None listed
Conditions
Brief summary
Breast cancer is the most common cancer and the second principal cause of cancer deaths among women worldwide as well as in Malaysia. Early detection of breast cancer can play an important role in reducing cancer morbidity and mortality. Mammography and clinical breast examination (CBE) are considered as screening methods for early detection of breast cancer. Practicing breast self-examination (BSE) could provide an opportunity for women to know how their breasts normally feel and notice any changes in their breast. Studies have shown that among younger women breast cancer tend to be more advanced stage and more aggressive than those affecting older women. The objective of this study was to comparing health educational strategies towards breast self-examination practice among female public universities’ students in Klang Valley. A multi-stage random sampling was used for selection of participants. All female students those fulfill the inclusion criteria of the study were invited to participate in the study with informed consent form. A translated, reliable and valid tool adopted from Champion’s Health Belief Model was used to determine women’s perceptions on breast cancer and BSE. Three types of intervention strategies namely knowledge-based, knowledge-based and skill-based and skill-based strategies were implemented for this study. The strategies were supported by educational module, presentation, and demonstration on BSE practice on breast silicon model. The control group received all of the informational material and BSE practice after the completion of the study. To evaluate the effect of the intervention, data were collected at baseline, 6 months and 12 months after intervention in 3 intervention groups and control group. Descriptive and multivariate statistics were used for analysis the data using SPSS version 19.0. Baseline data were collected from 792 female students in four groups. At 12- month follow assessment, data was collected from 183 (92.42%) in intervention group one, 186 (93.93%) in intervention group two, 189 (95.45%) in intervention group three and 184 (94.94%) in control group. The mean age of participants was 22 years with standard deviation 1.20 and majority of them were Malay (728, 91.9%), single (767, 96.8%). After intervention, there was a significant increase in the mean score of knowledge on breast cancer in intervention Group One (knowledge-based) (11.28-12.15, p-value less than or equal to 0.001), intervention Group Two (knowledge-based and skill-based strategy)(11.32-13.09, p-value less than or equal to 0.001) and intervention Group Three (skilled-based strategy)(11.05-11.52, p-value less than or equal to 0.008). Regarding knowledge of BSE, there was a significant increase in the mean score of knowledge BSE in intervention Group One (6.19-7.13, p-value less than or equal to 0.001), intervention Group Two (6.29-7.79, p-value less than or equal to 0.001) and intervention Group Three (6.01-6.70, p-value less than or equal to 0.001). Proportion of BSE practice was increased in intervention Group One (20.2%-21.9%, p-value less than or equal to 0.005), intervention Group Two (23.7%-30.1%, p-value less than or equal to 0.001) and intervention Group Three (18.0%- 24.3%, p-value less than or equal to 0.001), over the twelve months follow up in the intervention groups. Health Belief Model (HBM) constructs significantly differences for susceptibility, confidence and motivation in the intervention groups and control group (p-value less than or equal to 0.05). the logistic regression model showed that change in total knowledge score of breast cancer (OR=1.58), motivation (OR=1.47), susceptibility to breast cancer (OR=1.47) and seriousness of breast cancer (OR=1.28) were predictors of BSE practice after twelve months. The results provide evidence for the effectiveness an educational strategies using a multi-component approaches in improving breast self-examination practice, knowledge of breast cancer and BSE and beliefs within young female students in Malaysia. This study suggests that the three interventions had impacts on knowledge, beliefs and BSE practice but there were no significant differences among them which should lead to recommendation that policy makers should adopt the cheapest and most feasible of the three intervention strategies.
Interventions
Arm1 (knowledge and skill based strategy): used an educational module on breast health awareness which was developed based on American Cancer Society and Clinical Guidelines of Malaysia for breast cancer screening. It compromised of four sections: breast health awareness; normal breast; breast cancer; other screening methods. It delivered to all participate in this group by one-hour lecture which covered all contents of the “educational module on breast health awareness” in the form of slide p
Arm1 (knowledge and skill based strategy): used an educational module on breast health awareness which was developed based on American Cancer Society and Clinical Guidelines of Malaysia for breast cancer screening. It compromised of four sections: breast health awareness; normal breast; breast cancer; other screening methods. It delivered to all participate in this group by one-hour lecture which covered all contents of the “educational module on breast health awareness” in the form of slide presentation. It was presented by the main researcher with background of nursing and four years experience in breast health training. Educational module is followed immediately by the skill based training. This group received another one-hour training on breast silicon model by registered nursing to demonstrate the search strategy (concentric circle or line method) and palpation technique (how the fingers are positioned and press against the skin surface) when examining the breasts. Following the instructor’s demonstration, each student was asked to duplicate the examination on the breast model and asked their questions. Training was continued until the students perform the examination correctly and indicate that she was confident in her ability to do the examination. Arm2 (Knowledge-based strategy): In this strategy researcher used the same educational module which is used in arm 1 (knowledge-based and skill-based strategies). The educational module delivered to all the participants of this group on the day of the workshops. Power-point presentation covering the four sections of this module. It was presented by the main researcher with backgraound of nursing and four years experience in breast bealth training. Arm 3 (Skill-based Strategy): The lab training section included BSE practice on a silicon breast model. This lab training was the same with lab training section on arm 1 (knowledge-based and skill-based strategy).
Sponsors
Universiti Putra Malaysia (School of Graduate Studies)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Malaysian citizen 2. 20 years old and above 3. Female undergraduate students
Exclusion criteria
I. Students who are pregnant and breast feeding II. No Medic or Health Faculties involved III. Students in final semester of their study IV. Students who refused to be involved in study
Outcome results
None listed