Introduction
The best time to perform breast self-examination is when the breasts are not tender or swollen. Because many women experience tenderness and lumpiness in their breasts prior to menstruation, breasts self-examination should be performed after menses. Many health care providers advise women to perform a breast self-examination regularly every month, on the day following their menstrual period.1, 2, 3
Breast self-examination (BSE) is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. BSE was once promoted heavily as a means of finding cancer at a more curable stage, but large randomized controlled studies found that it was not effective in preventing death, and actually caused harm through needless biopsies and surgery.4, 5, 6, 7, 8, 9, 10, 11
Early diagnosis affords a better chance of survival and better prognosis in absence of an enact etiological agent for breast cancer, the most appropriate way of controlling it, will be early detection and treatment. Mammography is the method of choice but its use is limited due to high cost and unavailability. At present a simple inexpensive and early implant for the detection of breast cancer is breast self-examination. It is one of the simplest and most important health programmes to promote early detection. Regular breast self-examination can identify any abnormal changes in breast to establish good prognosis. If the young groups of women are targeted with accurate information and encouragement they will learn to examine themselves and detect every minute changes early in their later life.11
Many women feel that doing a breast self-exam is an important part of their health care. It helps them learn how their breasts normally feel, so that if they find a lump they will know whether it is something to discuss with their health care provider. However, there is controversy about recommending breast self-exams.10, 11, 12, 13, 14, 15, 16, 17, 18, 19
Objectives
To assess the attitude of adolescent girls regarding breast self-examination before and after the administration of structured teaching programme.
To find out the effectiveness of STP regarding BSE on Attitude score.
To find out the correlation between attitudes score of adolescent girls regarding breast self-examination.
To determine the association between the demographic variables and attitude of adolescent girls regarding breast self-examination.
Hypothesis
H1: There will be significant difference between mean pre test and post test attitude score on selected schools of adolescent girls on BSE at the level of P<0.05
H2: There will be significant correlation between knowledge score and attitude score of adolescent girls in selected schools of Indore.
H3: There will be significant association between the attitude score and selected demographic variables of adolescent girls in selected schools of Indore.
Research Methodology
It included the research approach, research design, sample size, sampling technique development of tool, pilot study data collection procedure, plan for data analysis for determining the effectiveness of intervention.
Setting of The Study
The study was conducted in Maharishi Vidhya Mandir, Indore (M.P.).
Population
The population of present study comprised of all adolescent girls who studying in Maharishi Vidhya Mandir, Indore (M.P.).
Sample
The sample of the present comprised of study comprised of all adolescent girls who studying in Maharishi Vidhya Mandir, Indore (M.P.).
Sampling Criteria
Attitude checklist
Use of 5 point likert scale consisted of 12 items .the criteria was prepared with five strongly disagree (1), disagree (2), uncertain (3), agree (4), strongly agree (5) It consist of 12items of to assess the attitude of adolescent girls regarding breast self-examination.
The reliability of the tool was established by administering the tool to 10 subjects. The reliability was calculated by Split half and Karl Pearsons correlation coefficient formula .the reliability of tool was calculated and ‘r’ found to be 0.8 for knowledge assessment and. 92 for attitude scale which is statistically reliable for the present study .the purpose was to determine the clarity of items, presence of ambiguous items and to ensure the reliability and feasibility of the tool.20
Result
Distribution of adolescent girls according to pretest and posttest attitude score grading.
Table 1
Distribution of adolescent girls according to pretest and posttest attitude score (n=60)
The above table shows the distribution adolescent girls according to pretest and posttest attitude grading.
The attitude questionnaire had 12 questions with Likert of 5. Strongly disagree carries 1 and Strongly agrees carries 5. Thus, a staff nurse can obtain a minimum of 12 marks and a maximum of 100 marks. These 100 marks were further graded as Poor (01-03 marks); Fair (04-06 marks), Good (07-09 marks) and Excellent (10-12). In the pretest, none of the adolescent girls obtained poor attitude grade, 22 (36.7%) obtained fair attitude grade, 36 (60.0%) obtained good attitude grade and 2 (3.3%) obtained excellent attitude grade. Then the adolescent girls were given intervention and then the same set of attitude questionnaire was re-administered. In the posttest, none of the adolescent girls obtained poor and fair attitude grades, 41 (68.3%) obtained good attitude grade and 19 (31.7%) adolescent girls obtained excellent attitude grade. Thus, the intervention was very helpful in improving the attitude grade of the adolescent girls.
The above fig 15 shows the distribution of adolescent girls according to pretest and posttest attitude grading. In the pretest, none of the adolescent girl obtained poor attitude grade, 22 (36.7%) obtained fair attitude grade, 36 (60.0%) obtained good attitude grade and 2 (3.3%) obtained excellent attitude grade.
In the posttest, none of the adolescent girlsobtained poor and fair attitude grades, 41 (68.3%) obtained good attitude grade and 19 (31.7%) adolescent girlsobtained excellent attitude grade. Thus, the intervention was very helpful in improving the attitude grade of the adolescent girls.
Table 2
Comparison of pretest and posttest attitude score (N=60)
|
Attitude Score |
Mean |
SD |
‘t’ Value |
P value |
|
Pretest |
52.78 |
8.24 |
-10.065, df=59 |
0.000* |
|
Posttest |
67.78 |
4.36 |
The above table shows the comparison of mean pretest and posttest attitude score. The mean pretest attitude score was 52.78 ± 8.35, while in the posttest it was 67.78 ± 4.36. The difference was found to be statistically significant (p<0.05), showing a higher mean attitude score in the posttest. Thus, the intervention was very helpful in improving the mean posttest attitude score.
Table 3
Comparing the correlation of knowledge and attitude score
The mean pretest knowledge score was 12.50 ± 3.26, while in the posttest it was 23.20 ± 2.49. The difference was found to be statistically significant (p<0.05), showing a higher mean knowledge score in the posttest. Thus, the intervention was very helpful in improving the mean posttest knowledge score. The mean pretest attitude score was 52.78 ± 8.35, while in the posttest it was 67.78 ± 4.36. The difference was found to be statistically significant (p<0.05), showing a higher mean attitude score in the posttest. Thus, the intervention was very helpful in improving the mean posttest attitude score.
Association between demographic variables and attitude score grading
Table 4
a: Association of pretest attitude score with age (N=60)
The above table shows the association between pretest attitude score and age. There was no statistically significant association seen between pretest attitude score and age (c2 = 0.878, df=4, p value = 0.928, Not significant) showing that the pretest attitude grade is independent of the age of the adolescent girls.
Table 0
The above table shows the association between pretest attitude score and type of family. There was no statistically significant association seen between pretest attitude score and type of family (c2 = 1.548, df =2, p value = 0.461, Not significant) showing that the pretest attitude grade is independent of the type of family of the adolescent girls.
Table 0
The above table shows the association between pretest attitude score and occupation of earning member. There was no statistically significant association seen between pretest attitude score and occupation of earning member (c2 = 0.282, df=2, p value = 0.844, Not significant) showing that the pretest attitude grade is independent of the occupation of earning member.
Table 0
The above table shows the association between pretest attitude grade and Family income per month. There was no statistically significant association seen between pretest attitude grade and Family income per month(c2 = 2.346, df=6, p value = 0.664, Not significant) showing that the pretest attitude grade is independent of the Family income per monthof the adolescent girls.
Table 0
The above table shows the association between pretest attitude score and educational status. There was no statistically significant association seen between pretest attitude score and educational status (c2 = 2.181, df=2, p value = 0.336, Not significant) showing that the pretest attitude grade is independent of the educational status of the adolescent girls.
Table 0
Table 0
Table 0
The above table shows the association between pretest attitude score and Age of strual Cycle.
There was no statistically significant association seen between pretest attitude score and Age of Menstrual Cycle (c2 = 4.132, df=6, p value = 0.604, Not significant) showing that the pretest attitude grade is independent of the Age of Menstrual Cycle of the adolescent girls.
The above table shows the association between pretest attitude score and Religion. There was no statistically significant association seen between pretest attitude score and Religion (c2 = 7.637, df=6, p value = 0.185, Not significant) showing that the pretest attitude grade is independent of the Religionof the adolescent girls. The above table shows the association between pretest attitude score and previous knowledge about breast self- examination.
There was no statistically significant association seen between pretest attitude score and previous knowledge about breast self –examination (c2 = 4.636, df=2, p value = 0.098, Not significant) showing that the pretest attitude grade is independent of the previous knowledge about breast self- examinationof the adolescent girls.
Conclusion
From the observations, we can conclude that there was a statistically significant improvement seen in both the knowledge score and attitude score after intervention. Thus intervention was very helpful in improving the knowledge score and attitude score of the adolescent girls. We find partial association between majority of the demographic variables and the knowledge. But no association was seen between demographic variables and the attitude score.To conclude intervention was very helpful in improving both the knowledge and attitude score of the breast self-examination among adolescent girls.
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