Teaching Breast Self-examination Research Articles

Breast Self-Examination, Correlates and Predictors of its Attitude among Ghanaian Undergraduate Health Trainees – A Follow up Report.

Breast Cancer (BC) is fast becoming a public health concern in resource deprived settings. Breast self-examination (BSE) is an inexpensive BC preventive method. There is paucity in BSE knowledge, attitude and performance (KAP) and correlates research evidence in health trainee undergraduates in Ghana. The purpose of this study is to examine Breast Self-Examination, Correlates and Predictors of its Attitude among Ghanaian Undergraduate Health Trainees. The study used a mixed method approach among 336 purposively sampled health trainee students. The study revealed that, majority (80.6%) of the female SPs ever practiced BSE, but only 38.3% performed routine monthly checks as recommended and a male minority (36.7%) had ever practised BSE. The study also found a significant positive (r = 0.282, p = 0.000) and very weak insignificant positive correlation (p = 0.041, p = 0.041) between their attitude towards BSE and health LOC on one hand and with their SWL scores respectively. The study recommends a restructuring of curricular of health trainee courses to prioritize BSE as the best BC preventive measure in resource deprived settings. Also many more males must be allowed participation in BSE KAP advocacy, education and research as important stakeholders. Moreover, BSE education must focus on regular routine performance for both males and females. Finally, health professionals as determinants of breast health (LOC) must be factored into BSE education.

Breast Self-Examination, Correlates and Predictors of its Attitude among Ghanaian Undergraduate Health Trainees – A Follow up Report.

Breast Cancer (BC) is fast becoming a public health concern in resource deprived settings. Breast self-examination (BSE) is an inexpensive BC preventive method. There is paucity in BSE knowledge, attitude and performance (KAP) and correlates research evidence in health trainee undergraduates in Ghana. The purpose of this study is to examine Breast Self-Examination, Correlates and Predictors of its Attitude among Ghanaian Undergraduate Health Trainees. The study used a mixed method approach among 336 purposively sampled health trainee students. The study revealed that, majority (80.6%) of the female SPs ever practiced BSE, but only 38.3% performed routine monthly checks as recommended and a male minority (36.7%) had ever practised BSE. The study also found a significant positive (r = 0.282, p = 0.000) and very weak insignificant positive correlation (p = 0.041, p = 0.041) between their attitude towards BSE and health LOC on one hand and with their SWL scores respectively. The study recommends a restructuring of curricular of health trainee courses to prioritize BSE as the best BC preventive measure in resource deprived settings. Also many more males must be allowed participation in BSE KAP advocacy, education and research as important stakeholders. Moreover, BSE education must focus on regular routine performance for both males and females. Finally, health professionals as determinants of breast health (LOC) must be factored into BSE education.

Knowledge and practice of breast self-examination among nursing staff in Bangalore

Breast cancer has emerged as a major public health problem and early detection helps in bringing down the burden. Even thoughMammography is the best choice for screening, it is expensive and requires skilled personnel. Breast Self-Examination (BSE) is important in early detection and for mass awareness especially in resource poor countries. Nurses and midwives constitute major contributors in delivering health care and education and if these are empowered and trained they can convince women to perform BSE. Various studies conducted on nurses BSE practice show that the nurses are generally ineffective practitioners of BSE and that their frequency of BSE teaching is low.To assess the knowledge and practice of effective BSE among female nurses. A descriptive cross sectional study was conducted among 90 female nurses working in a tertiary care hospital. A self-administered questionnaire was used to assess the knowledge and practice of BSE. Written consent was taken from the participants. Data was collected on the socio demographic information, knowledge and practice of BSE. Data was analysed using SPSS version 16.: 55.6% of the nurses said that BSE should be performed once in 6 months, 18.9% felt that it should be performed monthly. 42.2% of the nurses said that BSE has no relation to menstrual cycle. 86.7% of nurses said that BSE should be performed in standing up position and the first source of information was BSE awareness programmes. 75.6% nurses practiced BSE but only 33.3% were effectively practicing BSE. 50% of the nurses said that they were confident in performing BSE. The major reasons for practicing were, early detection has a great value and fear of Breast cancer. Themajor reasons for not practicing BSE were, afraid I will find something 54.5%.The study indicates that nurses had inadequate knowledge about BSE. Practice of BSE was high but very few practiced it effectively.

