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Fulltext Recognising symptoms of breast cancer as a reason for delayed presentation in Asian women--the psycho-socio-cultural model for breast symptom appraisal: opportunities for intervention

Taib NA, Yip CH, Low WY

Asian Pac J Cancer Prev, 2011;12(6):1601-8.
PMID: 22126506

INTRODUCTION: Advanced presentation of breast cancer and the problem of late diagnosis is well documented. Patient delay beyond three months has been shown to reduce survival. This paper aims to explore the experience of Malaysian women presenting with advanced breast cancer with regards to their interpretation of breast symptoms.

METHOD: Purposive sampling of 19 breast cancer patients presenting with delayed treatment and/ or advanced cancer diagnosed within two years at the University Malaya Medical Centre, Kuala Lumpur were carried out. In-depth interviews were conducted using a self-devised interview guide. The interview guide covered the journey of the patient from discovering of symptoms to their present state. The audiotaped interviews were transcribed verbatim. NVivo 8 qualitative software was utilised for data management. Grounded theory with thematic analysis was utilised.

RESULTS: Nine women delayed seeking diagnosis although recognizing the symptom, five did not recognize symptom, three delayed treatment and two did not delay health attention. Themes that emerged with regards to triggering help seeking behavior were: a) poor symptom knowledge and recognition; b) importance of knowledge of the disease and its' outcomes; c) role of coping mechanisms and affect; and lastly d) role of significant others in appraising a breast symptom.

CONCLUSION: Symptom recognition remains an important public health issue in Malaysia. Educating women, their significant others and primary health and primary care providers in detecting early staged breast cancer are needed. Supporting and sanctioning women with breast symptoms are important. The psycho-social-cultural model of symptom appraisal may serve as an important addition to the fight against cancer in countries that do not have the resources for population based screening mammogram programmes.

Matched MeSH terms: Breast Self-Examination
Awareness of Breast Cancer among Surgical Patients in a Tertiary Hospital in Malaysia

Kirubakaran R, Chee Jia T, Mahamad Aris N

Asian Pac J Cancer Prev, 2017 01 01;18(1):115-120.
PMID: 28240018

Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in
Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to
assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine
their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated selfadministered
questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of
September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear
regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD)
age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge,
risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean
total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination
and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards
breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process.
Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of
breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16.
Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast
cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus,
there is a need for more awareness programs to educate women about breast cancer and promote its early detection.

Matched MeSH terms: Breast Self-Examination
Fulltext Breast cancer awareness of rural women in Malaysia: is it the same as in the cities?

Norlaili AA, Fatihah MA, Daliana NF, Maznah D

Asian Pac J Cancer Prev, 2013;14(12):7161-4.
PMID: 24460269

Breast cancer is the most common cancer among women globally. This study was conducted to compare the awareness of breast cancer and the practice of breast self-examination (BSE), clinical breast examination (CBE) and mammography screening among rural females in Pahang and Perak. A cross-sectional study was carried out in five selected rural districts of Pahang and Perak. Two hundred and fifty households were randomly selected and interviewed face to face using a semi-structured questionnaire. The majority of residents from both states were Malay, aged between 50 and 60 years and had a secondary level of education. Malay women aged 40-49 years and women with a higher level of education were significantly more aware of breast cancer (p<0.05). About half of these women practiced BSE (60.7%) and CBE (56.1%), and 7% had underwent mammography screening. The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer and that more than half practice BSE and CBE. The women's level of education appears to contribute to their level of knowledge and health behaviour. However, more effort is needed to encourage all women in rural areas to acquire further knowledge on breast cancer.

Matched MeSH terms: Breast Self-Examination/statistics & numerical data*
Meta-synthesis exploring barriers to health seeking behaviour among Malaysian breast cancer patients

Yu FQ, Murugiah MK, Khan AH, Mehmood T

Asian Pac J Cancer Prev, 2015;16(1):145-52.
PMID: 25640342

Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta- synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

Matched MeSH terms: Breast Self-Examination/psychology
Fulltext Health risk factors and health promoting behaviour among medical and non-medical students

Norhaini, M., Norazlanshah, H., Khairil Anuar, M.I., Fazlyla Nadya, M.F., Mashita, M., Mohamad, G.M.

