Stages of Changes, Breast Self-Examination Practice and Related Health Beliefs in Women- A Theory-Based Study

Abstract

BACKGROUND Breast self-examination is an important, inexpensive and easy method to detect breast cancer and is recommended monthly for women who are twenty years old and above. This study aimed to investigate the stages of changes, breast self-examination practice and related beliefs in women of Gilan-e Gharb city. MATERIALS AND METHODS The present study was conducted with the participation of 299 literate women of Gilan-e Gharb city in 2015. The data were collected using a questionnaire including demographics, health beliefs and stages of behaviour change and questions related to the breast self-examination. A ten-step checklist was used to measure the accuracy of breast self-examination. The reliability and validity of the instruments were assessed and verified using appropriate methods. The data were analysed by SPSS 19 using the measure of descriptive statistics, T-test, Chi-square, Pearson correlation coefficient and regression. RESULTS The mean age of participants was 32.9 ± 6.1 years. Generally, the distribution of individuals according to the breast self-exam stages was as follows: Pre-contemplation 22.1%, contemplation 25.7%, preparation 22.9%, action 4.3% and maintenance 25%. People who conducted a regular breast self-examination had higher self-efficacy, perceived susceptibility and accuracy scores (p<.005). Stages of change, self-efficacy and perceived barriers were the most important predictors of breast self-exam in this study (p-value= .001). CONCLUSION The results showed that the majority of the participants do not implement regular breast self-examination and has been placed in passive stages of behaviour change. Stages of change, self-efficacy and perceived barriers were the most important predictors of breast self-exam in this study.

The Effect of Model Based Health Education on Performing Breast Self-Examination in Women

“…Various studies have reported different statistics of BSE in Iranian women, including 51% in Dezful (4), 46% in Mazandaran (8), 26% in Hamadan (9), 12.7% in Kerman (10), and 11.8% in Tehran (11). Also a previous study in Gilan-e gharb city -the setting of the present study-showed that Less than 30% of women in the general population have done BSE regularly (12).…”

“…Dependent variables of the study in this questionnaire were perceived susceptibility, severity, benefits, barriers, and selfefficacy related to the BSE. The validity and reliability of the HBM questionnaire related to BSE has been confirmed in Iranian studies (12,17). Validity of SOC questionnaire has been confirmed by the Content Validity Index (S-CVI) as %96, and two-week test-retest reliability of SOC has been reported as 85% (17).…”

“…Self-efficacy refers to individual's beliefs about their capabilities and the ability to organize a behavior and achieve goals (27). Previous study showed that self-efficacy after the stages of change had the highest correlation with BSE (12). Therefore, we used various methods in the intervention to improve self-efficacy of women including observing the behavior of the educator and understanding the feasibility of behavior, verbal encouragement, group support, and behavioral segmentation into smaller parts.…”

“…Face and content validity of Checklist of BSE performing was confirmed by a panel of experts. Also the reliability of data gathering checklist in multiple measurements (by different examiners) was approved (12).…”

“…behavior along with the Health Belief Model is the Stages of Change Model (SOC) which suggest the behavior change occurs in a fivestep including-1) Precontemplation stage: Women don't think about BSE, 2) Contemplation stage: in which women do not perform BSE, but they are thinking about doing it during the next six months, 3) Preparation stage: women do not perform but they are ready to do it in the next 30 days, 4) Action stage: women doing BSE for less than six months, and 5) Maintenance stage: woman did BSE more than 6 months (12). SOC model emphasized that people are not similar in adopting a behavior.…”