Health beliefs, behaviour and determining factors in breast self – examination among a group of university students

Objectives: Breast cancer is the most frequent malignancy in both Turkey and the World. Breast self-examination (BSE) is the cheapestand the easiest method for early detection. According to Turkey’s Ministry of Health, 65.1 percent of women have never performedBSE. Only 10.1 percent of women perform BSE monthly. The purpose of this study was to examine health beliefs, behaviour anddetermining factors in BSE among a group of university students.Materials and Methods: This cross-sectional analytical study was carried out with 15,940 female university students in 2016. Samplesize was 912. The research data was collected using a self-report questionnaire form and the adapted Turkish version of Champion’sHealth Belief Model Scale (CHBMS).Results: Ten point four percent of students (n=91) reported that they performed BSE monthly. Monthly BSE rates were higher in thestudents who were educated about BSE, who knew BSE timing and technique, who had been performed clinical breast examinationand whose confidence subscale of CHBMS was higher.Conclusion: In conclusion, health education programs should include BSE education in high schools and universities. Also, theseeducation programs should include all women and relate to the confidence subscale of CHBMS.

Primary and secondary prevention of breast cancer in China: a scoping review

BackgroundBreast cancer is the most commonly diagnosed cancer in women in China, with an annual incidence of 41·32 per 100 000 women. The total expense of cancer treatment in China was estimated to be 221·4 billion RMB. This scoping review summarises the current process of breast cancer primary and secondary prevention and identifies how China can improve prevention. MethodsWe identified articles from MEDLINE, Embase, CINAHL, and Web of Science, published in English between Jan 1, 1990 and Sept 25, 2018. Key search terms were breast cancer AND (primary prevention OR secondary prevention) AND China. We used WHO's definition for primary and secondary preventions and study population should be women 18 years or older. We excluded study protocols, abstracts, and studies focused on lifestyle interventions not directly concerning breast cancer. We assessed the quality of evidence using appraisal tools depending on the study design (including Cochrane risk of bias tool and risk of bias in non-randomised studies of interventions). We analysed breast cancer knowledge, attitudes, and practice and education interventions. FindingsOur search yielded 1967 articles and 16 eligible studies, which are cross-sectional (n=6), diagnostic (n=2), randomised control trial (RCT; n=4), cohort (n=2), mathematical modelling (n=1), and review (n=1). All six cross-sectional studies were relevant regarding women's knowledge, attitude, or practice. 86·3% of urban women aged 35–69 years old were reported to be knowledgeable of breast cancer by a cross-sectional study (n=1200), whereas this proportion was only 18·6% among women aged 25–70 years old in another cross-sectional study (n=122 058). The most common reason (24·8–58% of cases) for not attending breast cancer screening was absence of any symptoms. 24·0–26·5% women had received previous mammogram; 17·5–23·0% women have been imaged with ultrasound; and 21·7–43·6% women have received any form of breast cancer screening. Four studies reported on the effect of education programmes. One cohort study reported that breast cancer education interventions increased mammogram screening participation from 10·3% to 72·6% (p<0·001). One RCT showed that education programmes increased breast cancer knowledge from 20·4% to 62·8% (p<0·01); and one that education programmes increased frequency of breast self-examination from 9% to 34% (p<0·001). However, one RCT in the 1990s found that breast self-examination education itself does not reduce breast cancer mortality. InterpretationLimited number of primary and secondary interventions have been identified in China. Chinese women are still poorly aware of breast cancer and have low screening participation. FundingNone.

The effect of peer education on health beliefs about breast cancer screening

The aim of this study was to evaluate the effect of peer education about breast cancer screening on the health beliefs of female university students. The breast self-examination method is an effective technique that is also simple and inexpensive. In recent years, besides the classic methods of providing education on breast self-examination, it has been observed that the use of the technique of peer education is increasing and more and more studies are being conducted on this method and its effectiveness. This study is of quasiexperimental design using a single group, pretest/post-test model. The study was conducted with 742 university first-year students. The data for the study were collected using a Sociodemographic Questionnaire, the Breast Cancer Knowledge Questionnaire, Peer Education Satisfaction Questionnaire and Champion's Health Belief Model Scale. It was found that the students' perception of barriers to performing the breast self-examinationhad declined and their self-efficacy had increased, and that the level of perceived barriers to having a mammogram had decreased and 98% of the students were satisfied with the peer education. It was seen in this study that the level of knowledge of the students about breast cancer, perceived severity, barriers, benefits and self-efficacy as well as the rate of performing BSE displayed a significant increase after the peer education programme. The method of peer education may be utilized in the effort to increase young women's awareness about breast cancer and ensure that they learn about breast self-examinations. The peer education model can be useful in providing breast self-examination education to young people in school. The results of the present study may be beneficial in developing policies on health education on university campuses.

