Early Detection of Breast Cancer by Self-Examination: The Influence of Perceived Barriers and Health Conception
Purpose/Objectives: To discover the factors that influence the decision to perform breast self-examination (BSE).
Design: Quantitative, correlational.
Setting: Institutional; urban and suburban.
Sample: A nonrandomized convenience sample of 93 women.
Methods: Willing participants were asked to complete by mail a short demographic form, the Reduced Laffrey's Health Conception Scale, Champion's Health Belief Instrument, and a BSE questionnaire.
Main Research Variables: Health conception, barriers to BSE, frequency and thoroughness of BSE practice.
Findings: A wellness conception of health and frequency were not significantly related, nor did a significant relationship exist between a wellness conception of health and thoroughness of BSE. A negative relationship between barriers and thoroughness was highly significant. A statistically significant relationship did not exist between barriers and frequency of BSE.
Conclusions: Those with a clinical conception of health practiced BSE less frequently. If health is viewed as the absence of disease, BSE may be perceived as looking for trouble. Subjects with greater barriers were less thorough when they practiced BSE. The specific barriers tested in this study (i.e., feelings about practicing BSE, worry about breast cancer, embarrassment, time, unpleasantness of procedure, lack of privacy) interfered more with the thoroughness of the behavior than with the frequency of the behavior. The most reported barrier was worry about breast cancer. The data suggest that worry may interfere with performing BSE thoroughly.
Implications for Nursing: This work offers insight into the thoughts and behavior of women to promote a behavior that could save their lives. Potential implications for nursing practice could include issues related to better education and assessment of barriers to practicing BSE in women.
Jump to a section
References
American Cancer Society. (1978). Facts on breast cancer. New York: Author.
American Cancer Society. (2002). Cancer statistics. CA: A Cancer Journal for Clinicians, 52, 10.
Bouchard, L. (1992). The relationship among eudaimonistic conception of health, internal locus of control, hope and health promoting lifestyle in women with breast cancer. Unpublished doctoral dissertation, New York University.
Champion, V.L. (1984). Instrument development for Health Belief Model constructs. Advances in Nursing Science, 8(4), 73-85.
Champion, V.L. (1985). Use of the Health Belief Model in determining frequency of breast self-examination. Research in Nursing and Health, 8, 373-379.
Champion, V.L. (1987). The relationship of breast self-examination to Health Belief Model variables. Research in Nursing and Health, 10, 375-382.
Champion, V.L. (1992). Relationship of age to factors influencing breast self-examination practice. Health Care for Women International, 13, 1-9.
Champion, V.L. (1993). Instrument refinement for breast cancer screening behaviors. Nursing Research, 42, 139-143.
Frank-Stromborg, M., Pender, N., Walker, S., & Sechrist, K. (1990). Determinants of health-promoting lifestyles in ambulatory cancer patients. Social Science Medicine, 31, 1159-1168.
Frauman, A.C., & Nettles-Carlson, B. (1991). Predictors of health promoting lifestyle among well adult clients in a nursing practice. Journal of the American Academy of Nurse Practitioners, 1, 174-179.
Gehrke, A.W. (2000). Breast self-examination: A mixed message. Journal of the National Cancer Institute, 92, 1120-1121.
Jemal, A., Thomas, A., Murray, T., & Thun, M. (2002). Cancer statistics. CA: A Cancer Journal for Clinicians, 52, 23-45.
Kerr, M. (1994). Factors related to Mexican-American workers' use of hearing protection. (Doctoral dissertation, University of Michigan, 1994). Dissertation Abstracts International, 55(8B), 3238-3381. (UMI No. 9501083)
Laffrey, S.C. (1986). Development of health conception scale. Research in Nursing and Health, 9, 107-113.
Lashley, M.E. (1987). Predictors of breast self-examination practice among elderly women. Advances in Nursing Science, 9(4), 25-34.
Lierman, L.M., Young, H.M., Kasprzyk, D., & Benoliel, J.Q. (1990). Predicting breast self-examination using the theory of reasoned action. Nursing Research, 39, 97-101.
National Cancer Insitute. (1981). Questions and answers about breast lumps (Publication No. 82-2401). Bethesda, MD: U.S. Department of Health and Human Services.
Nekhlyudov, L., & Fletcher, S. (2001). Is it time to stop teaching breast self-examination? Canadian Medical Association Journal, 164, 1851-1852.
Pender, N. (1987). Health promotion in nursing practice (2nd ed.). Norwalk, CT: Appleton and Lange.
Pender, N. (1996). Health promotion in nursing practice (3rd ed.). Stamford, CT: Appleton and Lange.
Pender, N., Walker, S., Sechrist, R., & Frank-Stromborg, M. (1990). Predicting health-promoting lifestyles in the workplace. Nursing Research, 39, 326-332.
Rosenstock, I.M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2, 328-385.
Salazar, M. (1994). Breast self-examination beliefs: A descriptive study. Public Health Nursing, 11(1), 49-56.
Susan G. Komen Breast Cancer Foundation. (2000). Mammography: Size of tumors found by mammography and breast self-exam. Item No. 806-304 8/00. Dallas, TX: Author.
Trotta, P. (1980). Breast self-examination: Factors influencing compliance. Oncology Nursing Forum, 7(3), 3-17.
Wyper, M. (1990). Breast self-examination and the Health Belief Model. Research in Nursing and Health, 13, 421-428.