M.J., Barron, C.R., & Houfek, J. (1998). Ethnic differences in breast self-examination practice and health beliefs. <i>Journal of Advanced Nursing</i>, <b>27</b>, 419-428.
Fung, S.Y. (1998). Factors associated with breast self-examination behaviour among Chinese women in Hong Kong. <i>Patient Education and Counseling</i>, <b>33</b>, 233-243.
Gasalberti, D. (2002). Early detection of breast cancer by self-examination: The influence of perceived barriers and health conception. <i>Oncology Nursing Forum</i>, <b>29</b>, 1341-1347.
Gozum, S., & Aydin, I. (2004). Validation evidence for Turkish adaptation of Champion's Health Belief Model Scales. <i>Cancer Nursing</i>, <b>27</b>, 491-498.
Green, B.B., & Taplin, S.H. (2003). Breast cancer screening controversies. <i>Journal of the American Board of Family Practice</i>, <b>16</b>, 233-241.
Haydaroglu, A., Dubova, S., Ozsaran, Z., Bolukbasi, Y., Yilmaz, R., Kapkac, M., et al. (2005). Ege Universitesinde meme kanserleri: 3897 olgunun degerlendirilmesi [Breast cancer in Ege University: Evaluation of 3897 cases]. <i>Meme Sagligi Dergisi</i>, <b>1</b>(1), 6-11.
Jarvandi, S., Montazeri, A., Harirchi, I., & Kazemnejad, A. (2002). Beliefs and behaviours of Iranian teachers toward early detection of breast cancer and breast self-examination. <i>Public Health</i>, <b>116</b>, 245-249.
Jirojwong, S., & MacLennan, R. (2003). Health beliefs, perceived self-efficacy, and breast self-examination among Thai migrants in Brisbane. <i>Journal of Advanced Nursing</i>, <b>41</b>, 241-249.
Jirojwong, S., & Manderson, L. (2001). Beliefs and behaviors about Pap and breast self-examination among Thai immigrant women in Brisbane, Australia. <i>Women Health</i>, <b>33</b>(3-4), 47-66.
Karayurt, O., & Dramal, A. (2007). Adaptation of Champion's Health Belief Model Scale for Turkish women and evaluation of the selected variables associated with breast self-examination. [Electronic version]. <i>Cancer Nursing</i>, <b>30</b>, 69-77.
Lechner, L., De Nooijer, J., & De Vries, H. (2004). Breast self-examination: Longitudinal predictors of intention and subsequent behaviour. <i>European Journal of Cancer Prevention</i>, <b>13</b>, 369-376.
Ministry of Health. (1996). Health services utilization in Turkey. Ankara, Turkey: BIGTAS Survey Research Group, Health Project General Coordination Unity.
Ministry of Health. (1999). <i>Türkiye'de kadinlarda en sik görülen on kanser türü</i> [The most frequent ten cancers in females in Turkey]. Retrieved June 4, 2005, from <a target="_blank" href='http://www.saglik.gov.tr/TR/BelgeGoster.aspx?F6E10F8892433CFF71BE64510F6...
Ministry of Health. (2004). <i>Kadinlarda meme kanseri taramalari içLin ulusal standartlar</i> [The national breast cancer screening standards for women]. Retrieved May 22, 2005, from <a target="_blank" href='http://www.saglik.gov.tr/TR/BelgeGoster.aspx?F6E10F8892433CFFA79D6F5E6C1...
Ministry of National Education. (2002). National education at the beginning of 2002: Qualitative development in education. Retrieved February 19, 2007, from <a target="_blank" href='http://www.meb.gov.tr/stats/apk2002ing/apage224-236.htm'>http://www.meb....
Montazeri, A., Haji-Mahmoodi, M., & Jarvandi, S. (2003). Breast self-examination: Do religious beliefs matter? A descriptive study. <i>Journal of Public Health Medicine</i>, <b>25</b>, 154-155.
Norman, P., & Brain, K. (2005). An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer. <i>British Journal of Health Psychology</i>, <b>10</b>(Pt. 1), 1-16.
Ozturk, M., Engin, V.S., & Kisioglu, A.N. (1999). The practice of breast self-examination among women at Gülistan district of Isparta. <i>Eastern Journal of Medicine</i>, <b>4</b>, 47-50.
Petro-Nustus, W., & Mikhail, B.I. (2002). Factors associated with breast self-examination among Jordanian women. <i>Public Health Nursing</i>, <b>19</b>, 263-271.
Rosenstock, I.M. (1966). Why people use health services. <i>Milbank Memorial Fund Quarterly</i>, <b>44</b>, 94-127.
Salazar, M.K. (1994). Breast self-examination beliefs: A descriptive study. <i>Public Health Nursing</i>, <b>11</b>, 49-56.
Secginli, S., & Nahcivan, N.O. (2004). Reliability and validity of the breast cancer screening belief scale among Turkish women. <i>Cancer Nursing</i>, <b>27</b>, 287-294.
Secginli, S., & Nahcivan, N.O. (2006). Factors associated with breast cancer screening behaviours in a sample of Turkish women: A questionnaire survey. <i>International Journal of Nursing Studies</i>, <b>43</b>, 161-171.
Smith, R.A., Caleffi, M., Albert, U.S., Chen, T.H., Duffy, S.W., Franceschi, D., et al. (2006). Breast cancer in limited-resource countries: Early detection and access to care. <i>Breast Journal</i>, <b>12</b>(Suppl. 1), S16-S26.
Smith, R.A., Saslow, D., Sawyer, K.A., Burke, W., Costanza, M.E., Evans, W.P., III, et al. (2003). American Cancer Society guidelines for breast cancer screening: Update 2003. <i>CA: A Cancer Journal for Clinicians</i>, <b>53</b>, 141-169.
Susan G. Komen for the Cure. (2007). Breast self-exam. Retrieved February 22, 2007, from <a target="_blank" href='http://cms.komen.org/komen/AboutBreastCancer/EarlyDetectionScreening/EDS...
Thomas, D.B., Gao, D.L., Ray, R.M., Wang, W.W., Allison, C.J., Chen, F.L., et al. (2002). Randomized trial of breast self-examination in Shanghai: Final results. <i>Journal of the National Cancer Institute</i>, <b>94</b>, 1445-1457.
Umeh, K., & Dmitrakaki, V. (2003). Breast cancer detection in asymptomatic women: Health beliefs implicated in secondary prevention. <i>Journal of Applied Biobehavioral Research</i>, <b>8</b>, 96-115.
Umeh, K., & Rogan-Gibson, J. (2001). Perceptions of threat, benefits, and barriers in breast self-examination amongst young asymptomatic women. <i>British Journal of Health Psychology</i>, <b>6</b> (Part 4), 361-372.
Vietri, V., Poskitt, S., & Slaninka, S.C. (1997). Enhancing breast cancer screening in the university setting. <i>Cancer Nursing</i>, <b>20</b>, 323-329.
Youssef, F.A., & Kawar, L.N. (2003). Early detection measures for cancer in family caregivers of minority women: An educational program. <i>Home Health Care Management and Practice</i>, <b>15</b>, 215-221.
Yucel, A., Degirmenci, B., Acar, M., Ellidokuz, H., Albayrak, R., & Haktanir, A. (2005). Knowledge about breast cancer and mammography in breast cancer screening among women awaiting mammography. <i>Turkish Journal of Medicine Science</i>, <b>35</b>, 35-42.