Full Project – KNOWLEDGE OF BREAST CANCER, PRACTICE OF BREAST SELF-EXAMINATION AND BREAST SELF-EXAMINATION ENHANCEMENT STRATEGIES AMONG FEMALE UNDERGRADUATES IN HIGHER INSTITUTIONS IN IMO STATE

Full Project – KNOWLEDGE OF BREAST CANCER, PRACTICE OF BREAST SELF-EXAMINATION AND BREAST SELF-EXAMINATION ENHANCEMENT STRATEGIES AMONG FEMALE UNDERGRADUATES IN HIGHER INSTITUTIONS IN IMO STATE

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TABLE OF CONTENTS

Title Page

Approval Page

Certification

Dedication

Acknowledgement

Table of Contents

List of Tables

List of Figures

Abstract

CHAPTER ONE: Introduction

Background to the Study

Statement of the Problem

Purpose of the Study

Research Questions

Research Hypotheses

Significance of the Study

Scope of the Study

CHAPTER TWO: Review of Related Literature

Conceptual Framework

Breast cancer

Breast self-examination (BSE)

Knowledge of Breast Cancer and Practice of BSE

Measurement of knowledge of breast cancer and practice of BSE

Higher Institutions

Undergraduates

Enhancement Strategies of BSE

Socio-demographic factors associated with knowledge of breast cancer and practice of  BSE

Theoretical Framework

Health Belief Model

Powe’s Fatalism Model

Protection Motivation Theory

Empirical Studies

Summary of Literature Review

CHAPTER THREE: Methods

Research Design

Area of the Study

Population of the Study

Sample and Sampling Techniques

Instrument for Data Collection

            Validity of the instrument

            Reliability of the instrument

Method of Data Collection

Method of Data Analysis

CHAPTER FOUR: Results and Discussion

Results

Summary of Major Findings

Discussions

CHAPTER FIVE: Summary, Conclusions and Recommendations

Summary

Conclusions

Recommendations

Limitations of the Study

Suggestions for Further Study

References

 

Abstract

This study was undertaken to determine the knowledge of breast cancer, practice of breast self-examination (BSE) and formulate BSE enhancement strategies among female undergraduates in higher institutions in Imo State. To guide the study, eleven specific objectives with corresponding research questions were formulated, while eight null hypotheses were postulated. The study utilized descriptive survey design. The population of the study was consisted of 18,790 regular female undergraduates in higher institutions in Imo State and health experts in universities and colleges of education in Southeast, Nigeria. A sample of 1,089 female undergraduates representing 5.8 per cent of the female undergraduates’ population and 20 health experts in the field of Health and Physical Education and Public Health Education, participated in the study. A two-stage sampling procedure was employed to select the female undergraduates’ sample, while purposive sampling technique was employed to select the experts’ sample for the study. Data for the study were collected using three instruments. These were: a 34-item Knowledge of Breast Cancer and Practice of Beast Self-Examination Questionnaire (KBCPBSEQ), 9-item Knowledge of Breast Cancer and Practice of BSE Focus Group Discussion Guide (KBCPBSEFGDG) and a Part one and Part two item BSE Enhancement Strategies Questionnaire (BSEESQ). The KBCPBSEQ designed in a multiple choice and yes or no question format was used to generate quantitative data on female undergraduates’ bio data, knowledge of breast cancer and practice of BSE. The KBCPBSEFGDG was used to generate qualitative data on knowledge of breast cancer and practice of BSE, to complement the quantitative data. The BSEESQ was used to evaluate the researcher’s formulated BSE enhancement strategies for female undergraduates. Each of the three instruments used was validated by five experts. Split-half technique using Spearman Brown Formula and Cronbach’s alpha were used to establish the reliability of the KBCPBSEQ and BSEESQ respectively. Reliability coefficient of .73 and .87 were obtained for Section B and Section C of the KBCPBSEQ, respectively, while .73 and .95 were obtained for part one and part two of the BSEESQ respectively. 1,072 copies of duly completed and returned KBCPBSEQ, representing 98 per cent response rate, were used for data analysis. The verbal and non-verbal responses of the female undergraduates during the KBCPBSEFGDs were interpreted and analyzed qualitatively, while all the completed and returned 20 copies of the BSEESQ were used for data analysis. The data collected were analyzed by using descriptive statistics of mean percentage scores, percentages and mean for the purpose of answering the research questions, while the eight null hypotheses were tested using t-Test, ANOVA and Chi-square (χ2) statistics, at .05 level of significance. The result of the study revealed that: female undergraduates had moderate level of knowledge regarding concept of breast cancer (KCBC: 52.15%) and breast cancer risk factors (KBCRF: 53.57%), high level of knowledge regarding breast cancer signs and symptoms (KBCSS: 67.07%) and very low level of knowledge regarding breast cancer preventive measures (KBCPM: 8.5%). The result further revealed that overall, a low proportion (40.5%) of female undergraduates practised BSE, while specifically, a low proportion of female undergraduates practised BSE monthly (33.4%) and examined their breasts between the 7th and10th day of their menstrual cycle (39.9%). The result also revealed that there was no significant difference (p > 0.05) in the level of KCBC; KBCSS and KBCPM, while there was significant difference (p < 0.05) in the level of KBCRF according to age. There was no significant difference in the level of KCBC; KBCRF; KBCSS and KBCPM according to marital status. There was significant difference in the level of KCBC, while there was no significant difference in the level of KBCRF; KBCSS and KBCPM according to family history of breast cancer. There was significant difference in the level of KCBC and KBCRF, while there was no significant difference in the level of KBCSS and KBCPM according to religious denomination. There was no significant difference in the female undergraduates’ practice of BSE according to age, marital status, family history of breast cancer and religious denomination. Also, the result revealed that the BSE enhancement strategies formulated based on the findings were deemed very appropriate. The results were exhaustively discussed and recommendations were made. Among the recommendations made was that Higher institutions, Government, Non-Governmental Organizations, Center for Women and Gender Studies, Churches, Communities, Female Organizations, Health educators and health professionals in Imo State should adopt and use the Breast Self-Examination enhancement strategies formed in the course of this study, to mount intervention progarammes at the different settings were female undergraduates could be reached. This will help to raise to very high level, the knowledge of breast cancer and enhance the practice of BSE among female undergraduates, in Imo State.

 

CHAPTER ONE

Introduction

Background of the Study

Breast cancer remains a major health problem all over the world, affecting women in both the developing and developed countries. The incidence of breast cancer is even growing in regions of the world (such as Asia and Africa) that had a low incidence of the disease in the past. Based on studies during 1975 – 1990, Asia and Africa have experienced a more rapid rise in the annual incidence rate of breast cancer than that of North America and Europe (Shirazi, Champeau, & Talebi, 2006). According to Jayadevan, Jayakumary, Manda and Merlin (2010), the incidence of breast cancer is increasing in most countries of Asia and Africa. Isara and Ojedokun (2011) observed that breast cancer is a public health problem that is increasing throughout the world especially in developing countries, including Nigeria.

Breast cancer is the leading type of cancer in women. It is and still remains one of the cancers affecting all age groups of women worldwide. Lesccynska,Krajewska and Leszczynski (2004) stated that globally, breast cancer is the most common malignant neoplasm among women. Continuing, they stated that globally, over one million new cases of breast cancer among females are detected each year. According to American Cancer Society (ACS) (2009), National Cancer Institute estimated that one in eight women born today will be diagnosed with breast cancer at some time in her life. This is a dramatic increase from the rate in 1977, when the rate was one in fourteen women (George, 2000).

Breast cancer is a significant cause of cancer deaths among women all over the world, including women in Nigeria. Adebamowo and Ajayi (2000) stated that breast cancer is the second principal cause of cancer deaths among women in the world as well as in Nigeria. Continuing they reported that the prevalence rate of breast cancer according to a study in Nigeria was 116 per 100,000 and 27,840 cases occurred in 1999. The report further stated that Nigerian women usually present with advanced stages of the disease at which time little or no benefit can be derived in the form of therapy. Sasco (2001) reported that in Nigeria, over 100,000 women develop breast cancer annually with majority of patients arriving medical centres at a late stage, thus resulting in a high mortality rate. Muanya (2014) stated that according to National Cancer Control Programme report, breast cancer incidence in Nigeria has gone up at least four times over the decade and in 2010, it accounted for 40 per cent of women cancers.

Breast cancer incidence is growing faster in age groups (between 36 and 44 years) that had a low incidence of the disease.

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