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“A STUDY TO ASSESS THE EFFECTIVENESSS OF VIDEO TEACHING
PROGRAMME ON KNOWLEDGE REGARDING BREAST SELF
EXAMINATION AMONG POST MENOPAUSAL
WOMEN IN SELECTED AREA
OF RAICHUR”
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
JISHA PHILIP
NAVODAYA COLLEGE OF NURSING, RAICHUR
MAY- 2012
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1. Name of the candidate
:
Mrs. Jisha Philip
M.Sc Nursing 1st Year
Navodaya College Of Nursing
Manthralayam Road,
Raichur-584103
2. Name of the Institution
: Navodaya College Of Nursing,
Raichur
3. Course of study and
: M.sc Nursing 1st Year
Subject
4.
Medical Surgical Nursing
Date of admission
:
20-10-2011
5. Title of the Topic :
“ A STUDY TO ASSESS THE EFFECTIVENESS OF VIDEO TEACHING
PROGRAMME ON KNOWLEDGE REGARDING BREAST SELF
EXAMINATION AMONG POST MENOPAUSAL
WOMEN IN SELECTED AREA
OF RAICHUR”
6. BRIEF RESUME OF THE STUDY
“An Ounce Of preventiOn is better thAn A pOund Of cAre”
6.1 NEED FOR THE STUDY
Breast cancer is the uncontrolled growth of breast cells. The term breast
cancer refers to a malignant tumor that has developed from cells in the breast .1
Cancers originating from ducts are known as ductal carcinomas; those originating
from lobules are known as lobular carcinomas. Breast cancer is a disease of
humans and other mammals; while the overwhelming the majority of cases in
humans are women.2
The primary risk factors of breast cancers are female sex, age, lack f child
bearing or breast feeding, higher hormone levels, race, economic status, life style,
genetics etc.2 early menarche and (<12 years)and older age of menopause (>55
years) may increase a women’s risk of breast cancer by increase life time exposure
to reproductive hormones produced by her body. Post menopausal women with
high level of endogenous hormone (estrogen and testosterone) have about twice
risk of developing breast cancer compared to women with lowest level.3
Breast Self Examination (BSE) is a screening method used in an attempt to
detect early breast cancer. The method involves the women herself looking at and
feeling each breast for possible lumps or swelling. Breast cancer is one of the
important public health problem and studies have reported that awareness and
practice of breast examination is an important method of prevention. Breast self
examination is a cost effective method of early detection of cancer of the breast,
recommended by American Cancer Society and the National Cancer Institute.4
Several studies based on the breast cancer patient’s retrospective self reports
on their practice of the examination have established that a positive association
exists between performance of the examination and early detection of breast
cancer. There is evidence that most of the breast tumors are self discovered and the
majority of early self discoveries are by BSE performers. Medical advances have
shown that one third if diagnosed sufficiently early is potentially curable. This
observation demands that cancer control should be of increasingly priority in
health care program of developing countries.5
Breast cancer is the most common cause of cancer related death among
women worldwide. It appears to be the disease of both the developing and
developed countries. According to American Cancer Society, about 1.3 million
women will be diagnosed with breast cancer annually worldwide ,about 4,65,00
will be die from the disease .The life time probability of developing breast cancer
in developing countries is s about 4.8 percent and in developing countries is about
1.8 percent.3
Uttar Pradesh recorded the highest number of breast cancer deaths among states in
2010 -- 8,882 -- followed by Maharashtra (5,064), Bihar (4,518), West Bengal
(4,095), Andhra Pradesh (3,863), Madhya Pradesh (3,179) and Rajasthan
(3,097).Gujarat recorded 2,632 deaths, Kerala 1,618, Haryana 1,118 and Orissa
1,885.Delhi recorded an estimated 810 deaths due to breast cancer in 2010
compared to 779 in 2009 and 749 in 2008.When it comes to states recording low
breast cancer mortality rate, Lakshadweep recorded the lowest with three deaths
followed by Andaman and Nicobar Islands with 19 deaths. The north-eastern states
also showed low levels of breast cancer deaths. Sikkim recorded 30 deaths,
Mizoram 49 and Arunachal an estimated 63 deaths.6
The mean age of occurrence is about 42 in India as compared to 53 in the
white women. There is a rapid increase in the incidence between the age 35-50
years and a secondary rise after 65 years of age. With such a situation, the survival
rate goes down to as low as 0-25 percent whereas, when early lesion are operated,
the survival rate improves to almost 95 percent in addition to good cosmetic
results.