Malaysian Journal of Public Health Medicine, 2014;14(2):1-11.
MyJurnal

Students in tertiary level education are mostly young adults that are transiting from the teenage years to adulthood. Since there is less restriction as compared to their teenage years, university and college students might involve in risky behaviours that may affect their health, social and academic performance. Thus, the purpose of this study is to investigate and identify the differences of health risk factors and health promoting behaviour that have been practiced by students in Malaysia. A cross sectional study was conducted using closed-ended questionnaires distributed to university and college students via emails. The results showed that 77.0% students claimed they have no health problem. However 49.0% of the non-medical students did not know whether they have normal BMI. Among the medical students, 62.0% rarely do physical exercise even though most are seriously concern about their fat consumption (95.0%). Only 30.0% of the total students have awareness of wearing seat belt. For health promoting behaviour, 33.0% of female students have never perform breast self examination (BSE), while 65.0% of male students have never perform testicular self examination (TSE). These findings confirmed that there are differences in health risk factors and health promoting behaviour that have been practiced by the students.

Matched MeSH terms: Breast Self-Examination
Fulltext Association between breast self-examination knowledge level and practice among the Chinese female students of a private university in Kajang

Raadshini Vejayakumar, Jagjit Kaur Najar Singh, Thavamalar Paramasivam, Lim Pek Hong, Fong Ka Ling, Mohammed Abdul Razzaq Jabbar

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):25-0.
MyJurnal

Introduction: The incidence of breast cancer is high among Malaysian females especially those aged 25-59 years old and from Chinese ethnic background.Breast Self-Examination (BSE) is a traditional, cost-free screening method to identify breast abnormalities likegrowth and cancer. If performed correctly and consistently, it can facilitate early detection, early treatment and better prognosis. Despite having high risk, there is insufficient evidence about the BSE knowledge level and practiceamong Malaysian Chinese females. This research determines the association between BSE knowledge level, practice and selected socio-demographic variables among the Chinese female students of a private university in Kajang. Methods: Quantitative, correlation study was conducted among 192 Chinese female students in a private university. Purposive sampling method was utilized to recruit participants. Data were collected using self-administered questionnaire and analysed in terms of frequency and percentage. Chi-Square test was used for inferential analysis with significance level, p, set at

Matched MeSH terms: Breast Self-Examination
Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer

Ghazali SM, Othman Z, Cheong KC, Hock LK, Wan Mahiyuddin WR, Kamaluddin MA, et al.

Asian Pac J Cancer Prev, 2013;14(2):1141-5.
PMID: 23621202

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.

Matched MeSH terms: Breast Self-Examination/methods*
Fulltext Breast Self-Examination System Using Multifaceted Trustworthiness: Observational Study

Khana R, Mahinderjit Singh M, Damanhoori F, Mustaffa N

JMIR Med Inform, 2020 Sep 23;8(9):e21584.
PMID: 32965225 DOI: 10.2196/21584

BACKGROUND: Breast cancer is the leading cause of mortality among women worldwide. However, female patients often feel reluctant and embarrassed about meeting physicians in person to discuss their intimate body parts, and prefer to use social media for such interactions. Indeed, the number of patients and physicians interacting and seeking information related to breast cancer on social media has been growing. However, a physician may behave inappropriately on social media by sharing a patient's personal medical data excessively with colleagues or the public. Such an act would reduce the physician's trustworthiness from the patient's perspective. The multifaceted trust model is currently most commonly used for investigating social media interactions, which facilitates its enhanced adoption in the context of breast self-examination. The characteristics of the multifaceted trust model go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. Thus, in this study, we explored and evaluated use of the multifaceted trust model for breast self-examination as a more suitable trust model for patient-physician social media interactions in breast cancer screening.
OBJECTIVE: The objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians.
METHODS: We used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum.
RESULTS: Based on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (Pbreast self-examination system. Evaluation of trustworthiness indicators helps to ensure a trustworthy system and ethical interaction between a patient and physician. A new patient can obtain a consultation by referring to the best physician according to preference of other patients. Patients can also trust a physician based on another patient's recommendation regarding the physician's trust level. The correlation analysis further showed that the most preferred trustworthiness indicator is honesty.

