Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Using the health belief model to predict breast self examination among Saudi women

Authors: Mostafa A. Abolfotouh, Ala’a A. BaniMustafa, Aisha A. Mahfouz, Mohammed H. Al-Assiri, Amal F. Al-Juhani, Ahmed S. Alaskar

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

In the Kingdom of Saudi Arabia, breast cancer (BC) usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination (BSE) for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model (HBM).

Methods

A convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia (n = 225), and their non-working adult female family members (n = 208), were subjected to the Arabic version of revised Champion’s Health Belief Model Scale (CHBMS) and the Arabic version of Breast Cancer Awareness Measure (CAM), to assess their knowledge and attitude on BC respectively. Percentage mean score (PMS) for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05.

Results

The majority of women heard about BSE (91.2 %), only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast (54.9 %), or untrusting themselves able to do it (24.5 %). Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures (PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively). They reported low scores of; perceived susceptibility, seriousness, confidence and barriers (PMS: 44.8 %, 55.6 %, 56.5 % & 41.7 % respectively), and high scores of perceived benefits and motivation (PMS: 73 % & 73.2 % respectively) to perform BSE. Significant predictors of  BSE performance were: levels of perceived barriers (p = 0.046) and perceived confidence (p = 0.001) to BSE, overall knowledge on BC (p < 0.001), work status (p = 0.032) and family history of BC (p = 0.011).

