Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Breast Cancer | Research article

Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model

Authors: Triana Kesuma Dewi, Karlijn Massar, Robert A. C. Ruiter, Tino Leonardi

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM).

Methods

This investigation was a cross-sectional survey which was distributed among 1967 women aged 20–60 years. The Indonesian version of Champion’s Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice.

Results

44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice.

Conclusion

This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women’s self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.
Literature
1.
go back to reference American Cancer Society. Cancer Facts & Figures 2011. Atlanta: American Cancer Society; 2011. American Cancer Society. Cancer Facts & Figures 2011. Atlanta: American Cancer Society; 2011.
2.
go back to reference Ghoncheh M, Mohammadian-Hafshejani A, Salehiniya H. Incidence and mortality of breast cancer and their relationship to development in Asia. Asian Pac J Cancer Prev. 2015;16(14):6081–7.CrossRefPubMed Ghoncheh M, Mohammadian-Hafshejani A, Salehiniya H. Incidence and mortality of breast cancer and their relationship to development in Asia. Asian Pac J Cancer Prev. 2015;16(14):6081–7.CrossRefPubMed
4.
go back to reference Ministry of Health RI. Riset Kesehatan Dasar 2013 [basic Health Research 2013]. Jakarta: Ministry of Health RI; 2013. Ministry of Health RI. Riset Kesehatan Dasar 2013 [basic Health Research 2013]. Jakarta: Ministry of Health RI; 2013.
5.
go back to reference Ministry of Health RI. Manual book National Movement Program for cervical and breast cancer prevention and early detection. Jakarta: Ministry of Health RI; 2015. Ministry of Health RI. Manual book National Movement Program for cervical and breast cancer prevention and early detection. Jakarta: Ministry of Health RI; 2015.
6.
go back to reference Lauver D. Theoretical perspectives relevant to breast self-examination. Adv Nursing Sci. 1987;9:16–24.CrossRef Lauver D. Theoretical perspectives relevant to breast self-examination. Adv Nursing Sci. 1987;9:16–24.CrossRef
8.
go back to reference Narimah A, Rugayh H, Tahir A, Maimunah A. Breast examination, national health and morbidity survey 1996, vol. 20. Kuala Lumpur: Public Health Institute, Ministry of Health; 1999. Narimah A, Rugayh H, Tahir A, Maimunah A. Breast examination, national health and morbidity survey 1996, vol. 20. Kuala Lumpur: Public Health Institute, Ministry of Health; 1999.
9.
go back to reference Lam WW, Chan CP, Chan CF, Mak CC, Chan CF, Chong KW, Leung MH, Tang MH. Factors affecting the palpability of breast lesion by self-examination. Singap Med J. 2008;49(3):228–32. Lam WW, Chan CP, Chan CF, Mak CC, Chan CF, Chong KW, Leung MH, Tang MH. Factors affecting the palpability of breast lesion by self-examination. Singap Med J. 2008;49(3):228–32.
10.
go back to reference Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the breast health global initiative global summit 2017. Cancer. 2008;133:2221–43.CrossRef Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the breast health global initiative global summit 2017. Cancer. 2008;133:2221–43.CrossRef
11.
go back to reference Miller A, Baines C. The role of clinical breast examination and breast self-examination. Prev Med. 2011;59(3):118–20.CrossRef Miller A, Baines C. The role of clinical breast examination and breast self-examination. Prev Med. 2011;59(3):118–20.CrossRef
12.
go back to reference Pengpid S, Peltzer K. Knowledge, attitude and practice of breast self-examination among female university students from 24 low, middle income and emerging economy countries. Asian Pac J Cancer Prev. 2014;15(20):8637–40.PubMedCrossRef Pengpid S, Peltzer K. Knowledge, attitude and practice of breast self-examination among female university students from 24 low, middle income and emerging economy countries. Asian Pac J Cancer Prev. 2014;15(20):8637–40.PubMedCrossRef
13.
go back to reference Abolfotouh MA, BaniMustafa AA, Mahfouz AA, Al-Assiri MH, Al-Juhani AF, Alaskar AS. Using the health belief model to predict breast self-examination among Saudi women. BMC Public Health. 2015;15:1163–74.PubMedPubMedCentralCrossRef Abolfotouh MA, BaniMustafa AA, Mahfouz AA, Al-Assiri MH, Al-Juhani AF, Alaskar AS. Using the health belief model to predict breast self-examination among Saudi women. BMC Public Health. 2015;15:1163–74.PubMedPubMedCentralCrossRef
14.
go back to reference Secginli S, Nahcivan NO. Factors associated with breast cancer screening behaviours in a sample of Turkish women: a questionnaire survey. Int J Nur Stud. 2006;43:161–71.CrossRef Secginli S, Nahcivan NO. Factors associated with breast cancer screening behaviours in a sample of Turkish women: a questionnaire survey. Int J Nur Stud. 2006;43:161–71.CrossRef
15.
go back to reference Noroozi A, Jomand T, Tahmasebi R. Determinants of breast self-examination performance among Iranian women: an application of the health belief model. J Cancer Educ. 2011;26(2):365–74.PubMedCrossRef Noroozi A, Jomand T, Tahmasebi R. Determinants of breast self-examination performance among Iranian women: an application of the health belief model. J Cancer Educ. 2011;26(2):365–74.PubMedCrossRef
16.
go back to reference Nahcivan NO, Secginli S. Health beliefs related to breast self-examination in a sample of Turkish women. Oncol Nurs Forum. 2007;34:425–32.PubMedCrossRef Nahcivan NO, Secginli S. Health beliefs related to breast self-examination in a sample of Turkish women. Oncol Nurs Forum. 2007;34:425–32.PubMedCrossRef
17.
go back to reference Birhane N, Mamo A, Girma E, Asfaw S. Predictors of breast self-examination among female teachers in Ethiopia using health belief model. Arch Public Health. 2015;73(1):39.PubMedPubMedCentralCrossRef Birhane N, Mamo A, Girma E, Asfaw S. Predictors of breast self-examination among female teachers in Ethiopia using health belief model. Arch Public Health. 2015;73(1):39.PubMedPubMedCentralCrossRef
18.
go back to reference Rosenstock IM. Why people use health services. Milbank Q. 1966;44:94–127.CrossRef Rosenstock IM. Why people use health services. Milbank Q. 1966;44:94–127.CrossRef
19.
go back to reference Sheeran P, Abraham C. The Health Belief Model. In: Conner M, Norman P, editors. Predicting Health Behaviour. Research and Practice with Social Cognition Models. Buckingham: Open University; 2003. p. 23–61. Sheeran P, Abraham C. The Health Belief Model. In: Conner M, Norman P, editors. Predicting Health Behaviour. Research and Practice with Social Cognition Models. Buckingham: Open University; 2003. p. 23–61.
20.
go back to reference Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661–9.PubMedCrossRef Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661–9.PubMedCrossRef
21.
go back to reference Champion VL. Instrument development for health belief model constructs. Adv Nurs Sci. 1984;6:73–85.CrossRef Champion VL. Instrument development for health belief model constructs. Adv Nurs Sci. 1984;6:73–85.CrossRef
22.
go back to reference Champion VL. Revised susceptibility, benefits, and barriers scale for mammography screening. Res Nurs Health. 1999;22:341–85.PubMedCrossRef Champion VL. Revised susceptibility, benefits, and barriers scale for mammography screening. Res Nurs Health. 1999;22:341–85.PubMedCrossRef
23.
go back to reference Champion VL, Scott C. Reliability and validity of breast cancer screening beliefs scale in African American women. Nurs Res. 1997;46:331–7.PubMedCrossRef Champion VL, Scott C. Reliability and validity of breast cancer screening beliefs scale in African American women. Nurs Res. 1997;46:331–7.PubMedCrossRef
24.
go back to reference Tavafian SS, Hasani L, Aghmolaei T, Zare S, Gregory D. Prediction of breast self-examination in a sample of Iranian women: an application of the health belief model. BMC Womens Health. 2009;9(1):37.PubMedCentralCrossRefPubMed Tavafian SS, Hasani L, Aghmolaei T, Zare S, Gregory D. Prediction of breast self-examination in a sample of Iranian women: an application of the health belief model. BMC Womens Health. 2009;9(1):37.PubMedCentralCrossRefPubMed
25.
go back to reference Wang WL, Hsu SD, Wang JH, Huang LC, Hs WL. Survey of breast cancer mammography screening behaviors in eastern Taiwan based on a health belief model. Kaohsiung J Med Sci. 2014;30(8):422–7.PubMedCrossRef Wang WL, Hsu SD, Wang JH, Huang LC, Hs WL. Survey of breast cancer mammography screening behaviors in eastern Taiwan based on a health belief model. Kaohsiung J Med Sci. 2014;30(8):422–7.PubMedCrossRef
26.
go back to reference Karayurt O, Dramal A. Adaptation of champion’s health belief model scale for Turkish women and evaluation of the selected variables associated with breast self-examination. Cancer Nurs. 2007;30(1):69–77.PubMedCrossRef Karayurt O, Dramal A. Adaptation of champion’s health belief model scale for Turkish women and evaluation of the selected variables associated with breast self-examination. Cancer Nurs. 2007;30(1):69–77.PubMedCrossRef
27.
go back to reference Oh KM, Taylor KL, Jacobsen KH. Breast cancer screening among Korean American’s: a systematic review. J Commun Health. 2017;42(2):324–32.CrossRef Oh KM, Taylor KL, Jacobsen KH. Breast cancer screening among Korean American’s: a systematic review. J Commun Health. 2017;42(2):324–32.CrossRef
28.
go back to reference Shin KR, Park HJ, Kim M. Practice of breast self-examination and knowledge of breast cancer among female university student. Nurs Health Sci. 2012;14:292–7.PubMedCrossRef Shin KR, Park HJ, Kim M. Practice of breast self-examination and knowledge of breast cancer among female university student. Nurs Health Sci. 2012;14:292–7.PubMedCrossRef
29.
go back to reference Guliford K, McKinley E, Turner L. Breast cancer knowledge, beliefs, and screening behaviors of college women: application of the health belief model. Am J Health Educ. 2017;48(4):256–63.CrossRef Guliford K, McKinley E, Turner L. Breast cancer knowledge, beliefs, and screening behaviors of college women: application of the health belief model. Am J Health Educ. 2017;48(4):256–63.CrossRef
30.
go back to reference Data and Information Center Indonesian Health Ministry. Cancer Situation. Buletin Jendela Data dan Informasi Kesehatan. 2015;1:1–11. Data and Information Center Indonesian Health Ministry. Cancer Situation. Buletin Jendela Data dan Informasi Kesehatan. 2015;1:1–11.
31.
go back to reference Statistics of Surabaya City. Surabaya municipality in figure 2016. Surabaya: Statistics of Surabaya City; 2016. Statistics of Surabaya City. Surabaya municipality in figure 2016. Surabaya: Statistics of Surabaya City; 2016.
32.
go back to reference Dewi TK. Validation of the Indonesian version of champion’s health belief model scale for breast self-examination. Psychol Res Behav Manag. 2018;11:433–8.PubMedPubMedCentralCrossRef Dewi TK. Validation of the Indonesian version of champion’s health belief model scale for breast self-examination. Psychol Res Behav Manag. 2018;11:433–8.PubMedPubMedCentralCrossRef
33.
go back to reference Xiong Q, Valero V, Kau V, Kau SW, Taylor S, Smith TL, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis: the M.D. Anderson Cancer Center Experience. Cancer. 2001;92:2523–8.PubMedCrossRef Xiong Q, Valero V, Kau V, Kau SW, Taylor S, Smith TL, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis: the M.D. Anderson Cancer Center Experience. Cancer. 2001;92:2523–8.PubMedCrossRef
34.
go back to reference Oemiyati R, Rahajeng E, Kristanto A. Prevalensi Tumor dan Beberapa Faktor yang Mempengaruhinya di Indonesia. Buletin Penelitian Kesehatan. 2011;39(4):190–204. Oemiyati R, Rahajeng E, Kristanto A. Prevalensi Tumor dan Beberapa Faktor yang Mempengaruhinya di Indonesia. Buletin Penelitian Kesehatan. 2011;39(4):190–204.
35.
go back to reference Ng C, Pathy NB, Taib NA, The YC, Mun KS, Amiruddin A, et al. Comparison of breast cancer in Indonesia and Malaysia – a clinico-pathological study between Dharmais Cancer Centre, Jakarta and university Malaya medical center, Kuala Lumpur. Asian Pac J Cancer Prev. 2011;12:2943–6.PubMed Ng C, Pathy NB, Taib NA, The YC, Mun KS, Amiruddin A, et al. Comparison of breast cancer in Indonesia and Malaysia – a clinico-pathological study between Dharmais Cancer Centre, Jakarta and university Malaya medical center, Kuala Lumpur. Asian Pac J Cancer Prev. 2011;12:2943–6.PubMed
36.
go back to reference Khokhar A. View point: how to make women familiar with their breasts? Asian Pac J Cancer Prev. 2013;14:5539–42.PubMedCrossRef Khokhar A. View point: how to make women familiar with their breasts? Asian Pac J Cancer Prev. 2013;14:5539–42.PubMedCrossRef
37.
go back to reference Tennen H, Affleck G. The costs and benefits of optimistic explanations and dispositional optimism. J Pers. 1987;55:377–93.CrossRef Tennen H, Affleck G. The costs and benefits of optimistic explanations and dispositional optimism. J Pers. 1987;55:377–93.CrossRef
38.
go back to reference Weinstein ND, Lyon JE. Mindset, optimistic bias about personal risk and health-protective behaviour. Brit J Health Psych. 1999;4:289–300.CrossRef Weinstein ND, Lyon JE. Mindset, optimistic bias about personal risk and health-protective behaviour. Brit J Health Psych. 1999;4:289–300.CrossRef
39.
go back to reference Weinstein ND. Unrealistic optimism about future life events. J Pers Soc Psych. 1980;39:806–20.CrossRef Weinstein ND. Unrealistic optimism about future life events. J Pers Soc Psych. 1980;39:806–20.CrossRef
40.
go back to reference Avci IA. Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community. Eur J Oncol Nurs. 2008;12(2):127–33.PubMedCrossRef Avci IA. Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community. Eur J Oncol Nurs. 2008;12(2):127–33.PubMedCrossRef
41.
go back to reference Azaiza F, Cohen F. Health beliefs and rates of breast cancer screening among Arab women. J Women's Health. 2006;15(5):520–30.CrossRef Azaiza F, Cohen F. Health beliefs and rates of breast cancer screening among Arab women. J Women's Health. 2006;15(5):520–30.CrossRef
42.
go back to reference Halligan P. Caring for patients of Islamic denomination: critical care nurses’ experiences in Saudi Arabia. J Clin Nurs. 2006;15(12):1565–73.PubMedCrossRef Halligan P. Caring for patients of Islamic denomination: critical care nurses’ experiences in Saudi Arabia. J Clin Nurs. 2006;15(12):1565–73.PubMedCrossRef
43.
go back to reference Rogers RW, Deckner CW. Effects of fear appeals and physiological arousal upon emotion, attitudes, and cigarette smoking. J Pers Soc Psych. 1975;32:22230.CrossRef Rogers RW, Deckner CW. Effects of fear appeals and physiological arousal upon emotion, attitudes, and cigarette smoking. J Pers Soc Psych. 1975;32:22230.CrossRef
44.
go back to reference Ruiter AC, Kessels LTE, Peters GY, Kok G. Sixty years of fear appeal research: current state of the evidence. Int J Psych. 2014;49(2):63–70.CrossRef Ruiter AC, Kessels LTE, Peters GY, Kok G. Sixty years of fear appeal research: current state of the evidence. Int J Psych. 2014;49(2):63–70.CrossRef
45.
go back to reference Floyd DL, Prentice-Dunn S, Rogers RW. A meta-analysis of research on protection motivation theory. J App Soc Psych. 2000;30:407–29.CrossRef Floyd DL, Prentice-Dunn S, Rogers RW. A meta-analysis of research on protection motivation theory. J App Soc Psych. 2000;30:407–29.CrossRef
46.
go back to reference Milne S, Sheeran P, Orbell S. Prediction and intervention in health-related behavior: a meta-analytic review of protection motivation theory. J App Soc Psych. 2000;30:106–43.CrossRef Milne S, Sheeran P, Orbell S. Prediction and intervention in health-related behavior: a meta-analytic review of protection motivation theory. J App Soc Psych. 2000;30:106–43.CrossRef
47.
go back to reference Ruiter RAC, Abraham C, Kok G. Scary warnings and rational precautions: a review of the psychology of fear appeals. Psychol Health. 2001;16:613–30.CrossRef Ruiter RAC, Abraham C, Kok G. Scary warnings and rational precautions: a review of the psychology of fear appeals. Psychol Health. 2001;16:613–30.CrossRef
48.
go back to reference Straughan PT, Seow A. Attitudes as barriers in breast screening: a prospective study among Singapore women. Soc Sci Med. 2000;51:1695–703.PubMedCrossRef Straughan PT, Seow A. Attitudes as barriers in breast screening: a prospective study among Singapore women. Soc Sci Med. 2000;51:1695–703.PubMedCrossRef
Metadata
Title
Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model
Authors
Triana Kesuma Dewi
Karlijn Massar
Robert A. C. Ruiter
Tino Leonardi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7951-2

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue