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YEAR 2008-2010.



















(ICMR Bulletin 2003). The primary health care which is a key to achieve the goal of health for all 2000 A.6 per lakh.000 new cases are detected every year (K.B. In India 80. 1. the patient comes very late for treatment (Dr. The incidence rate of breast cancer for Urban Indian Women is 18 to 25/1.6. even after knowledge of the presence of breast lump. . The risk factors are obesity. inspiring the women of today to stride a head in life. There is a need for developing new or improved method through systematic investigations of traditional system of medicine I order to optimize the use of available resources. The national health plan have consistently emphasized on the importance of maternal and child health. and hormonal drugs. high intake of fatty diet. 2003). 1994). INTRODUCTION Every year we celebrate the women’s International Day. Singh.K.000 where as for India Rural Women it is 8. While women have made progress in most off the field but still her tends to in inexplicably neglect her own health. 2002). World wide.C Bakance.D included indigenous system of medicine as an important element. Due to lack of awareness and poverty.00. null parity. The cause of breast cancer is unknown. BLACK(1997) defines breast cancer as a group of malignant disease that commonly occurs in the female breast and infrequently in the male breast. early menarche below the age of 11 years and late menopause.1. genetics. The mean age of occurrence of cancer in India women in 42 years as cared to 53 years in white women and it is leading cause of death among middle aged when (Drakshyani devi. BRIEF RESUME OF THE INTENDED WORK:6.05 million new cases have been reported in the year 2001.

NEED FOR THE STUDY Breast cancer is the second commonest cancer in women in India. inexpensive. prevention and procedure of breast self examination.  Physical examination of the breast by a trained health professional clinical breast examination every 3 years between age 20 and 40 and every year these after. current guidelines accepted by the American College of Radiology. So that health Institutions are publishing and announcing a but breast cancer.2.More over Indian is developing county. . early diagnosis. American cancer society. Which give good results in early cancer stages? This makes breast cancer a major problem requiring intensive health awareness campaign and screening and detection prognosis. next to cancer of cervix early diagnosis affords a better chance of survival and better prognosis several methods are available for early diagnosis. and early implant for the detection of breast cancer is breast self examination. Now a days cost of care is high. So “Prevention is better than cure”. risk factors. 6. National Cancer institute regarding breast surveillance practices includes the following: Monthly breast self examination from the age of 20 years. The most cost effective and long lasting programme would be to teach women themselves and to motivate them to participate in detection In 2003. causes. One ounce prevention is better than tones of cure. Regular breast self examination can identify any abnormal changes in breast to establish good prognosis. It is one of simplest and important health programmers to promote early detection.  Screening mammography for symptomatic women between the ages of 40 and 49 every year and mammography once or twice annually for women 50 years of age and older. At present simple. 60% are women are considering to the low and middle class family.

The WHO.due to some reasons like lack of confidence. and it will assist to reduce the stress for mothers. inability to examine. It will helpful to avoid biopsies. it is important for patients to understand that various treatment options are available. NIMMAGAD says. USA adopted the UN millennium Declaration two of 8 millennium developmental goals are related to improving maternal health respectively. alleged complexity of the procedure forgetfulness fear of the possible discovery of a lump and embarrassment. As stated “ All guilty is not gold. The women should be told what to look for while performing a breast self examination such as lump. the largest every gathering of heads of state in the United Nations in New York. is that dreaded through the cancer may be. as measure by execution of BSE components. Mamma care method explained in greater proficiency in carrying out BSE. In fact. Dr. the maternal mortality ration. Doctor recommended that regular self breast examination after the age of 30 in necessary. . This inclusion is the result of many years of advocacy for the need to recognize the link between maternal health and development. DBE can be an important complement to mammography in the earlier detection of breast cancer. and all the breast problems are not related to breast cancer” In the year 2000. scores of women have overcome breast cancer to lead successful lives. Finally the women should be reminded that most breast problems are not related to malignancy and they should be advises to reduce anxiety. associated with manipulation of breast. nipple discharges nipple retraction. lack of time. the International confederation of midwives and the FIGO are pleased to see the inclusion in the MDGs of the target to reduce by 3/4 th between 1990 and 2015. pain or tenderness dimpling of the skin or oedema. SHARON Mc DONALD evidence suggests that. and in higher sensitivity. redness. as measured by lump detection. pointing to the importance of these health factor in global development and poverty reduction. medical visits. for some women.

Therefore the investigator feels that nurses have an educational role concerning breast lesions. The investigator took this study to draw some implications. No study has been done so for on the impact of an admission of mothers in the female medical ward. area hospital. They are the source of information. It is necessary. So that assessment of breast cancer becomes a part of health announcement in reproductive health lessons. nurses can reduce associated fear. By allowing clients to take about breast cancer. to develop a feeling of self confidence and self satisfaction in the individual in the handling of minor health problems and how to do breast self examination. women’s education is more emphasized and people are more aware about the health problems and health facilities. Now a day. The findings of the study will be useful for future students in dealing and understanding the importance of breast self examination. Women are key group to target with health information and training programme for the following reasons:  Firstly they themselves are risk and in need of information  Secondly. . Women may then seek earlier assessment diagnosis and effective treatment. correcting these misconceptions and supplying accurate fact. anxiety and create awareness. Madanapalle. 2005 suggest the performing breast self examination correctly is important women’s who want to perform self examinations should ask their health care provider to demonstrate how to do it and how to tell the difference between normal tissue and suspicious lumps. In this context in order to improve holistic care it is essential to gain insights into factor influencing to do BSE.SASLOW.

age.  To evaluate women after giving planned health teaching regarding Breast self examination. BREST SELF EXAMINATION A technique that all women can use to assess their own breast.5.  To find out the relation between selected variables and pre-test and post-test knowledge.  To educate women regarding Breast self examination. OPERATIONAL DEFINITIONS EVALUATE.3 STATEMENT OF THE PROBLEM:“A study to evaluate the effectiveness of a structured teaching progrmme on breast self examination among women admitted in female medical word. marital status. religion. Expected outcome of planned health teaching Breast self examination among women. STRUCTURED TEACHING PROGRAMME Referred to systematically planned teaching strategy designed to provide information regarding Brest Self Examination.Bangalore 6. . educational status.6.4 OBJECTIVES  To assess the knowledge of Breast self examination among women. SELECTED VARIABLES OF THE WOMEN Name. place. 6. Hinduja Sindhi Hospital . address.

MSN.  It is assumed that the tool prepared by the investigator will gather reliable and valid data for the study.  It is assumed that planned health teaching will improve the knowledge of women’s regarding Brest self examination. The National Cancer Institute and American cancer society recommended annual mammograms for asymptomatic women over 50 years or over 40 if here is family history of breast cancer or if the woman has ha breast cancer before.6. 6. 6. RN.7 RESEARCH HYPOTHESIS: H1= The mean post – test knowledge score of mothers on breast self examination will be significantly higher than the mean pre – test knowledge scores as evident. The review of literature of the present study is organized under the following headings.6 ASSUMPTIONS  It is assumed that the women will have knowledge on Breast Self Examination. It is usually diagnosed at a more advanced stage but the pathology. 2004 is a clinical oncologist.S.A M.K. in his study he stated that the incidence of breast cancer in men is about one percent of that in women and accounts for 0.  It is assumed that women selected for study will co-opearate and respond appropriately before and after structured teaching programme regarding Breast self examination.8 REVIEW OF LITERATURE.2% of male cancers. According to Indian National Cancer Registry report of 1987. it was estimated that one in nine Indian women will get breast cancer as comported to one in three women in U. TISH KNOFB. . pattern of metastasis and prognosis are similar to women.