Integration of breast cancer prevention and early detection into cancer palliative care model.

BackgroundBreast cancer is common among Ghanaian women. Late stage presentation has been credited to knowledge deficit and lack of breast cancer prevention and early detection services for women.ObjectiveThis study aimed to develop a model to facilitate the integration of breast cancer prevention and early detection into cancer palliative careMethodThis study used synthesized concepts emerging from a single case study research. The case was a tertiary health care facility, embedded with sub-units of analysis. Mixed-method approach was used to collect data from 102 participants. The study examined the experiences and views of the participants on breast cancer and screening pathways in Ghana. Thematic analysis and descriptive statistics ware used to analyze the qualitative and quantitative data respectively. This was followed with a cross-case analysis across the sub-units of analysis. A theory development approach was further used towards the development of a model, following three steps: concept analysis, statement synthesis and theory synthesis.ResultsSix key concepts synthesized from the data were used to develop the model: initiate and sustain breast cancer prevention and early detection program, collaboration of health professionals, patients, families and micro-communities, conducive environment of the health care facility and needed resources, actions, services, and lastly diffusing innovation into the community through agents.ConclusionA model has been developed based on the experiences shared by women diagnosed with advanced breast cancer, their first degree relatives, micro-communities as well as clinicians working in a palliative care setting. This model will aid clinicians to provide breast cancer education, teach breast self-examination and offer clinical breast examination to families and micro-communities of advanced breast cancer patients receiving supportive care in a resource-limited setting.

The Impact of Female Students' Breast Self-Examination training on their Mothers' Awareness

Background & aim: Breast cancer is the most common cancer in women, which its early diagnosis is of paramount importance for the prevention of its associated mortality and morbidity. Breast self-examination (BSE) is one of the methods for the early detection of breast cancer. Education plays an important role in increasing BSE practice. Regarding this, the present study was conducted to measure the impact of BSE training to female students on their mothers’ awareness. Methods: This quasi-experimental study was conducted on 100 university students and their mothers in Sari, Iran, in 2015. After educating the students about BSE, they were asked to train their mothers in this regard. The data were collected before and one month after training, using demographic, BSE attitude assessment, and BSE questionnaires. Data analysis was performed in SPSS software (version 17) using descriptive statistics, Chi-square test, t-test, and Fisher's exact test. Results: The results of the independent t-test revealed a significant difference between the two groups in terms of knowledge at the post-training stage (P=0.000). Furthermore, the two groups had significant mean differences in the knowledge scores obtained before and after the training (p <0.001). Also, the intervention group showed a significant difference in their knowledge scores at the post-training stage, compared to that at the pre-training phase (P=0.000). However, regarding the control group, this variable was not significantly different between the two stages (P=0.29). Conclusion: As the findings indicated, BSE education could positively affect mother’s knowledge in this regard. Therefore, it is suggested to use this training method for promoting mothers’ knowledge about BSE.

Comparative Assessment of Knowledge, Attitudes, and Practice of Breast Self-Examination among Female Secondary and Tertiary School Students in Ghana.

