• 지역사회간호학회지
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• 제7권2호
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• pp.281-293
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• 1996

Breast cancer ranks as one of the major health problems of adult women. Studies have shown that Breast Self-Examination (BSE) is effective in detecting breast cancer in its early stages. To motivate women BSE practicing, a nonequivalent control group pretest-posttest design was conducted. Women 40 years or older who participated in the public education program for BSE from March 11 to April 6, 1996, were randomized in an experimental group(N=50) which received a letter about the Breast Cancer Risk Appraisal and in a control group(N=50) which didn't received a letter about the Breast Cancer Risk Appraisal. After 6 months, a follow-up phone survey was taken on all participants to measure the effectiveness of the intervention. Collected data was analyzed by one, two, and three-way ANOVA with an SAS program. The results are summarized as follows : 1. The level of the Breast Cancer Risk Appraisal of the subjects is high risk(17%), moderate risk(12%), boderline risk(14%), no increased risk (57%). 2. The intervention was effective in increasing the practice scores of BSE for women(F=5.12, P<.05). 3. BSE practice scores according to breast cancer risk appraisal level of the experimental group was not significantly increased after the intervention as contrasted with the control group (F=2.33, P>.05). 4. BSE practice scores according to educational level of the experimental group was significantly increased after the intervention, as contrasted with that of the control group (F=10.09, P<.001) .On the basis of this study it can be concluded that the Breast Cancer Risk Appraisal increases practice of BSE.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.437-441
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• 2012

Objective: Health risk appraisal is often utilized to modify individual's health behavior, especially concerning disease prevention, and web-based health risk appraisal services are being provided to the general public in Korea. However, little is known about the psychological effect of the health risk appraisal even though poorly communicated information by the web-based service may result in unintended adverse health outcomes. This study was conducted to explore the psychological effect of health risk appraisal using epidemiological risk factor profile. Methods: We conducted a randomized trial comparing risk factor list type health risk appraisal and risk score type health risk appraisal. We studied 60 women aged 30 years and older who had no cancer. Anxiety level was assessed using the Spielberger State-Trait Anxiety Inventory YZ. Results: The results of multivariate analysis showed that risk status was the independent predictors of increase of state anxiety after health risk appraisal intervention when age, education, health risk appraisal type, numeracy, state anxiety, trait anxiety, and health risk appraisal type by risk status interaction was adjusted. Women who had higher risk status had an odd of having increased anxiety that was about 5 times greater than women who had lower risk status. Conclusions: Our findings indicate that communicating the risk status by individual health risk appraisal service can induce psychological sequelae, especially in women having higher risk status. Hospitals, institutes, or medical schools that are operating or planning to operate the online health risk appraisal service should take side effects such as psychological sequelae into consideration.

• 보건교육건강증진학회지
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• 제26권1호
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• pp.15-26
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• 2009

Objectives: The current study evaluated the effects of an integrated breast health program according to levels of breast cancer risk appraisal on knowledge on breast cancer, early detection behaviors, and diet patterns and attitudes in Korean healthy women. Method: A nonequivalent control group pre-posttest design was used. A total of 413 women aged 40-59, registering at the Life Long Health Center in two cities, were classified into intervention groups of 179 women and control groups of 234 women. The integrated breast health program included education, counseling on breast cancer, early detection behaviors, and appropriate diet with multimedia and individual practice session using breast models, reflecting characteristics of each level according to levels of risk appraisal. The knowledge on breast cancer, early detection behaviors, and diet were investigated using questionnaires at baseline and three months after intervention. Results: In both normal and borderline-risk group, intervention groups reported significantly higher scores of knowledge on breast cancer and higher stages of BSE behaviors than control groups. Conclusion: The results showed positive effects on knowledge and early detection behaviors of breast cancer in normal and borderline-risk groups. Further studies should investigate longitudinal effects of the intervention program on dietary change.

• 대한간호학회지
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• 제33권8호
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• pp.1119-1126
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• 2003

Background. Breast cancer is the most common form of cancer among Korean women. Only 14 % of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). Purpose. The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. Methods. First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n=494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. Results. After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2 % of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

• 성인간호학회지
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• 제18권1호
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• pp.146-156
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• 2006

Purpose: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. Method: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). Results: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. Conclusion: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.

• 지역사회간호학회지
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• 제8권1호
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• pp.89-101
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• 1997

Breast cancer ranks as one of the major health problems in adult women. The purpose of this study is to determine relationships among the practice of Breast Self-Examination(BSE) and the variables of cancer risk and other genernal factors. This knowledge may be helpful in designing a BSE educational program to promote breast self-examination on a regular basis. The study population included 205 women who live in K city. Personal interviews were conducted to determine the individual's breast self-examination behavior, the level of Breast Cancer Risk according to general factors as well as her reasons for not doing a breast self-examination. The collected data was analyzed with an SAS program The results were summarized as follows : 1. The level of Breast Cancer Risk of the subjects is as follows: high risk(9%), moderate risk(11%), boderline risk(12%), no increased risk (68%). 2. There was no difference in the practice of BSE between women who were at high cancer risk and at no increased cancer risk. 3. BSE practice levels according to general foctors were significantly related to the residence and the level of education of the subjects. The performing of regular breast self-examination in urban areas was 7% and in rural areas was 0%. Regularly practiced breast self-examination in women with a low education was 5% and in college educated women, it was 29%. 4. BSE education was significantly related to the residence and the level of education of the subjects. The majority learned BSE through 'a magazine or journal'. 5. The reason of the majority of women did not perform a regular breast self-examination was, 'Didn't know the BSE technique'. On the basis of this study it can be concluded that the development of a BSE education program is needed to help women perform the examination correctly.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8135-8142
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• 2014

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

• 여성건강간호학회지
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• 제17권2호
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• pp.157-168
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• 2011

Purpose: This study was done to examine differences in mammography screening according to breast cancer and social network characteristic. Methods: Data were collected from 187 married women 35 years and older who were using public health centers, health promotion centers, cultural centers, obstetrics and gynecology hospitals or other relevant community sites. Data were collected between October 24 and December 4, 2008. Data were analyzed using the SPSS/WIN 15.0 program. Results: The participation rate for mammography screening was 35.3%. The following general and breast cancer characteristics showed statistically significant differences: religion, family incomes, regular medical-care, general health examinations during past 2 years, and history of breast disease. The following social network characteristics showed statistically significant differences: social norms and subjective norms. Using logistic regression analysis, regular medical-care, breast cancer risk appraisal, social norm, and subjective norms were highly predictive of subsequent mammography. Conclusion: The results of this study indicate that it is important to develop and provide tailored intervention programs through integrated socially mediated programs. By consciously including social network and support systems, breast cancer detection efforts would not end as a one-time event, but naturally build on network structure of adults women, thus facilitating regular mammography screening.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.167-174
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• 2016

One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.