Conclusions

Saudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.
Literature
1.
2.
Elkum N, Dermime S, Ajarim D, Al-Zahrani A, Alsayed A, Tulbah A, et al. Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: the Saudi Arabia experience. BMC Cancer. 2007;7(1):222.CrossRefPubMedPubMedCentral
3.
Alsaif AA. Breast self-examination among Saudi female nursing students in Saudi Arabia. Saudi Med J. 2004;25(11):1574–8.PubMed
4.
Radi SM. Breast cancer awareness among Saudi females in Jeddah. Asian Pac J Cancer Prev. 2013;14(7):4307–12.CrossRefPubMed
5.
Ceber E, Soyer MT, Ciceklioglu M, Cimat S. Breast cancer risk assessment and risk perception on nurses and midwives in Bornova Health District in Turkey. Cancer Nurs. 2006;29(3):244–9.CrossRefPubMed
6.
Othman A, Ahram M, Al-Tarawneh MR, Shahrouri M. Knowledge, Attitudes and Practices of Breast Cancer Screening Among Women in Jordan. Health Care Women Int. 2015;36(5):578–92.CrossRefPubMed
7.
Arevian M, Noureddine S, Abboud S. Beliefs related to breast cancer and breast cancer screening among Lebanese Armenian Women. Health Care Women Int. 2011;32(11):972–89.CrossRefPubMed
8.
Mahfouz AA, Hassanein MH, Nahar S, Farheen A, Gaballah II, Mohamed A, et al. Breast cancer knowledge and related behaviors among women in Abha city, southwestern Saudi Arabia. J Cancer Educ. 2013;28(3):516–20.CrossRefPubMed
9.
El Bcheraoui C, Basulaiman M, Wilson S, Daoud F, Tuffaha M, AlMazroa MA, et al. Breast Cancer Screening in Saudi Arabia: Free but Almost No Takers. PLoS One. 2015;10(3):e0119051.CrossRefPubMedPubMedCentral
10.
Thomas DB, Gao DL, Ray RM, Wang WW, Allison CJ, Chen FL, et al. Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst. 2002;94(19):1445–57.CrossRefPubMed
11.
Semiglazov V, Manikhas A, Moiseenko V, Protsenko S, Kharikova R, Seleznev I, et al. Results of a prospective randomized investigation [Russia (St. Petersburg)/WHO] to evaluate the significance of self-examination for the early detection of breast cancer. Vopr Onkologii. 2002;49(4):434–41.
12.
Kosters J, Gotzsche P. Regular self-examination or clinical examination for early detection of breast cancer. Int J Epidemiol. 2008;37(6):1219.
13.
14.
Allen TL, Van Groningen BJ, Barksdale DJ, McCarthy R. The breast self-examination controversy: what providers and patients should know. J Nurse Pract. 2010;6(6):444–51.CrossRef
15.
16.
Thornton H, Pillarisetti RR. ‘Breast awareness’ and ‘breast self-examination’ are not the same. What do these terms mean? Why are they confused? What can we do? Eur J Cancer. 2008;44(15):2118–21.CrossRefPubMed
17.
Dandash KF, Al-Mohaimeed A. Knowledge, attitudes, and practices surrounding breast cancer and screening in female teachers of Buraidah, Saudi Arabia. Int J Health Sci. 2007;1(1):61.
18.
Petro‐Nustus W, Mikhail BI. Factors Associated with Breast Self‐Examination Among Jordanian Women. Public Health Nurs. 2002;19(4):263–71.CrossRefPubMed
19.
Canbulat N, Uzun Ö. Health beliefs and breast cancer screening behaviors among female health workers in Turkey. Eur J Oncol Nurs. 2008;12(2):148–56.CrossRefPubMed
20.
Mikhail BI, Petro-Nustas WI. Transcultural adaptation of Champion’s health belief model scales. J Nurs Scholarsh. 2001;33(2):159–65.CrossRefPubMed
21.
Savage SA, Clarke VA. Factors associated with screening mammography and breast self-examination intentions. Health Educ Res. 1996;11(4):409–21.CrossRefPubMed
22.
Yarbrough SS, Braden CJ. Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours. J Adv Nurs. 2001;33(5):677–88.CrossRefPubMed
23.
Champion V, Menon U. Predicting mammography and breast self-examination in African American women. Cancer Nurs. 1997;20(5):315–22.CrossRefPubMed
24.
Secginli S, Nahcivan NO. Factors associated with breast cancer screening behaviours in a sample of Turkish women: a questionnaire survey. Int J Nurs Stud. 2006;43(2):161–71.CrossRefPubMed
25.
Alam AA. Knowledge of breast cancer and its risk and protective factors among women in Riyadh. Ann Saudi Med. 2006;26(4):272.PubMed
26.
Amin TT, Al Mulhim A, Al MA. Breast cancer knowledge, risk factors and screening among adult Saudi women in a primary health care setting. Asian Pac J Cancer Prev. 2009;10(1):133–8.PubMed
27.
Sharaa HM. Beliefs and Reported Practices Related to Breast Self Examination among Sample of Egyptian Women. 2013.
28.
Agboola A, Deji-Agboola A, Oritogun K, Musa A, Oyebadejo T, Ayoade B. Knowledge, Attitude and Practice of Breast Self Examination in Female Health Workers in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. The International Medical Journal. 2009;8(1):5–10.
29.
Alwan N, Al Attar W, Eliessa R, Madfaic Z, Tawfeeq F. Knowledge, attitude and practice regarding breast cancer and breast self-examination among a sample of the educated population in Iraq. 2012.
30.
31.
Champion VL. Instrument refinement for breast cancer screening behaviors. Nurs Res. 1993;42(3):139–43.CrossRefPubMed
32.
Balogun M, Owoaje E. Knowledge and practice of breast self-examination among female traders in Ibadan Nigeria. Annals Ibadan Postgraduate Med. 2007;3(2):52–6.CrossRef
33.
Ahmed BA. Awareness and practice of breast cancer and breast-self examination among university students in Yemen. Asian Pac J Cancer Prev. 2009;11(1):101–5.
34.
Obaikol R, Galukande M, Fualal J. Knowledge and Practice of Breast Self Examination among Female Students in a Sub-Saharan African University. 2010.
35.
Millat W. Knowledge of secondary-school female students on breast cancer and breast self-examination in Jeddah, Saudi Arabia. 2000.
36.
Jahan S, Al-Saigul AM, Abdelgadir MH. Breast cancer. Knowledge, attitudes and practices of breast self examination among women in Qassim region of Saudi Arabia. Saudi Med J. 2006;27(11):1737–41.PubMed
37.
Kashgari RH, Ibrahim AM. Breast cancer: Attitude, knowledge and practice of breast self examination of 157 Saudi women. J Fam Commun Med. 1996;3(1):10.
38.
Persson K, Johansson I, EK AC. Breast self‐examination among Swedish women: A survey of frequency, knowledge, and attitudes. J Cancer Educ. 1995;10(3):163–7.PubMed