Background Breast cancer remains a serious public health problem globally. It is particularly increasing among adolescents and premenopausal women. Breast self-examination (BSE) is the most effective and feasible means of detecting breast cancer early in developing countries. This study aimed at evaluating and comparing knowledge of BSE among secondary and tertiary school students and at revealing their attitudes and practices about BSE. Method This cross-sectional study was conducted among 1036 female secondary and tertiary school students of Kwame Nkrumah University of Science and Technology and Technology Senior High School. Data was obtained using a pretested questionnaire to access sociodemography, knowledge, attitudes, and practice of BSE among the students. Result Most students were within the age of 15–24 years; 90.9% were aware of BSE. A high level of knowledge on BSE was found in 54.5% of the students. Knowledge was significantly higher in tertiary than secondary school students (p=0.002). 24.1% of the students thought BSE could be performed anytime; however only 8.1% of the students performed BSE monthly as recommended, whilst 41.8% had never practiced. Of these, more secondary students had never practiced BSE as compared to the tertiary students. 22.3% indicated they would wait for a change in a detected breast lump before seeking medical attention. 96.3% of the participants agree BSE is a good practice which must be encouraged. Conclusion Teaching of BSE should be intensified beginning at the high school level, emphasizing practice and its benefits for early detection of breast cancer.

Breast self-examination in Greek midwives and midwifery students.

The aim of this study is to assess breast self-examination (BSE) practice in a representative sample of Greek midwives and midwifery students. Breast self-examination (BSE) is infrequent in healthcare professionals, including physicians and nurses. All midwives (n=245) and graduating midwifery students (n=165) who attended a congress of midwives were eligible to participate in the study, and a self-administered, anonymous questionnaire was developed to assess BSE practice. Midwives performed BSE more frequently than students (p<0.001). In addition, 27.0% of students performed BSE less frequently than every year whereas the midwives' rate is 14.0% (p<0.001). The proportion of subjects searching for specific signs of breast cancer during BSE and the BSE technique did not differ between midwives and students. In midwifery students, higher perceived knowledge of breast cancer-related issues was associated with more frequent BSE. Only a minority of Greek midwives and midwifery students practice BSE every month, and therefore implications for nursing management in BSE education should be included in midwifery school curricula to ensure increased BSE frequency, improved BSE accuracy and the promotion of BSE teaching to patients.

Effectiveness of planned teaching intervention on knowledge and practice of breast self-examination among first year midwifery students.

IntroductionThe prevalence of cancer is growing rapidly in all parts of the word and Ethiopia is no exception. Secondary prevention, as simple as monthly breast self-examination, is the best option to tackle the rising of this epidemic. Health awareness programs on screening and early detection are the corner stones to reduce the morbidity and mortality resulting from breast cancer.ObjectiveThe aim of the study is to assess the effectiveness of planned teaching program on knowledge and practice of breast self-examination among first year female midwifery students in Hawassa health Sciences College.Methods and materialsA pre-experimental one group pre-posttest design was used among 61 students who were selected by systematic random sampling technique. Data was collected using structured questionnaire and adapted and approved checklist. Data was entered using Epi-Info and analyzed using SPSS version 20. Pre-and post-intervention results were calculated using paired t-test.ResultsThe mean age of the study participants was 20.13(±2.27) and 77% of the study participants were single. Before the intervention 14(23%) of respondents had information and practiced breast self-examination, only 8(13.1%) performed breast self -examination on a regular monthly basis. The number and percentage of the knowledgeable respondents pre-post intervention is 23(37.7%) and 35(57.4%), respectively. The mean knowledge difference for the pre-post intervention is 0.18±0.695 (P < 0.05). The respondents’ pre- post interventions score of satisfactory practical competency were 10(16.4%) and 43(70.5%), respectively as well. The mean net gain for the pre-post breast self-examination intervention is 0.51± 0.62 (P < 0.001). Both the knowledge and practical competency scores showed highly significant increment after the intervention, showing that the research hypothesis was accepted.Conclusion and recommendationsPlanned teaching intervention on knowledge and Breast self-examination of students has resulted in an increment of both knowledge and the practice of breast self-examination. Teaching breast self-examination with demonstration to all at risk groups as a secondary prevention for breast cancer and large scale studies on heterogeneous groups is important.

Perspective of Saudi women in the Makkah region on breast cancer awareness.