Despite an increase in knowledge about breast cancer, relatively low percentage
of women practice BSE regularly and competently. Each women’s breast cancer
risk may be higher or lower, depending upon several factors including family
history, genetics, age of menstruation and other factors that have not yet been
identified.7
Potentially important strategy in reducing breast cancer mortality in the use of
screening to achieve earlier detection of cancer. This is very important because an
excellent prognosis is directly associated with the stage at which the tumor is
detected and how localized lesion is. It is here that the task of spreading awareness
of prevalence of this cancer and advising women on understanding self breast
examination comes into picture.8
Health officials must try and talk about this condition so that women have a
look into their own health. It is estimated that only 25-30 percent of women
performs BSE proficiently and regularly each month. Women who performs BSE
and detect a change may delay seeking medical attention because of fear, economic
factors, lack of education, and modesty. Despite these factors, many women can
discover their own breast cancer3. Hence the Investigator felt the need to assess the
effectiveness of video teaching on knowledge regarding BSE among post
menopausal women.
6.2 REVIEW OF LITERATURE
A review of literature on the research topic makes the researcher
familiar with the existing studies and provides knowledge. It creates accurate
picture of the information found on the subjects. It is the reading and organization
of previously written material relevant to the specific problems to be investigated,
frame work and method to appropriate to perform the study.9
1.Studies related to video teaching on Breast self Examination
A community based descriptive study was conducted with employers in
private sector office of Delhi. A total of 106 women participated in the study. They
were trained in the technique of breast self examination on the help of video and
demonstration of BSE on breast model. The aim of the study was to identify the
barriers to do breast self examination every month. By using the short text
message(SMS) the feedback they got, as the barriers to do BSE were due to that
they forgot(54%),busy(47%),anxiety(12%),pain in the breast(4%).The study
suggested that after two months of reminding the samples, the practice of BSE
increased significantly.10
A comparative study was conducted in Iran, on the effectiveness of video
teaching and individual instruction on BSE in various health services center. The
sample size of the study was 120. Questionnaire were prepared to assess the
effectiveness of the intervention. The results showed that the pre test scores
indicated that majority had no information on BSE. But the post test score showed
an increase in the level of knowledge. The study suggested that the video teaching
for the performance of BSE was effective.11
A study was conducted in Lord shell health center in Southampton, to
evaluate the effectiveness of teaching materials on BSE in primary care settings.
The sample size was 495 women over 16 years of age. The materials used in the
study were leaflet and tape/slide program. The study design was 2x2 factorial
design. Questionnaire was used to assess the effectiveness. Four different
experimental conditions evaluated were No leaflet or tape, leaflet only, tape /slide
program, leaflet and tape/slide program. Results showed that the combined method
of leaflet and tape/slide program was more effective than other teaching materials.1
2. Studies related to breast self Examination
A study was conducted in Chennai to assess the effectiveness of structured
teaching program on BSE for early detection of breast cancer among nursing
assistant students. The sample size of the study was 60.The too, used were
structured questionnaire, likert scale and an observational checklist, used to
measure the knowledge, attitude, and practice of BSE. The study concluded that in
relation to effectiveness of structured teaching program, majority of them had
adequate knowledge on breast cancer and breast self examination. The study
revealed that 78.33 per cent had moderately favorable attitude and 82.67 per cent
had good practice on breast self examination.13
A study was conducted in New York to examine the relationship among
breast cancer risk, knowledge, general cancer belief and breast self examination
practice and to determine the predictors of breast self examination practice among
Chinese women in New York. Study offers a descriptive approach that makes use
of correlation cross-sectional survey. Five significant predictors are related to
breast self examination practice are result of study findings were age,
acculturation, private insurance status, legal status, and length of stay in NewYork.