Matched MeSH terms: Breast Self-Examination
Fulltext Reliability and validity of Champion's Health Belief Model Scale for breast cancer screening among Malaysian women

Parsa P, Kandiah M, Mohd Nasir MT, Hejar AR, Nor Afiah MZ

Singapore Med J, 2008 Nov;49(11):897-903.
PMID: 19037556

Breast cancer is the leading cause of cancer deaths in Malaysian women, and the use of breast self-examination (BSE), clinical breast examination (CBE) and mammography remain low in Malaysia. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence breast cancer screening practices. The Champion's Health Belief Model Scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer and screening methods in the Western culture. The purpose of this study was to translate the use of CHBMS into the Malaysian context and validate the scale among Malaysian women.

Matched MeSH terms: Breast Self-Examination/statistics & numerical data
Fulltext Knowledge and practice of breast self-examination among women aged 20-60 attending outpatient department in Kuantan. [Tahap pengetahuan dan amalan pemeriksaan sendiri payudara di kalangan wanita berumur 20-60 tahun yang hadir di jabatan pesakit luar Kuantan.]

Nurly Zahureen, M., Ardi, A., Wan Rosealaiza, W.A.G., Nur Aiza, Z., Suzana, H., Norazemi, A.

Malaysian Journal of Public Health Medicine, 2003;3(2):33-37.
MyJurnal

The National Health Morbidity Survey 1996 showed only 34.2% of women aged 20 years and above had done breast self examination (BSE). This data showed the practice of BSE is still low despite of various awareness programmes and activities carried out. A cross sectional study through Systematic Random Sampling was done at Out Patient Department, Kuantan Health Office to know the knowledge and practice of BSE among women aged 20~60 years. The results showed 94.9% respondents had received information about BSE, however only 31.6% knew the appropriate time to do BSE, 14.7% knew the purpose of doing at that time and only 29.9% knew how frequent they should do BSE. 74% of respondents did BSE, however 70.2% of them did not do monthly and 67.2% did not do at the suggested time. There was an association between the practice of BSE with the knowledge and sociodemographic characteristics i.e. educational level, income, ethnic group and marital status.
Key word: Breast self-examination, breast cancer, Kuantan.
Study site: Klinik Kesihatan, Kuantan, Pahang, Malaysia

Matched MeSH terms: Breast Self-Examination*
Fulltext Awareness, knowledge and breast cancer screening practices among IIUM non-academic staff

Aaina Mardhiah Binti Abdul Mutalib, Soo-Foon Moey, Nur Nadira Aiza Binti Kamarudin

International Journal of Allied Health Sciences, 2019;3(2):616-624.
MyJurnal

In Malaysia, breast cancer is the commonest cancer among women indicating that early diagnosis and screening practice is important to increase the survival rate. Breast self-examination (BSE), clinical breast examination (CBE) and mammography are the main screening practices for breast cancer. Knowledge and awareness of breast cancer can play an important role in aiding early detection of breast cancer. Little is known about the knowledge of breast cancer and screening practices among the non-academic staff in IIUM, Kuantan. As such this study aims to determine the knowledge and screening practices of breast cancer amongst the non-academic staff at the International Islamic University Malaysia (IIUM), Kuantan Campus. A cross-sectional study was conducted on 100 nonacademic staff from ten different departments in IIUM, Kuantan from March to April 2017. Data were collected using a self-administered questionnaire on knowledge of breast cancer and screening practices. The relationship between socio-demographic characteristics and knowledge of breast cancer and breast cancer screening practices were carried out using chi-square. No significance difference was found between knowledge of breast cancer and socio-demographic factors. However significant relationships were found between the age of respondents and BSE as well as the level of education of respondents and CBE. Most non-academic staff possessed an average level of knowledge on breast cancer and screening practices due to possibly ease of access to information. Low performance of breast screening practices was indicated possibly due to lack of awareness, misconception of the need and benefits derived from such screening practices.

Matched MeSH terms: Breast Self-Examination
Fulltext Targeting health disparity in breast cancer: insights into women's knowledge of their cancer profile in Malaysia

Loh S, Packer TL, Yip CH, Passmore A

Asian Pac J Cancer Prev, 2009 Oct-Dec;10(4):631-6.
PMID: 19827884

OBJECTIVE: Poor health literacy is positively associated with poorer quality of health decision-making and health outcomes in women facing a cancer diagnosis. In developing countries, poor access to complete and accurate information continues to pose a challenge for women. This paper describes the knowledge of Malaysian women with regard to breast cancer and how participation in a self-management program can improve the situation.

METHODS: Secondary analysis of data collected during a clinical trial on women newly diagnosed with breast cancer (n=147) was performed to examine baseline knowledge of breast cancer profile. Knowledge levels of women in the experimental (n= 69) group attending a self-management program were compared to a control group (n= 78) to determine change in the level of knowledge over time.

RESULTS: At baseline, a high percentage of women were unaware of their breast cancer profile. Not a single woman had knowledge of all six basic characteristics; 83% did not know their HER2 status, type of breast cancer (68%), grade of cancer cell (64%), hormonal receptor status (55%), size of breast cancer (18%) and/or their stage of breast cancer (13%). At post intervention, there was significantly better knowledge within the experimental group.

CONCLUSION: Malaysian women in this cohort study demonstrated very low levels of knowledge of their cancer profile. Clinical implications for countering treatment-decision difficulties include the need for a shift in the way information and services are delivered to allow women to take a more active role in their own care. Multi-modal efforts including basic information dissemination to increase women's knowledge can contribute to narrowing of the gap in health disparity.

Matched MeSH terms: Breast Self-Examination/utilization*
Fulltext Knowledge and behavior regarding breast cancer screening among female teachers in Selangor, Malaysia

Parsa P, Kandiah M, Mohd Zulkefli NA, Rahman HA

Asian Pac J Cancer Prev, 2008 Apr-Jun;9(2):221-7.
PMID: 18712963

A cross-sectional study was carried out to determine the knowledge and practices of 425 female secondary school teachers from 20 selected secondary schools in Selangor, Malaysia on breast cancer screening (BCS). A self-administered, structured questionnaire was used for data collection. This study showed moderate to low knowledge on breast cancer (BC) and BCS among teachers. Only 19%, 25% and 13.6% eligible women performed breast self-examination (BSE), clinical breast examination (CBE) and mammography respectively, on a regular basis. Level of breast cancer knowledge was significantly associated with BSE (p<0.001). Having heard/ read about BCS, and regular visit with a physician were associated with BCS behaviors (P<0.05). There was no association between BCS behaviors (P>0.05) and age, family history of breast cancer, marital status or having health insurance. Efforts are needed to increase knowledge and remove misconceptions about breast cancer and screening practices among Malaysian women.

Matched MeSH terms: Breast Self-Examination/psychology
Fulltext Knowledge, attitudes and practice of breast self-examination among women in a suburban area in Terengganu, Malaysia

Rosmawati NH

Asian Pac J Cancer Prev, 2010;11(6):1503-8.
PMID: 21338188

INTRODUCTION: Breast cancer is the most frequently diagnosed cancer in Malaysian women, irrespective of age group and ethnicity. The observed low survival rates are related to late stage at presentation despite the availability of breast self examination (BSE) as a reliable screening method for early detection.

MATERIALS AND METHODS: This cross-sectional study was designed to determine the knowledge, attitude and practice towards BSE amongst women aged 15 years old and above. Systemic random sampling was applied and information gathered through guided interview by using a structured questionnaire.

RESULTS: A total of 86 respondents were recruited, with a mean age of 40.5 years (SD: 15.51), more than 80% having a secondary or tertiary level of education. The total score was 16.9 (total mean percent: 60.4%) for knowledge, 37.1 (77.3%) for attitude and 9.56 (34.1%) for practice. The proportions of respondents with good score for knowledge, attitude and practice were 38.4%, 73.3% and 7.0%, respectively. Not knowing the correct method of BSE, lack of knowledge on cancer signs and lack of motivational support from parents, spouse or friends appeared to be related with the poor practices.

CONCLUSION: Enhancement of breast cancer awareness and focusing on recognized barriers by health care professionals with the involvement of spouses, family and community would have a substantial beneficial impact on BSE practice.

Matched MeSH terms: Breast Self-Examination
Fulltext The usage and knowledge of mammography among women in sub-urban area in Terengganu, Malaysia

Rosmawati NH

Asian Pac J Cancer Prev, 2010;11(3):767-71.
PMID: 21039051

INTRODUCTION: Breast cancer is the leading cancer in women today and the major challenge is late presentation then later contributes to poor outcome and high fatality rate. Mammography is effective in early detection of breast cancer and consequently significantly improves the breast cancer survival.

MATERIALS AND METHODS: This cross-sectional study was used to study the knowledge and awareness towards mammogram amongst women aged 15 years old and above. A systemic random sampling was applied and information gathered through guided interview by using a structured questionnaire.

RESULTS: Eighty-six respondents were recruited. The mean age of respondents was 40.5 years (SD: 15.51) and more than 80% had secondary and tertiary level of education. The percentage of respondents ever performed mammogram was 10.5% (95% CI: 4.0%-17.0%). The rate of correct answers was between 8.1% and 48.8%. Most of the respondents do not sure the answer (45.3%-61.6%) rather than wrongly answer (4.7%-43.0%). Only about 8% truly answer that mammogram should be done once in a life. There are 10.5% of women claimed that mammogram had no serious side effect and not a painful procedure. Nearly half of respondents (48.8%) correctly mentioned that Mammogram can detect breast cancer in early stage.

CONCLUSION: Only a small percentage of women ever performed mammogram and there are seriously unaware and poor knowledge pertaining to mammography screening for breast cancer among women in sub urban area. A massive health education campaign through multiple methods and agencies are needed to enhance the knowledge and awareness on mammogram.

Matched MeSH terms: Breast Self-Examination*
Fulltext The relationship of socio-demographic characteristics and knowledge of breast cancer on stage of behavioral adoption of breast self-examination

Moey SF, Mutalib AMA, Mohamed NC, Saidin N

AIMS Public Health, 2020;7(3):620-633.
PMID: 32968682 DOI: 10.3934/publichealth.2020049

Background/aim: In Malaysia, breast cancer is the most common cancer among women. As such, early diagnosis and screening practices are important to increase the survival rate. Breast self-examination (BSE) is one of the main screening methods for breast cancer. Socio-demographic characteristics and knowledge of breast cancer are amongst the crucial roles in determining women's behavioral adoption in performing BSE. This study aims to assess the relationship of socio-demographic factors and knowledge of breast cancer on the stage of behavioral adoption of BSE among Malaysian women in Kuantan, Pahang.
Materials and methods: A cross-sectional study was conducted on 520 women from three different government health clinics in Kuantan and IIUM Family Health Clinic from February to April 2018. Data were collected using a self-administered questionnaire on socio-demographic factors and knowledge of breast cancer and its effect on the behavioral adoption of BSE.
Results: Significant difference was found between socio-demographic characteristics and behavioral adoption of BSE. However, only breast screening and the best time for screening were found to be significant with the behavioral adoption of BSE and knowledge of breast cancer.
Conclusion: It is found that most women in Kuantan, Pahang perform BSE but were still unaware of the importance of performing BSE for early breast cancer detection. This study was expected to enhance women's awareness of the benefits of performing BSE.

Matched MeSH terms: Breast Self-Examination
Fulltext Psychosocial predictors of breast self-examination among female students in Malaysia: a study to assess the roles of body image, self-efficacy and perceived barriers

Ahmadian M, Carmack S, Samah AA, Kreps G, Saidu MB

Asian Pac J Cancer Prev, 2016;17(3):1277-84.
PMID: 27039760

BACKGROUND: Early detection is a critical part of reducing the burden of breast cancer and breast selfexamination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women.

OBJECTIVE: This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia.

MATERIALS AND METHODS: Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future.

RESULTS: Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future.

CONCLUSIONS: Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.

Matched MeSH terms: Breast Self-Examination/psychology; Breast Self-Examination/statistics & numerical data*
Fulltext Knowledge and practice of breast self-examination among female non-medical students in Universiti Kebangasaan Malaysia (UKM) in Bangi

Mohd Rohaizat Hassan, Hasanain Faisal Ghazi, Mohamed AS, Saladina Jaszle Jasmin

Malaysian Journal of Public Health Medicine, 2017;17(1):51-58.

Breast Self-Examination (BSE) is a process whereby women examine their breasts regularly to detect any abnormal swelling or lumps in order to seek prompt medical attention. The purpose of this study was to investigate the knowledge and practice of BSE among female non-medical students in UKM, Bangi. A cross-sectional study was conducted using self-administered and validated questionnaire among 364 students. The results showed that only 37.1% performs BSE and 45% of the students have good knowledge. Age, marital status, using internet and pamphlets as source of information, personal, and family history of BC, were significantly associated with knowledge level of students. Practice of BSE was significantly associated with knowledge level. From multivariate analysis, BSE was more likely to be done among students with family history, students who using internet and pamphlet as sources of information, also among students with good knowledge. As conclusions, the practice of BSE is inadequate among the respondents in spite of most of them had heard about BSE. The results suggest the need of providing continuing educational programs to increase the knowledge level on BSE which in turn will have a positive effect on students to practice and motivate to perform BSE.

Matched MeSH terms: Breast Self-Examination
Fulltext Knowledge and practice of breast self-examination among students in a private higher learning institution in Malaysia

Nimir, Amal R., Al-Dubai, Sami A. R., Alshagga, Mustafa A., Saliem, Ahmed M.

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

Breast cancer is one of the most frequently encountered malignancies among young females in Malaysia, which accounts for 30.4% of newly diagnosed cancers. All women at or above the age of 20 are considered at risk of developing breast cancer. This is a cross-sectional study. The study was conducted in a private medical university in Malaysia during year 2012. Two hundred students were recruited in this study using universal sampling. Data collection was done using a selfadministration questionnaire. Chi-square test was used to assess the association between the practice of breast selfexamination and socio-demographic variables. Only 19.5% of the study sample has sufficient knowledge about BSE which is acquired mostly from local media. Having a family history of malignancy other than breast cancer seems to be the only significant variable associated with knowledge about BSE (P=0.002). Other variables such as demographic data, menstrual history and social history were also tested, but found to be not significant. Frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to alert the women to any abnormal changes in the breasts so that they will be able to seek medical advice immediately.

Matched MeSH terms: Breast Self-Examination
Fulltext Does performance of breast self-exams increase the probability of using mammography: evidence from Malaysia

Dunn RA, Tan A, Samad I

Asian Pac J Cancer Prev, 2010;11(2):417-21.
PMID: 20843127

OBJECTIVES: Breast self-examination (BSE) was evaluated to see if it is a significant predictor of mammography.

METHODS: The decisions of females above age 40 in Malaysia to test for breast cancer using BSE and mammography are jointly modeled using a bivariate probit so that unobserved attributes affecting mammography usage are also allowed to affect BSE. Data come from the Malaysia Non-Communicable Disease Surveillance-1, which was collected between September 2005 and February 2006.

RESULTS: Having ever performed BSE is positively associated with having ever undergone mammography among Malay (adjusted OR=7.343, CI=2.686, 20.079) and Chinese (adjusted OR=3.466, CI=1.330, 9.031) females after adjusting for household income, education, marital status and residential location. Neither relationship is affected by jointly modelling the decision problem. Although the association is also positive for Indian females when mammography is modelled separately (adjusted OR=5.959, CI=1.546 - 22.970), the relationship is reversed when both decisions are modelled separately.

CONCLUSIONS: De-emphasizing BSE in Malaysia may reduce mammography screening among a large proportion of the population. Previous work on the issue in developed countries may not apply to nations with limited resources.

Matched MeSH terms: Breast Self-Examination*

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