OBJECTIVE:To assess the perspective of Saudi women in the Makkah region on breast cancer awareness and early detection.MATERIALS AND METHODS:A mixed method study was conducted among 25-65 years old healthy Saudi females from Makkah region during the awareness campaign in October 2014. The participants were recruited by personal invitations at the women's places of work and social gatherings. The initial invitations were issued by either the research coordinator or the investigator. All women were asked to complete a short questionnaire on basic knowledge on breast cancer. This was followed by focus group discussions. All interviews were carried out by female breast cancer consultant oncologists. All discussion transcripts were summarized and categorized into main themes; data presented as frequencies and percentages.RESULTS:Forty Saudi females, aged 25-65 years, were included in the study. Nearly 38% of them had never attended any awareness campaign on breast cancer. Only 10% of the participants correctly answered all five basic questions on the risk and early detection of breast cancer; 63% of the women had never been taught breast self-examination. Participants' perception was discussed in five focus groups. Four themes were identified during the discussions: knowledge about breast cancer and screening; resources of breast cancer awareness; social support for access to awareness program; and beliefs on breast cancer and early detection.CONCLUSION:We recommend that strategies on breast cancer awareness in our population should focus on early detection by improving the knowledge and skills of women. These strategies should include programs widely accessible through primary health-care centers and other health-care institutions. In addition, we recommend that physicians and family members should be involved in these programs.

Comparison of Direct and Indirect Methods of Teaching Breast Self-Examination – Influence on Knowledge and Attitudes of Iranian Nursing and Midwifery Personnel

Background:Breast cancer is the most common cancer in women. Monthly breast self-examination (BSE) has been presented as one of the best screening methods available. The aim of this study was to compare effects of both direct and indirect methods of teaching of BSE on knowledge and attitudes of nursing and midwifery personnel.Materials and Methods:The present study was performed on 89 nursing and midwifery personnel in Valiasr hospital of Borujen city. Participants were randomly divided into a direct and an indirect training group. Researcher-designed BSE knowledge and attitude and demographic information questionnaires were used for data collection.Results:Before the education intervention, the mean levels of knowledge and attitude were 9.82±2.79 and 56.5±6.21 in the direct training group and 9.59±2.71 and 54.5±4.51 in the indirect training group; after the intervention, they reached 19.2±0.96 and 62.9±4.21, and 11.0±2.58 and 59.0±3.44, respectively. The difference in the mean levels of knowledge and attitude were significantly higher in the direct training group post intervention (P<0.05).Conclusion:It appears that educational planners and hospital personnel education officials should seek to teach aspects of crucial health behavior to female personnel using cooperative and direct training methods.

The Effect of the Education using the Breast Model on the Female College Students' Knowledge and Techniques of the Self-Examination of the Breasts

Objectives: For the early discovery of breast cancer, it is intended to verify the effects on the knowledge and the technologies after executing the practice education using a breast model for the breast self-examination. Methods/ Statistical analysis: This was a quasi-experimental research with 38 persons in the experimental group and 37 persons in the control group. The breast self-examination education was carried out 60 minutes a day for 6 times in the experimental group. And, to the control group, the written guide to the breast self-examination was provided. Findings: 32 persons (84.2%) of the experimental group and 28 persons (78.7%) of the control group had the plan for an early medical checkup. As there were no statistically significant differences in two groups, the homogeneity was confirmed. Regarding the knowledge on the breast self-examination, the averages were increased 1.92 points in the experimental group and 0.97 points in the control group after intervention. Regarding the technologies of the breast self-examination, the averages were increased 3.65 points in the experimental group and 1.78 points in the control group after intervention. The experimental group was measured higher than the control group. Improvements and applications: It appeared that the practice education improves the knowledge on, and the technologies of, the breast self-examination.

Supporting women with learning disabilities during breast cancer diagnosis in Ireland

As women grow older, they are at increased risk of developing breast cancer. Evidence suggests that more breast examinations are being carried out, yet the low incidence of women with a learning disability attending mammogram examinations is a cause of concern. This article provides an overview of breast cancer and offers possible reasons for this low attendance. It also describes the vital role of the learning disability nurse in supporting a woman who has learning disabilities with breast screening, investigative and diagnostic procedures, and the diagnosis of breast cancer. Recommendations on how to increase the number of women with learning disabilities attending mammogram examinations include preparation beforehand, classes to teach breast self-examination and the awareness of the healthcare professional carrying out the mammogram.

여성 수도자의 유방자가검진 교육 경험에 대한 융합적 연구

본 연구의 목적은 문제 기반 학습(PBL) 및 실습을 융합하여 유방 자가 검진 교육 후 여성수도자들의 경험을 포커스 그룹 인터뷰 연구방법을 이용하여 면담, 확인하고 유방 자가 검진 교육을 문제 기반 학습과 실습을 융합하여 새로운 발전적 방향을 모색하고자 하는데 있다. 여성수도자들은 주 1회, 2시간, 4주간 문제 기반 학습 유방 자가 검진 교육을 받고 3개월 간 유방 자가 검진 실천율을 확인하는 프로그램에 참여한 후 '유방암에 대한 인식', '유방 자가 검진 교육에 대한 인식', '유방 자가 검진 교육 경험', '유방 자가 검진을 위한 문제 기반 학습 및 실습 융합 교육경험'과 '교육 후 변화'의 범주가 도출되었다. 대상자들은 교육 후 지식이 증가하고 새로운 실기능력을 습득한 것에 대체적으로 만족하였으나 규칙적으로 수행하지 못하는 개인적, 환경적 요인을 타나냈다. 또한 교육 전 일관되지 않은 인식과 막연하게 안심하고 있던 태도에서 교육 후 오히려 불안감이 증가되어 관심을 더 가지게 되었음을 나타내 유방암과 유방 자가 검진에 대한 동기가 증가된 것으로 판단되어 긍정적 효과로 파악되었다. 추후 수도자의 요구에 맞는 융합적 유방 자가 검진 교육 프로그램의 개발이 필요하다. Objectives : The purpose of this study was to find a constructive way of the Breast Self-Examination teaching methods, identify experience who religious women participated in breast self-examination. Method : This study is a qualitative study using focus group interview method. Women religious took Breast Self-Examination program based on Problem Based Learning procedure. Results : Major Four Themes were derived. 'Breast cancer awareness', 'Breast Self Examination awareness', 'Convergence of PBL and practice on BSE experience', 'Change after convergent BSE education'. Conclusion : Women religious who have risk factors for breast cancer, want to improve the irregularities and to raising skills of BSE for self healthcare ability through convergent BSE education program for women religious.

Abstract SS1-1: Breast cancer early detection strategies in absence of screening mammography

Abstract In spite of the current controversy surrounding over-diagnosis, mammography remains the gold standard for breast cancer screening in the developed world. However, mammography is not suitable technology for low-income countries because of its high cost and the sophisticated infrastructure that is needed to realize its effectiveness. Breast self examination (BSE) may appear to be an appropriate screening procedure; however, randomized trials in the erstwhile Soviet Union and China have produced negative results largely because of non-compliance. Clinical breast examination (CBE) is also an attractive option for low-income countries. Robust evidence of effectiveness of CBE from randomized trials of head-to-head comparison of CBE with no screening is lacking. Indirect evidence from the Canadian NBSS suggests that, in women aged 50 – 59, mammography adds little to mortality reduction over and above that achieved by CBE alone. A randomized trial in Mumbai is underway comparing CBE + BSE teaching with no screening and the results are expected in 2016. Thus, at the present time, direct evidence is lacking to recommend CBE as a screening procedure in low-income countries. The incidence of breast cancer, although rising, remains substantially lower in low-income countries than that in the developed world. For example, in India, the crude incidence rate is 18.45 per 100,000 compared to 157.1 in the US. Low incidence rates raise serious questions about cost-effectiveness of screening. Lack of adequate and easily accessible breast cancer treatment facilities and that of reliable cancer registries are other barriers to screening in these countries. Lack of awareness about hazards of breast cancer is another major challenge since this leads to low motivation and poor compliance to screening. A high degree of compliance is essential at every level of screening for it to be successful. These include compliance to the screening test, attendance at the referral center for further investigations, compliance to the prescribed treatment if cancer is confirmed, completing the entire course of treatment which can be prolonged and attendance at regular follow-up. Although the Mumbai study recorded &amp;gt;70% compliance overall, this was achieved at a high man-power cost. Nearly 100 full-time personnel had to be engaged to make door-to-door visits on multiple occasions to persuade women to comply with the various steps of screening in addition to examining 75,000 women every two years and maintaining yearly surveillance on the control group. The study highlighted that for screening to be successful in low-awareness countries, a vertical programme is essential. A rough estimate based on the Mumbai experience suggests that a vertical programme to screen all women aged 35 – 64 in India, and to achieve ∼70% compliance, would require over US$ 100 million per year in man-power cost alone. Whether this money is better spent on strengthening breast cancer treatment facilities, for developing human resource in cancer care or for remedying the many deficiencies in the health-care delivery system in general is the moot question. Citation Format: Mitra I. Breast cancer early detection strategies in absence of screening mammography. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr SS1-1.

A new strategy in nursing education: From hybrid simulation to clinical practice

Various instructional environments are used in nurse education to develop students' psychomotor and communication skills, reduce their anxiety levels, and enhance their satisfaction. To examine the effect of three different instructional environments on the development of the students' psychomotor and communication skills and their levels of anxiety and satisfaction. A prospective study design was used. The study sample consisted of 60 nursing students. Before the implementation of the study, the students' cognitive skills and trait anxiety levels were evaluated. The students were divided into five groups and five nursing activities (Leopold's maneuvers, teaching breastfeeding, family planning education, teaching vulvar self-examination and teaching breast self-examination) were specified for each group. They implemented these nursing activities under the supervision of a faculty member in the nursing skills laboratory (NSL), standardized patient laboratory (SPL) and clinical practice environment (CPE) respectively. In each instructional environment, the students' psychomotor and communication skills, state anxiety levels and satisfactions were evaluated. The median scores for psychomotor skills [NSL=73.1;SPL=81.5;CPE=88.6] and communication skills [NSL=64.9;SPL=71.6;CPE=79.0] were found to increase as the students went on practicing in a more complicated environment (p<0.05). Similarly, it was determined that the students' anxiety levels decreased as they were practicing incrementally [NSL=33.0;SPL=32.0;CPE=31.0]. As the instructional environments were getting more similar to the reality, the students' satisfaction levels were found to become higher. Students who deliberately practice in the instructional environments until they are competent develop their psychomotor skills while reducing their anxiety levels, and enhancing their communication skills and satisfaction. For that reason, the development of students' competency areas is thought to be effective for enhancement of patients and health care workers' safety.

Influence of educational level on knowledge and practice of breast self-examination among women in Sokoto, Nigeria

Background: Breast cancer is the leading cause of cancer death among women worldwide. Breast self‑examination (BSE) remains the most effective means of early detection of breast cancer among women in middle‑ and low‑income countries where mammography is neither available nor affordable. Aim: This study explored the influence of educational level on knowledge and practice of BSE among women in Sokoto, Nigeria. Subjects and Methods: A quantitative cross‑sectional design was employed using structured questionnaire. A sample of 400 participants was selected for the study using multistage sampling technique among educated women in Sokoto. Statistical Package for Social Sciences (SPSS version 20.0, IBM Corp, New York) was used for data analysis. Chi‑square was used to establish significant relationships. Results: Findings showed that 75% (294/392) of women had average knowledge of BSE, but only 34.4% (135/392) practiced BSE regularly. Moreover, there was a significant relationship between educational level and the knowledge and practice of BSE. Conclusion: Findings of this study suggest that though women may have knowledge about BSE, the practice of BSE is sporadic.Therefore, there is a need for health care practitioners to provide women with BSE education and emphasize on the need for regular practice of BSE. KEY WORDS: Breast cancer, breast self‑examination, educational level, knowledge, practice

Healthcare Professionals' Perceptions and Knowledge of the USPSTF Guidelines on Breast Self-Examination.

In 2009, the US Preventive Services Task Force (USPSTF) published revised guidelines for breast cancer screening, which recommended against teaching breast self-examination (BSE). The objective of this study was to assess providers' perceptions and knowledge regarding these updated guidelines. A cross-sectional survey study was administered to 205 attending and resident physicians, nurse practitioners, physician's assistants, and registered nurses working in five medical and gynecological practices affiliated with a large academic teaching hospital in western Massachusetts. The survey solicited demographic data and inquired about practitioners' perceptions and knowledge of the revised guidelines. Fewer than half (41.1%) of respondents correctly identified the new USPSTF guidelines for BSE. Among those who stated they were aware of guidelines, only 37.1% adhered to them. Overall, 70% report that they teach patients to perform BSE. Teaching BSE was associated with female sex (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.11-6.29), a belief that BSE reduces morbidity and mortality (OR 2.91, 95% CI 1.08-7.81), and internal medicine residency (OR 0.18, 95% CI 0.06-0.59). Knowledge of the 2009 USPSTF guidelines is suboptimal and greater efforts should be made to educate healthcare professionals about them.