KNOWLEDGE, ATTITUDE AND PRACTICE OF BREAST SELF-EXAMINATION AMONG WOMEN OF CHILDBEARING AGE

1.1 Introduction

Breast self-examination is the practice whereby female of reproductive age examine their breasts regularly to identify any abnormality, swollen breast or lumps to seek immediate medical attention. Predictive factors are those factors that can be used to determine whether a person is likely to take an action in a given situation (Ahmed, 2005). The predictive factors of breast screening may be seen in various contexts: educational, economic, socio- cultural, demographic and physical (Osubor et al., 2006). The increase of breast cancer incidence and late presentation has risen four times for about four decades. Breast Cancer is a common women terminal disease across the world and in every culture with more than 4.7million new cases reported annually (Adetifa & Ojikutu, 2009). Identifying predictive factors of breast self examination will be of help in motivating women to practice breast examination thereby enhancing early detection of breast cancer and reducing mortality from breast cancer (Oluwatosin, 2010).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

Breast cancer was and continues to be among the most prevalent and growing malignant diseases among Iranian women in the past four months. Breast cancer is a disease that involves the patient, family, and community, and wastes many financial and spiritual resources. This cancer is developed in breast tissues including ducts (tiny tubes that carry the milk) and lobules (milk-producing glands). Breast cancer is not gender- specific, but rarely develops in men. Although the exact cause of breast cancer is unknown, specific risk-factors have been identified. Different types of cancer have different risk factors. Some of these risk factors such as cigarette-smoking, alcohol use, and diet can be changed and depend on life style. However, other factors like age, race, gender, and family history are fixed and unchangeable. Having one or more of these risk factors does not necessarily mean infliction.

Despite the growing campaigns on breast cancer awareness in Nigeria generally and Southeast particularly (Okobia, Bunker, Okonofua, et al., 2006), the rates of its spread tend to grow while the practice of required remedial practices continue to vary widely among women. Most of the rural women are either unaware of the cancer, have poor knowledge of breast cancer, or exhibit poor preventive and curative practices (Akpo, 2010; Makanguola, Amoo, Ajibade, et al., 2003). Consequently, civil society organizations, and relevant agencies in the Southeast Nigeria embarked on multiple media programmes using different radio channels, televisions, newspapers, and social media to create awareness of the cancer, its preventive and curative behaviours or measures. This paper investigates the phenomenon in Southeast with a view to the level and nature of awareness therein, and the associated influence on the health behaviour of women.

Although many of these risk factors increase the chance of breast cancer development and progress, its exact mechanism is not clear. It seems that hormone plays a very important role in some types of breast cancer; however, its development and progress mechanisms are not very clear. In general, it can be said that such factors as aging, history of breast cancer development in family, certain changes in breasts, genetic changes, history of productivity and menopause, lack of physical activity, alcohol-use, diet and nutrition, race, and radiation therapy to chest are risk factors of breast cancer.

This disease affects different physical, mental, and social aspects of women life. On the other hand, such factors as social and family supports during the illness can reduce its negative impacts.

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Practice of Breast Self Examination among Women of Childbearing Age.

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1.3 Statement of Problems

Investigation revealed that despite health education efforts to enlighten women on breast health awareness including the awareness of different screening methods available, the increasing incidence of breast cancer and late presentation at an advanced stage are still challenges to health care professionals.

To date, little research has been done regarding the impact of awareness programs in breast cancer control in Nigeria and even less at the community level in rural areas. Hence there is need to assess the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women.

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1.4 Aim and Objectives of Study

The aim of the study is to scrutinize the Knowledge, Attitude and Practice of Breast Self Examination among Women of Childbearing Age. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess the level of knowledge and practice of breast self-examination among women of reproductive age.
2. To identify the relationships between socio-demographic variables (age, educational level) and level of breast self-examination knowledge.
3. To investigate the practice of breast self-examination among women of reproductive age.
4. To determine the women of reproductive age attitude towards breast self-examination in the area under study.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the level of knowledge and practice of breast self-examination among women of reproductive age?
• What are the relationships between socio-demographic variables (age, educational level) and level of breast self-examination knowledge?
• What is the practice of breast self-examination among women of reproductive age?
• What are the women of reproductive age attitude towards breast self-examination in the area under study?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: Knowledge of breast self-examination and breast symptoms is not a predictor of utilization of breast screening services among women of reproductive age.
• H1: Knowledge of breast self-examination and breast symptoms is a predictor of utilization of breast screening services among women of reproductive age.

Hypothesis Two

• H0: There is no significant relationship between socio-demographic variables (age, educational level) and level of breast self-examination knowledge.
• H1: There is a significant relationship between socio-demographic variables (age, educational level) and level of breast self-examination knowledge.

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1.7 Significance of Study

The study will enable relevant agencies concerned with eradicating breast cancer in Nigeria in general to appraise the cancer media campaign, its contents, and framework for possible modification. The finding is expected to provide information to health care providers that will shape their education and awareness programmes on breast cancer.

It shall identify the problems limiting the success of the media campaign. The information obtained from this study may be of help to other researchers interested in working in this field as it will serve as a reference material for further research.

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1.8 Scope of Study

The study focuses on the Knowledge, Attitude and Practice of Breast Self Examination among Women of Childbearing Age in Warri-South Local Government Area, Delta State.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Definition of Terms

Breast self-examination: it is a process whereby female of reproductive age examine their breasts regularly to detect any abnormal swelling or lumps to seek prompt medical attention.