Findings showed that women who have regular practice of BSE most likely
belonged to older generation as compared with young person.14
A cross sectional study was conducted in Turkey, to determine level of
knowledge about breast cancer and to evaluate health belief concerning the model
that promotes BSE and mammography. The sample size of the was 244 women
aged between 20-64 years. The tool used were questionnaire, consisted of socio
demographic variables, risk factors and signs of breast cancer and adapted version
of Champions Health Model Scale. The study revealed that only 56 percent of
them had sufficient knowledge on breast cancer. Level of breast cancer knowledge
was the only variable significantly associated with the Breast self Examination
and mammography practice.BSE performers among the study group were more
likely to be women who exhibited higher confidence and perceived greater benefits
from BSE practice.15
A study was conducted in Jordan to investigate factors and beliefs that may
be related to practice of BSE among a group of Jordanian women. A total of 519
samples were selected from two major Universities in Jordan by using a stratified
random sampling. The study result indicated that although the majority sample
population (67 per cent)had heard or read about BSE. The study concluded that
benefits, susceptibility and motivation influenced the performance of BSE.16
A study was conducted in Udupi district of Karnataka to determine of
structured teaching program on the prevention of breast cancer among women of a
selected village. The sample was 50 women aged 30 -60 years. The data was
obtained using structured knowledge questionnaire and an observational checklist
on the performance of breast self examination. Majority (62 per cent) had
knowledge that breast cancer is not curable. The teaching program was found to be
effective in increasing the knowledge of women an prevention of breast cancer and
ability to perform BSE. There was a significant correlation between the knowledge
and ability to perform Breast self examination.17
6.3 STATEMENT OF THE PROBLEM
“A STUDY TO ASSESS THE EFFECTIVENESS OF VIDEO TEACHING
PROGRAMME ON KNOWLEDGE REGARDING BREAST
SELF EXAMINATION AMONG POST MENOPAUSAL WOMEN IN SELECTED
AREA OF RAICHUR”
6.4 OBJECTIVES OF THE STUDY
 To assess the existing knowledge regarding Breast Self Examination among
post menopausal women.
 To evaluate the effectiveness of video teaching programme on Breast Self
Examination among post menopausal women.
 To determine the association between post test knowledge score regarding
Breast Self Examination among post menopausal women with selected socio
demographic variables.
6.5
OPERATIONAL DEFINITIONS
1. Effectiveness: A significant gain in knowledge regarding Breast self
Examination as determined by significant difference in pre test and post
test knowledge score.
2. Video teaching programme: It refers to systematically planned
teaching programme designed to provide information regarding Breast
self Examination by using video.
3. Breast Self Examination: It is a process whereby women examine their
breasts to detect any abnormality, swelling or lumps in order to seek any
prompt medical attention.
4. Post menopausal women: It refers to women who are in the period of
permanent cessation of menstrual cycle, aged between 45-60 years .
6.6 HYPOTHESES
On the basis of objectives of the study, the following hypothesis have
been formulated.
H1 : The post test knowledge score will be significantly higher than pre
test knowledge score among post menopausal women regarding breast self
examination.
H2: There will be a significant association between post test knowledge
scores on knowledge regarding Breast Self Examination with selected
demographic variables.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
Design:
The research approach adopted for this study is one group pre test and
post test, pre experimental design.
O1 X O2
O1 –pre test on knowledge regarding breast self examination
X- video teaching on breast self examination
O2- post test on knowledge regarding breast self examination
Setting of the study:
The study will be conducted in a selected area of Raichur. Siyathalab,
Ward number 32 is chosen for conducting the study.
Raichur is one of the backward district situated in northern part of
Karnataka. It has an area of 60 sq.km and it consist of 5 towns and 300 villages.
The total population of Raichur is 19,22,773 with 35 revenue wards and 8 election
wards.
Siyathalab is situated at eastern part of Raichur ,it has an area of 786.88
hectors and extends from Gandhi chowk to Gung Circle. It is 12th revenue ward of
Raichur with total population 30,586. The number of women in ward no: 32 is
approximately 13,000and the number of post menopausal women are
approximately 3000
Boundaries of Siyathalab area are,
East - Hyderabad main road
West - Goushala Road
North - Hindi-Urdu medium school
South -Mahabaleshwar chowk to petrol pump road
Population:
The population included in this study are post menopausal women
between 45 -60 years of age who are residing at Siyathalab area of Raichur.
Sample size:
The sample size of this study comprises of 40 post menopausal women
between 45 -60 years of age who are residing at Siyathalab area of Raichur .
Sampling technique:
Convenient sampling technique is used to select the area and simple
random sampling technique is used to select the sample.
CRITERIA FOR SAMPLE SELECTION:
Inclusion criteria:
The study includes post menopausal women who are,





in the age group of 45 – 60years
willing to participate in the study
are available at the time of data collection
residing at Siyathalab area
are able to understand English or Kannada.
Exclusion criteria:
The study excludes who have,
 not attained menopause
 been diagnosed with breast cancer.
SELECTED VARIABLES
The selected variables of the present study are
- Dependent variable ; knowledge regarding Breast Self Examination among
post menopausal women
- Independent variable; effectiveness of video teaching programme on
Breast self Examination
EXTRANEOUS VARIABLES:
1.Age ;it is categorized as,
a. 45-50 years
b. 51-55 years
c. 56-60years
2. Education; it is categorized as
a.
b.
c.
d.
Primary school
High school
PUC/Diploma
Degree and above
3.Family Income; it is categorized as
a. 2000- 3000
b.
3001 - 4000
c. 4001- 5000
d. 5000 and above
4.Religion; it is categorized as
a. Hindu
b. Muslim
c. Christian
5.Occupation; it is categorized as
a.
b.
c.
d.
e.
f.
House wife
coolie
Business
Private employee
Government employee
Others
6.Age at menarche
a. 10-12 years
b. 13-15 years
c. 16 years and above
7.Age at marriage
a. 18-22 years
b. 23-28 years
c. 29 years and above
8.Habits
a.
b.
c.
d.
Alcohol
Tobacco
Smoking
Others
9.Diet
a. vegetarian
b. mixed
10.Age at menopause
a. 40-50 years
b. 51-60 years
11.Source of information
a.
b.
c.
d.
e.
Mass media
Friends
Relatives
Neighbors
Health care professionals
7.2 METHODS OF DATA COLLECTION
Data collection instrument
Data collection is the gathering of information from the samples. The
researcher will develop a structured questionnaire to collect the data. It consists of
two parts,
Part 1 – deals with socio demographic variables.
Part 2 – deals with knowledge items regarding breast self examination.
Data collection method
After obtaining prior permission from concerned authorities and consent from
samples, the Investigator will assess the knowledge of the post menopausal
women regarding BSE by using structured questionnaire. Followed by the
implementation of video teaching programme on breast self examination and the
Investigator will again conduct post test after a gap of 7 days to assess the
knowledge gain by using structured questionnaire.
7.3 PLAN FOR DATA ANALYSIS:
Data analysis is the systematic and synthesis of research data, the testing of
the research hypothesis by using the obtained data. It is planned to analyses and
interpret data with help of descriptive and inferential statistics. The following
methods are planned to analysis the data.
 Frequency and percentage will be used to summarize the sample
characteristics.
 Mean and standard deviation for pre test and post test knowledge on breast
self examination
 Paired ‘t’ test will be used to find out effectiveness of video teaching breast
self examination.
 Chi square test will be used to find out the association between knowledge
regarding breast self examination of post menopausal women with selected
socio demographic variables.
7.4 PROJECTED OUTCOME:
Based on the need of the study, the future researchers can aim on
educating the women regarding awareness of Breast Self Examination in various
settings, which augments their knowledge and facilitates the women to educate
other women.
7.5 DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON PATIENTS OR
OTHER HUMAN OR ANIMALS ? IF SO, DESCRIBE BRIEFLY.
YES, study requires intervention, video teaching program is used to impact
the knowledge regarding BSE among postmenopausal women.
7.6 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM
YOUR INSTITUTION IN CASE OF 7.5?
 Permission will be obtained from the Institutional Ethical Committee,
Navodaya Education Trust, Raichur.
 Permission will be obtained from the Research Committee, Navodaya
college of Nursing.
 Consent will be obtained from all participants.
LIST OF REFERENCES
1. http;//www.breastcancer.org/symptoms/understand_bc/statistics.jsp.
2. http;//www.wikepedia.org/breast cancer
3. American Cancer Society,http;//www.cancer.org/breast cancer.facts
&figures 2011-2012.
4. Potter and Perry, FUNDAMENTALS OF NURSING ,7th edition,
Elsevier Publication, St.Louis Missouri Page no;610-614
5. Dugas, INTRODUCTION TO PATIENT CARE, 4th edition, Saunders
Publications, Philadelphia, Page no;652-654
6. Kounteya Sinha,TNN,The Times Of India “THE BREAST CANCER
CASES ON THE RISE” 2011.
7. D.C Dutta, TEXT BOOK OF GYNECOLOGY, 5th edition, New Central
book agency (p) Ltd, Kolkata, page no;538-541
8. Myles, “TEXT BOOK OF OBSTESRICS, 6th edition,2006,New central
book agency (p)Ltd, Kolkata.
9. BT Basavanthappa “Text Book of Nursing Research” Bangalore, Jaypee
Brothers 1998
10.Khokhar A SMS as a reminder system for making working women from
Delhi, Breast Cancer aware. Asian Par J CANC PREV 2009 apriljune10(2);319-322
11.N.Varz Zadeh, Z.Esmaeli, Journal Of Mazandaran University Of
Medical Sciences 2001,Vol 11,page no;22-26
12.Pubmed Central –The journal of Royal College Of General
Practioners—Journal test>JR Coll Gen Pract> vol 35(281):dec 1985.
13.Shanmukhasundram S. Abstract academy Health meet, 2005, Abstract
No;3105
14.Chen,Wei-Ti,DNSc,RN, Cancer Nursing, Jan/feb 2009, vol 32, page
no;64-72
15.. BMC Public Health http;//www.biomedcentral.com/1471-2458/8/359
16.. Roa by Western Petro, Nustus Sc DRN And Blanche(J Michel DNSc
RN C.N.S) Pubmed.
17.http;//www.pubmed.com.
18. Brunner and suddarth’s “TEXT BOOK OF MEDICAL SURGICAL
NURSING”, Philadelphia Lippincott,10th edition, 2004
9. Signature of the Candidate
:
10. Remarks of the Guide
:
11. Name and Designation of the
Guide
:
Ms. ANNAPOORNA. S
Professor & HOD
Medical & Surgical Nursing
Navodaya College Of Nursing
Raichur
11.2. Signature
:
11.3.Co-guide(if any)
:
11.4 Signature
:
11.5 Head of the department
:
11.6 Signature
:
Ms. ANNAPOORNA.S
Professor & HOD
Medical & Surgical Nursing
Navodaya College Of Nursing
Raichur
12.Remarks of the Chairman And Principal:
12.1.Signature
: