The Effects of a Breast Self-Examination Education Program in Taiwanese Women: A Triangulation Study
Date Issued
2007
Date
2007
Author(s)
Yang, Jui-Chen
DOI
en-US
Abstract
BACKGROUND: Breast cancer is a major threat to the health among Taiwanese women. The Taiwanese Government has provided free mammography biannually to women between the ages of 50 and 69 years since 2004. Women are also encouraged to do BSE every month. However, its effectiveness has not been unequivocally established. The possible reasons for this concern include the varied methods used to teach BSE techniques as well as differing evaluations of the methods. Furthermore, there is little understanding how do women decided whether attending BSE training?
PURPOSE: The aims of this study were three fold: First, to examine the effects of an innovative community-wide BSE instructional program (also known MCp) on increased BSE attitudes and competency (such as practice and accuracy); Second, to explore the utility of Health Belief Model as a theoretical framework for explaining the BSE behaviors of Taiwanese women; and, Third, to explore and to illustrate the patterns of how women made the decisions of learning BSE.
METHODS: A randomized prospective study, combining of quantitative and qualitative data collected by direct observation and interaction with the participants. Measurement conducted at baseline and at 4-month follow-ups. The instruction will consist of a three-part BSE intervention program, including provided information about breast cancer and BSE, enhanced BSE competence and provided reminders. Participants were 203 women aged 50 or less from community setting to complete the measurement. We performed thematic analysis of 31 interviews that were previously conducted in similar participants.
FINDINGS: Whereas most of the participants did not practice BSE regularly and accurately in the pre-training period, the statistical results of this study strongly support the hypothesis that the intervention would positively and significantly affect BSE competency and health beliefs. Furthermore, the present study revealed that a limited utility of HBM as a theoretical framework for explaining the BSE competency of Taiwanese women at 4-months after treatment, but the self-efficacy was a significantly positive predictor to BSE proficiency. Contradictory, there was a spurious relationship between the self-efficacy on frequency, sensitivity and positive predictive value. Our findings indicated that women participated BSE training was a purposive action, which the safety needs provided the principal motivation. Furthermore, a ladder motivation model was constructed to explain these participants’ motivation for entering the BSE training. The participants’ decision motivation supported the Abraham Maslow’s hierarchy of needs.
CONTRIBUTION: This study demonstrated the feasibility of a program for teaching proficient BSE to Taiwanese women. It revealed that a sizeable sample of these women could learn to perform BSE to high quantitative standards of sensitivity, proficiency and having continued to practice it at acceptable frequencies. Moreover, this study contributes to current knowledge about BSE in several ways. It provides an alternative perspective to the linear cognitive-behavioral approaches to in depth explore BSE practice, highlighting the importance of the social environment and shared understanding among women. It is important for health professionals to assist women in their breast self-care efforts. With more understanding of processes that underpin their self-care needs, primary care professionals are better placed to provide meaningful services to this population of women.
Subjects
乳房自我檢查
健康信念模式
三角交叉檢視法
breast self-examination (BSE)
Health Belief Model (HBM)
triangulation
Taiwanese women
SDGs
Type
other
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