39.
Janda M, Obermair A, Haidinger G, Waldhoer T, Vutuc C. Austrian women’s attitudes toward and knowledge of breast self‐examination. J Cancer Educ. 2000;15(2):91–4.PubMed
40.
Salaudeen A, Akande T, Musa O. Knowledge and attitudes to breast cancer and breast self examination among female undergraduates in a state in Nigeria. Eur J Soc Sci. 2009;7(3):157–65.
41.
Abdel FM. Breast self-examination practice and its impact on breast cancer diagnosis in Alexandria, Egypt. 2000.
42.
Wardle J, Steptoe A, Smith H, Groll-Knapp E, Koller M, Smith D, et al. Breast self-examination: attitudes and practices among young women in Europe. Eur J Cancer Prev. 1995;4(1):61–8.CrossRefPubMed
43.
Ng K, Fung S, Chow L. Practice of breast self-examination among high risk Chinese women in Hong Kong. Chin Med J (Engl). 2000;113(12):1100–3.
44.
Pavia M, Ricciardi G, Bianco A, Pantisano P, Langiano E, Angelillo IF. Breast and cervical cancer screening: Knowledge, attitudes and behaviour among schoolteachers in Italy. Eur J Epidemiol. 1999;15(4):307–11.CrossRefPubMed
45.
Odusanya O. Breast cancer: knowledge, attitudes, and practices of female schoolteachers in Lagos, Nigeria. Breast J. 2001;7(3):171–5.CrossRefPubMed
46.
Parsa P, Kandiah M, Mohd Zulkefli NA, Rahman HA. Knowledge and behavior regarding breast cancer screening among female teachers in Selangor Malaysia. Asian Pac J Cancer Prev. 2008;9(2):221–7.PubMed
47.
Haji‐Mahmoodi M, Montazeri A, Jarvandi S, Ebrahimi M, Haghighat S, Harirchi I. Breast Self‐Examination: Knowledge, Attitudes, and Practices Among Female Health Care Workers in Tehran, Iran. Breast J. 2002;8(4):222–5.CrossRefPubMed
48.
Nahcivan NO, Secginli S. Health beliefs related to breast self-examination in a sample of Turkish women. Oncol Nurs Forum. 2007;34(2):425–32.CrossRefPubMed
49.
Gaballah I. Awareness, Knowledge and Practice of Breast Self-Examination Among Saudi Women. Med. J. Cairo Univ. 2011;79(2):81-6.
50.
Tastan S, Iyigün E, Kılıc A, Unver V. Health beliefs concerning breast self-examination of nurses in Turkey. Asian Nursing Res. 2011;5(3):151–6.CrossRef
51.
Champion VL, Miller TK. Variables related to breast self-examination: Model generation. Psychol Women Quart. 1992;16(1):81–96.CrossRef
52.
Tavafian SS, Hasani L, Aghamolaei T, Zare S, Gregory D. Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model. BMC Women's Health. 2009;9(1):37.CrossRefPubMedPubMedCentral
53.
Champion VL, Scott CR. Reliability and validity of breast cancer screening belief scales in African American women. Nurs Res. 1997;46(6):331–7.CrossRefPubMed
54.
Gözüm S, Aydin I. Validation evidence for Turkish adaptation of Champion’s Health Belief Model scales. Cancer Nurs. 2004;27(6):491–8.PubMed
55.
Yavari P, Pourhoseingholi MA. Socioeconomic factors association with knowledge and practice of breast self-examination among Iranian women. Asian Pac J Cancer Prev. 2007;8(4):618–22.PubMed
56.
Kara B, Acikel CH. Health beliefs and breast self‐examination in a sample of Turkish nursing students and their mothers. J Clin Nurs. 2009;18(10):1412–21.CrossRefPubMed
57.
Avcı İA. The health beliefs relating to mammography of midwives and nurses. Meme Sağlığı Dergisi. 2007;3(2):4–9.
58.
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.CrossRefPubMed
59.
Dündar PE, Özmen D, Öztürk B, Haspolat G, Akyıldız F, Çoban S, et al. The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey. BMC Cancer. 2006;6(1):43.CrossRefPubMedPubMedCentral
60.
Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J Surg Oncol. 2006;4(1):11.CrossRefPubMedPubMedCentral
61.
Jumah JAB. Knowledge & Practice of Saudi Women about the Prevention of Breast Cancer. International Journal of Applied. 2013;3(2):8-13.
62.
63.
McMenamin M, Barry H, Lennon A-M, Purcell H, Baum M, Keegan D, et al. A survey of breast cancer awareness and knowledge in a Western population: lots of light but little illumination. Eur J Cancer. 2005;41(3):393–7.CrossRefPubMed
64.
Madanat H, Merrill RM. Breast cancer risk-factor and screening awareness among women nurses and teachers in Amman Jordan. Cancer Nurs. 2002;25(4):276–82.CrossRefPubMed
65.
Cavdar Y, Akyolcu N, Ozbaş A, Oztekin D, Ayoğu T, Akyüz N. Determining female physicians’ and nurses’ practices and attitudes toward breast self-examination in Istanbul, Turkey. Oncol Nurs Forum. 2007;34(6):1218–21.CrossRefPubMed
66.
Demirkiran F, Balkaya NA, Memis S, Turk G, Ozvurmaz S, Tuncyurek P. How do nurses and teachers perform breast self-examination: are they reliable sources of information? BMC Public Health. 2007;7(1):96.CrossRefPubMedPubMedCentral
67.
Dirksen S, Lewis S. Nursing Management: Breast Disorders. Medical-surgical nursing: Assessment and Management of Clinical Problems (SM Lewis, MM Heitkemper, SR Dirksen, eds). 2004:1360–83.
Metadata
Title
Using the health belief model to predict breast self examination among Saudi women
Authors
Mostafa A. Abolfotouh
Ala’a A. BaniMustafa
Aisha A. Mahfouz
Mohammed H. Al-Assiri
Amal F. Al-Juhani
Ahmed S. Alaskar
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2510-y

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue

Research article

Do discrimination, residential school attendance and cultural disruption add to individual-level diabetes risk among Aboriginal people in Canada?

Research article

Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France

Research article

USA’s expanded overseas tuberculosis screening program: a retrospective study in China

Research article

Viral transmission risk factors in an Egyptian population with high hepatitis C prevalence

Research article

The association between medical students’ lifestyles and their attitudes towards preventive counseling in different countries

Research article

Health and health behaviours before and during the Great Recession, overall and by socioeconomic status, using data from four repeated cross-sectional health surveys in Spain (2001–2012)