in that he stated that the disease develops under the influence of various physical and chemical agents known as carcinogens. breast cancer is the leading cause of death in women between ages 39 to 44.D.K and U. metastasis involvement of the mammary nodes info great importance as a prognostic factor. 2005. 2006 written new soviet theory about origin of cancer. Breast cancer frequently metastasizes in the auxiliary nodes. M.S.. 2006 in his study stated that. R. LUCKMANN & SORENSON. a through breast examination is always done with the patient in the erect and supine position and with full relaxation of the patients shoulder and pectoral muscles. RUTH ANN MILLER. in his study state that malignancies of breast in highest in women in U. it is also the leading cause of cancer deaths in women between ages 35 to 74. eventually relapse have recurrence of the disease and die of metastases... PARAMESH KUMARKAR. Many breast cancer patients who remain disease free after initial treatment. the incidence of breast cancer is increasing world over.K. 2005 in their pilot study of 138 women with mastectomies that explored the consistent finding of more left breast cancer in American women. d.g.BHADURI. 2005. in his study explained that.D. Ph. SUSAN ALBRECHT. 2004 in his study stated about cancer detection in that. There is 2-3 fold increase in the risk of breast cancer amongst the first degree relatives of the patient with the cancer in the breast.A and other western countries where as in India carcinoma of female genital tract has highest incidence.o.MAN OF SHARMA. DILIP ROY. .

and to reveal not only that they work. Dr. No inherited (somatic) mutations also have been identified in breast tumors. 2004 the present findings indicate that attempts to encourage self examination of breast are only moderately successful and even its use is not necessarily strongly indicative of promptness of presentation. somatic mutations in the ERBB2 (also called Her -2/neu).CLYNN OWENS. and prevent others from forming. More over. and replace them with vaccine – induced immune cells that are activated to seek out and destroy breast cancer cells. M. EMENS in currently (2007) conducting a clinical study that integrates a cellbased breast cancer vaccine with low. Dr. and ultimately breast cancer prevention.E. These studies are all designed to strategically integrate breast cancer vaccines with standard and novel breast cancer drugs to achieve the greatest therapeutic impact. She will soon begin another clinical study that adds chemotherapy-modulated vaccination to standard Trastuzumb (Herceptin) therapy for patients with metastatic brest cancer that expresses high levels of the HER-2/nue also takes advantage of the ability of Trastuzumab to further increase the numbers of activated immune cells that fight breast cancer.D.DUFFY & R.Emern is also investigating immune based therapies that target not only the malignant breast cancer cells. 2006 advised “The biggest misconception about mammography is that is picks up every breast . but also how they work. This should ultimately shrink existing breast tumors. Susan Orel. For example.J. but also the tumorassociated blood vessels that support breast cancer growth and progression. The study is designed to use low dose chemotherapy to step away suppressive immune cells that help tumors to grow and spread. In addition the findings suggest that wider knowledge of the availably of breast conversation treatment could not only improve promptness and decrease anxiety in women in general and particularly ion increasing women’s knowledge of available breast conversation treatments. and TP53 genes have been associated with some cases of breast cancer. immune-modulating doses of chemotherapy in patients with metastasis breast cancer. it is clear that not only are many women ignorant regarding the facts of breast cancer and its treatment. DIRAS3. This research should pave the way for breast cancer vaccines to become a unique but standard part of breast cancer treatment.

Of these genes. bring it to your doctor’s attention. . the target is a molecular “switch” in the protein – making machinery of the cancer cell that enables a tumor to aggressively develop its won blood supply. a study released Thursday said. But so far. In fact. In 2007 American cancer research centre suggests that inherited variants of the ATM. ATM and CHEK2 have the strongest evidence of being related to the risk of developing breast cancer. Get it evaluated”. Medicines to reduce Breast cancer Risk center 2006 in US Results suggest that selective estrogen receptor modulators (SERMs) such as tamoxifen and raloxifence may lower breast cancer risk in women with certain breast cancer risk factors. NBN. PALB2. It is a chance for the participants to learn about cancer and at the same time help in promoting awareness. CHICAGO (AFP) 2005 – Researchers have identified a new target for drugs to help treat the most common form of breast cancer in the developing world. however. The program involves 60 miles of walking and is participated by millions of people nationwide. 2006 according to the Deserved Health website. most women are reluctant to take these medications because of concern about possible side effects. one of the most effective breast cancer awareness programs is the breast cancer walk which is a Breast Cancer 3 Day benefit. as well as certain versions of the AR gene. BARDI. BRIP1. Women with what is called locally advanced breast cancer can develop tumors that grow anywhere from 2 centimeters to 10 centimeters in diameter. So if you feel a lump that doesn’t show up on a mammogram. may also be associated with breast cancer risk. mammography misses at least 10 percent of breast cancer. CHECK2.cancer. RAD50. and RAD51 genes. The fund raising program is participated by men and women who want to make a difference in the lives of these breast cancer victims. Ot all studies have shown these connections.

and 3 percent had performed breast self examination and 32 percent never practiced breast self examination monthly. attitude. conducted a descriptive survey among 6380 female secondary students with mean age of 18 years to identify their knowledge of breast cancer and attitudes towards breast self examination. The study results reveals that in pre test 66 percent said that they never examined their breast.K.33 percent of teacher’s ad knowledge on Brest Self Examination and 66. The . The finding reveals that knowledge mean scores in pre test were 26.4 percent and 7.SINGH et.4 percent had positive attitude towards learning breast self examination.5 It suggested that there was a significant on breast cancer and Breast self examination..Gaczkowski T. carried out pre-experimental study on awareness regarding Breast Self Examination among 30 school teachers at Sawing.M students in West Bengal regarding breast cancer and BSE to assess the effects of planned teaching programme. Milaat W.1 percent respectively know the correct frequency and timing.67% teachers did not have any knowledge regarding Breast Self examination. It indicated that information will be effective in improving awareness and practice. Ladwick R. Post test mean was 21.N.6 percent reported ever-hearing of breast self examination and only 14. 33.67% had gained knowledge regarding Breast Self Examination. ability scores in pretest man was 0. In post test 96.5 and sum of square deviation 31.A (2000). Choudhary U.. The result of this study demonstrates that a one time intervention can be successful in increasing breast self examination practice and knowledge of breast self examination and cancer in adolescents.K et al. Only 39.43. The findings that in Pre-test. The findings of the study were that over 80 percent students failed to answer 50 percent of the questions correctly. (2003).K. mean gain was 47. in post test mean was 73. Pratima Chatterjee (2202) conducted pre-experimental study on 30 G. 82. 1998) conducted descriptive study on knowledge. al.66.23. and beliefs on breast cancer detection practice among 57 South Asian Women. (2001) carried pre-experimental study on breast self examination to identify the belief knowledge and practice of breast self examination in adolescent girls.

Their responses were then collected and analyses. Lecy. (2004).experimental study on evaluation of a community based programme for Breast Self examination among 1997 community nurse practitioners in Korea. Kim H. The majority 54% said they did not know very much about breast cancer. Iran. level of education.2% in control group. It was hoped this will help to reduce the morbidity and mortality associated with Carcinoma of breast. The practice of breast self examination monthly.S. 24. 98% had formal education. It suggests that there is a need for vigorous health education programme for women.(2002) conducted study on breast self examination among 410 female health care workers from seven health centers in Tehran. Most of women aware of breast self examination and its usefulness never practice it. M. had no statically significant relationship with the breast health practice scores. The mean knowledge score related to Breast cancer and Breast self examination was significantly higher for the women in the intervention group than in control group.. JEBBIN N.0% did not practice. but only 6% performed breast self examination monthly. 21% opined that early detection of cancer was important. Haji-Mahmoodi. at. et.5% of then had heard of Breast self examination but 39. The study finding suggest that the knowledge . The results of study reveals 30. 85.M.5% of women in the intervention group performed regular Breast Self Examination compared to 10. 49% had undergone clinical breast Examination and 46% had never had mammography.Montazeri A. conducted a study on Attitudes to knowledge and practice of Breast Self Examination among 200 women in Port Harcourt.findings revealed that 13% practiced Breast Self Examination monthly. Most 58% were married 75% of the women knew about breast cancer and prevalence 63% percent of the respondents claimed that they know how to examine their breast. They reported 5% that cancer could cured early.0% practiced Breast self examination only occasionally.J. personal history of breast problems and knowledge of how to examine the breast. The practice of breast self examination was significantly associated with are. ADOTEY J. (2003) conducted a quasi.

al. 178 teachers in Brighten Young University. Madnat H.R.and behavior of female health workers concerning Breast Cancer is relatively poor and it needs to be information about Breast Self Examination.. The findings of study nurses were more aware than teachers of the importance of breast cancer screening and its techniques mean screening awareness score for nurses was 88. The findings reveal statistically significant differences in outcome variables between the intervention and control groups.3 percent of women 40 and older. The majority of these women reported that their breast cancer knowledge was inadequate. et. Wood R. et. knowledge attitude and behaviors towards breast cancer early detection. . statistically significant differences in outcome variables between the intervention and control group. on effect of an educational intervention aged 60 or older. al.. Duffy M. and 70 percent of women 50 and older. on effect of an educational intervention on promoting Breast Self examination. Sadler G. 61.E.1% for teachers.Y. Merrill R>M (2002) did survey method study on breast cancer risk factor and screening of health and human performance among 163 nurses. (2002) conducted quasi-experimental pre-test and post-test design study among 328 African American and Caucasian Women on the effect of an educational intervention aged 60 or older.. Monthly breast self examination adherence was own only 40. (2201) conducted descriptive study on 194 Asian Indian Women.3% compared with 73. Pre-test and post test interviews conducted by nurses at two-week intervals.7 percent. These results prove important information about the level of breast cancer awareness among women nurses and teachers in Jordan and may be useful for developing future prevention and screening education programme.

RESEARCH VARIABLE There are independent variable and dependent variables are used. Sauter M. The findings suggest that one hour lesson can improve knowledge and attitudes of adolescent girls with respect to breast self examination and early cancer detection. . Independent – Structure teaching program on Breast self examination Dependent variables demographic data. The study was evaluate the effectiveness of structured teaching programme on breast self examination of women in female medical ward. II.1 SOURCES OF DATA Women’s admitted in female medical ward in Hinduja Sindhi Hospital Bangalore 7..Clark JK. al. RESEARCH DESIGN The research design in the plan for the study providing the overall framework for collecting data. 7. conducted quasi-experimental study on knowledge land attitude towards breast self examination among 137 adolescent girls. METHODS AND MATERIAL 7. Design depends upon the purpose of the study and the condition under which the study in conducted. Polit & hungler stated that a research design incorporates the most important methodological decisions that a researcher in the selection of subjects for interviewing and determines the type of analysis to be used.2 METHODS OF DATA COLLECTION I. The descriptive design was selected since it aided in attaining first hand information and enhanced obtaining accurate and meaningful data. et. (2000).

The Hinduja Sindhi Hospital is having the bed strength of 100. SETTING The pre-test study to be conduct in Female medical ward Hinduja Sindhi Hospital Bangalore. IV.III. . EXCLUSION CRITERIA : The women who - are not willing to participate in the study - has previous diagnosis of psychiatric disorder VII. VI. the female medical ward has total sanction bed strength of 20. The average nurse patient ratio is 1:10 V. SAMPLE TECHNIQUE Purposive sampling technique used for this study. The populations of the study comprised of the women’s admitted in female medical ward in Hinduja Sindhi Hospital Bangalore. SAMPLE The present study comprised of 50 women who are admitted in female medical ward. CRITERIA FOR SAMPLE SELECTION INCLUSION CRITERIA The women - who are admitted in female medical ward between 1 to 7 days - who ere available at the setting to conduct post test. POPULATION According to Polit & Hungler a population comprises of entire set of individuals having some common characteristics.

METHODS OF DATA COLLECTION DURATION OF STUDY One month used for the study X. Obstetrics and Gynecology and Nursing. educational status and marital status. TOOLS FOR DATA COLLECTION Structured questionnaire and Planned Health Teaching Programme are developed with the help of related literature from various text books. PROJECTED OUTCOME The result of the study will determine the existing knowledge of women on breast self examination and practice of important it also gives insight to teach women about preventive measures. Section C: Contained their knowledge on breast cancer. Section B: dealt with Anatomy and Physiology of breast. journals and discussion with the experts in the field of Oncology. . Section E: consist of prevention of breast cancer IX.VIII. Section D: dealt with knowledge on breast self examination. PLAN FOR DATA ANALYSIS It consist of inferential and descriptive data analysis XI. religion. Section A: Consisted of demographic data of the women such as name. age.

492. M. 224-227. jaypee brothers. 1st edition New Delhi. medical publishers(p) LTd. “Principles of Anatormy and Physiology” 8th edition New York.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN BEINGS OR ANIMALS? The study in conducted on Breast Self Examination Among Women Admitted In female ward Hinduja Sindhi Hospital Bangalore. .T. “Luchmann and sorensesn’s Medical surgical nursing” 4th edition. “Natomy and physiology for nurses”. 100-120 4. are not involved in any invasive investigation or interventions. MOsby Printers 1994. 3. Jayapee Brothers Meducal Publishers (p) LTd.935-936.Tortora. Diskson.Black and esther matassarin. Inderbir Singh. 3rd edition. 1998. Herper Collins Copllege Publishers 1996. New Delhi.. Joyce. Philadelpohia. “Nursing Research” 1st edition.64. Francine H. 7.. 1993 2055-2061. 2005 285-286.7.491. 1997. “Maternal Newborn Nursing Theory and practice” 1st edition.65 and 75. prior permission will be obtained from the concerned authority of the hospitals to conduct the study. Kalan. Gerard J.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM THE CONCERNED AUTHORITY OF THE HOSPITALS TO CONDUCT THE STUDY? Yes. 5. W.. Jacobs. New Delhi. privacy and anonymity will be assured to the women.. Silverman. LIST OF REFERENCES 1. The purpose of the study will be explained to the women in Hinduja Sindhi Hospital confidentiality. 6.. Basavathappa B.Nichols. Saunders Company. 2. Elaine Zwelling.B. “Maternal – Infant Nursing Care”. 8..

196219.. “Awareness regarding Breast Self Examination in school teacher effect of Health education Programme”. “Progress in obsetrics and gynecology” vol. Indian Journal of Medical Sciences.ii. The Indian Journal of Nursing and Midwifery Vol. ‘The lipopincott manual of nursing practice” 5th edition.1574-1578. “harrison’s principles of internal medicine” 16th edition vol.K. Jaypee Brothers Lilppincott company. . No-12 December 1994. 13. sage publication. Dr. Drakshyani Devi. “Test book of preventive and social medicine” 16th edition. New York..11. New York.. K. Lippoincott.Densive and Hunger. “Teacher’s knowledge and practice of Breast Self Examination”.7. 2005 27-28. Suzanne C.A. 10. Philadelphia.33 No-3.Be Bakane. “Rehabilitating breast cancer patients” Health Action March. March 1998.Bare. Fung SY.. Lippincott william’s company 1992. 12.. 3. No.. 52-57.1302-1305.6 September 2003.1991. l fuci. 1989. “Brunner and Suddhartha’s. 11. “Breast Self Examination among Saudi Female nursing students in Saudi Arabia” Saudi medical journal Vol. New Delhi jaypee brothers.284-287. Dr. “a text book of nursing research principles and methods” 4th edition. J. “Factors associated with Breast Self Examination behavior among earliler women in Hong Kong” Patient Education counseling Vol. Philadelphia.7. Kasper Braunwadl. 45. New York. November 2004.MC Quiston web..B..K.Singh. 1995 41-80/ 9. 2. 2002. Lippincott company. new year. Park K. 8. JOURNALS 1.Smeltzer Brunda G. “Forundations of nursing theory” California. Vol. “test book of medical and surgical nursing” 7th edition. 2000 289-291. 4. Alsaif A. Studd. Polit F. 24.233-243. Churchill living sone Edinburgh London. Me graw-? Ill companies.... 15.1310-1219.

kr.5... jaz@cast. “ A study to develop and evaluate the effectiveness of an information booklet on cancer risk” Nursing Journals of India. No-1. April jclark@gw. February Women’s Health Issues vol. Goergia Robina Sadler zylu@um. WEBSITE Budden@jcu. Al. 7. K. Niger Journal Medicine. “Chinese women Behaviours and attitudes towards Breast Caner education and screening”. 166-170. “Attitudes to knowledge and practice of Breast Self Examination in port Harcourt”.bsu. 227-228. .edu.sdu.S Bairwa. Jebbin NJ. LXXXIII. 13 No-2. No. woodr@bc. Vol.1 10 October cylee@yumc. 6.