Korean J Women Health Nurs.  2010 Jun;16(2):105-115. 10.4069/kjwhn.2010.16.2.105.

The Effects of Breast Self-examination Program Enriched Environmentally among Healthy Women

• Park KY
• Kim SH

• KMID: 2308172
• DOI: http://doi.org/10.4069/kjwhn.2010.16.2.105

Abstract

PURPOSE
The purpose of this study was to determine the effects of an environmental enrichment program on barrier, benefit, confidence, and compliance of breast self-examination in women at 3 months after instruction.
METHODS
Nonequivalent control group pretest-posttest design was conducted among 62 healthy women. Data were collected through the self-reported questionnaires from December 2008 to March 2009. Women were assigned to one of two treatment groups: (a) no-support of environmental enrichment with the instruction control group; (b) the support of environmental enrichment with the instruction experimental group. All women received the same instruction on breast self-examination once a week for two weeks. Data were analyzed with paired t-test, McNemar test and ANCOVAs of controlling for age run using SPSS/WIN 17.0.
RESULTS
The experimental group was significantly lower than control group on perceived barrier (F=5.91, p=.02) and higher than control group on compliance of breast self-examination (F=4.57, p=.04) after environmental enrichment program. However the environmental enrichment program did not make significant differences on benefit (F=0.01, p=.91) and confidence (F=0.77, p=.38).
CONCLUSION
Findings suggest that the environmental enrichment should be needed to support women's breast self-examination and expanded for compliance of breast self-examination to promote the secondary prevention of women breast cancer.

Keyword

Environment; Breast self-examination; Barrier; Confidence; Compliance

MeSH Terms

Breast
Breast Neoplasms
Breast Self-Examination
Compliance
Female
Humans
Surveys and Questionnaires
Secondary Prevention

Figure

• 

  Figure 1 Research design. Exp.=experimental group; Cont.=control group; O1=participants' characteristics, barrier, benefit, confidence, and compliance of breast selfexamination; O2=barrier, benefit, confidence, and compliance of breast self-examination; E1, E2=education on breast self-examination, once a week for 2 weeks; X1=environmental enrichment program.

Reference

1. Bener A., Honein G., Anne O. The determinants of breast cancer screening behavior: A focus group study of women in the United Arab Emirates. Oncology Nursing Forum. 2002. 29(9):E91–E98.

2. Champion V.L., Menon U. Predicting mammography and breast self-examination in African American women. Cancer Nursing. 1997. 20(5):315–322.

3. Choe M.A., Hah Y.S., Kim K.S., Yi M.S., Choi J.A. A study on exercise behavior, exercise environment and social support of middle-aged women. Journal of Korean Academy of Nursing. 2008. 38(1):101–110.

4. Choi K.O. Effectiveness of teaching in accordance with the teaching program types for the breast self-examination. 1996. Seoul: Kyung Hee University;Unpublished doctoral dissertation.

5. Clark V.A., Savage S.A. Breast self-examination training: A brief review. Cancer Nursing. 1999. 22(4):320–326.

6. Cohen M. Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer. Psychooncology. 2006. 15(10):873–883.

7. Dundar P.E., Ozmen D., Oxturk B., Hasploat G., Akyildiz F., Coban S, et al. The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey. BioMed Central Cancer. 2006. 24:6–43.

8. Elmore J.G., Armstrong K., Lehman C.D., Fletcher S.W. Screening for breast cancer. Journal of the American Medical Association. 2005. 293(10):1245–1256.

9. Hur H.K., Park S.M., Kim G.Y. Factors related to the stage of mammography screening in married Korean women. Journal of Korean Academy of Adult Nursing. 2004. 16(1):72–81.

10. Janda M., Stanek C., Newman B., Obermair A., Trimmel M. Impact of videotaped information on frequency and confidence of breast self-examination. Breast Cancer Research Treatment. 2002. 73(1):37–43.

11. Jirojwong S., MacLennan R. Health beliefs, perceived self-efficacy, and breast self-examination among Thai migrantsin Brisbane. Journal of Advanced Nursing. 2003. 41(3):241–249.

12. Common knowledge for breast cancer. Korean Breast Cancer Society. 2009. Retrieved July 17, 2009. from http://www.kbcs.or.kr.

13. Lee E.H., Kim J.S., Song M.S. Translation and validation of Champion's health belief model scale with Korean women. Cancer Nursing. 2002. 25(5):391–395.

14. Lee E.O., Lim N.Y., Park H.A. Nursing·medical research & statistical analysis. 1998. Seoul: Soomoonsa.

15. Lee Y.W., Lee E.H. Predicting factors of breast self-examination among middle-aged women. Journal of Korean Academy of Adult Nursing. 2001. 13(4):551–559.

16. Lierman L.M., Young H.M., Powell-Cope G., Georgiadou F., Benoliel J.Q. Effects of education and support on breast self-examination in older women. Nursing Research. 1994. 43(3):158–163.

17. Ludwick R., Gaczowski T. Breast self exams by teenagers: Outcome of a teaching program. Cancer Nursing. 2001. 24(4):315–319.

18. Malotte C.K., Jarvis B., Fishbein M., Kamb M., Iatesta M., Hoxworth T, et al. Assessing breast self-examination compliance in the natural environment. Journal of Behavioral Medicine. 1986. 9(4):363–371.

19. The analysis of patient with cancer on National Health Insurance (2007). Ministry for Health, Welfare and Family Affairs. 2009. Retrieved March 15, 2009. from http://stat.mw.go.kr.

20. Nahcivan N.O., Secginli S. Health beliefs related to breast self-examination in a sample of Turkish women. Oncology Nursing Forum. 2007. 34(2):425–432.

21. Nekhlyudov L., Fletcher S. Is it time to stop teaching breast self-examination? Canadian Medical Association Journal. 2001. 164(13):1851–1854.

22. Park S.M., Hur H.K., Kim G.Y., Song H.Y. A descriptive study for developing a program to promote compliance with regular breast self-examination (BSE). Korean Journal of Women Health Nursing. 2007. 13(2):88–97.

23. Pender N.J. M.A. Choi I.S Lee . Health promotion in health practice. 1997. Seoul: Hyunmoonsa;(Original work published 1996).

24. Rosenstock I.M., Strecher V.J., Becker M.H. Social learning theory and the health belief model. Health Education Quartely. 1988. 15(2):175–183.

25. Salazar M.K., Carter W.B. Evaluation of breast self examination beliefs using a decision model. Western Journal Nursing Research. 1993. 15:403–421.

26. Seo Y.O. The difference of women's knowledge, attitudes and practice education after education for breast self-examination. Journal of Korean Academy of Adult Nursing. 2003. 15(1):5–13.

27. Stamler L.L., Thomas B., Lafreniere K. Working women identify influences and obstacles to breast health practices. Oncology Nursing Forum. 2000. 27(5):835–842.

28. Tennessen C., Cimprich B. Views to nature: Effectson attention. Journal of Environmental Psychology. 1995. 15:77–85.

29. Thomas B., Stamler L.L., Lafreniere K.D., Delahunt T.D. Breast health educational interventions: Changes in beliefs and practice of working women. Journal of the American Association of the Occupational Health Nurses. 2002. 50(10):460–467.

30. van Praag H., Kempermann G., Gage F.H. Neural consequences of environmental enrichment. Nature Reviews Neuroscience. 2000. 1(3):191–198.

31. Yang Y.H. The effect of BSE education with practice on knowledge, self-efficacy and performance in middle-aged women. Journal of Korean Academy of Fundamentals Nursing. 2007. 14(2):189–197.