“A STUDY TO ASSESS EFFECTIVENESS OF STUCTURED

TEACHING PROGRAMME ON THE KNOWLEDGE

OF WOMEN REGARDING BREAST SELF-
EXAMINATIONIN SELECTED
RURAL AREA OF
SURAT.”

Dissertation submitted for the partial fulfilment of the requirement for the degree of
BACHELOR OF SCIENCE IN NURSING
of
VEER NARMAD SOUTH GUJARAT UNIVERSITY,
SURAT, GUJARAT
4TH YEAR BASIC B.SC NURSING

VIBRANT NURSING COLLEGE, MASMA, SURAT

GUJARAT
“A STUDY TO ASSESS EFFECTIVENESS OF STUCTURED
TEACHING PROGRAMME ON THE KNOWLEDGE
OF WOMEN REGARDING BREAST SELF-
EXAMINATION IN SELECTED
RURAL AREA OF
SURAT.”

Dissertation submitted for the partial fulfilment of the requirement for the degree of
BACHELOR OF SCIENCE IN NURSING
of
VEER NARMAD SOUTH GUJARAT UNIVERSITY,
SURAT, GUJARAT
4TH YEAR BASIC B.SC NURSING

(COLLEGE LOGO)

VIBRANT NURSING COLLEGE, MASMA, SURAT

GUJARAT
“A STUDY TO ASSESS EFFECTIVENESS OF STUCTURED
TEACHING PROGRAMME ON THE KNOWLEDGE
OF WOMEN REGARDING BREAST SELF-
EXAMINATION IN SELECTED
RURAL AREA OF
SURAT.”

Dissertation submitted for the partial fulfilment of the requirement for the degree of
BACHELOR OF SCIENCE IN NURSING
of
VEER NARMAD SOUTH GUJARAT UNIVERSITY,
SURAT, GUJARAT
4TH YEAR BASIC B.SC NURSING

NAME OF THE STUDENTS

MS.KOMAL UTTAMBHAI PATEL

MS.RUPAKUMARI RAMDEV PAL
MS.CHHAYA CHUNILAL PARGI
MS.DRASHTIGULABBHAI PATEL
MS.HASMITA BHARATBHAI SOLANKI

NAME OF GUIDE

VIBRANT NURSING COLLEGE, MASMA, SURAT

GUJARAT
 CERTIFICATION OF WORK FROM PRINCIPAL

This is to certify that the dissertation entitled“A study to assess Effectiveness of Structured
Teaching Program on the Knowledge of Women regarding Breast Self-Examination in
selected Rural area of Surat.” is a bonafied research work done byMS.KOMAL
UTTAMBHAI PATEL, MS.RUPAKUMARI RAMDEV PAL, MS.DRASHTI
GULABBHAI PATEL, AND MS.HASMITA BHARATBHAI SOLANKIin partial
fulfilment of the requirement for the degree of bachelor of science in nursing.

Signature of the Principal

Mrs. ALKA TAJNE
M.SC. (N), Ph.D Scholar
Principal,
Department of Child Health
Nursing,
Vibrant Nursing College,
Masma, Surat.

Date:

Place:

(college seal)

CERTIFICATION OF WORK FROM GUIDE/CO-GUIDE

This is certify that the dissertation entitled “A study to assess Effectiveness of Structured
Teaching Program on the Knowledge of Women regarding Breast Self-Examination in
selected Rural area of Surat.” is a bonafied research work done byMS.KOMAL
UTTAMBHAI PATEL, MS.RUPAKUMARI RAMDEV PAL, MS.DRASHTI
GULABBHAI PATEL, AND MS.HASMITA BHARATBHAI SOLANKIin partial
fulfilment of the requirement for the degree of bachelor of science in nursing.

Signature of Guide

Date:

Place:

DECLARATION BY THE CANDIDATES

I hereby declare that this dissertation/thesis
entitled
“A study to assess Effectiveness of Structured Teaching Program on the Knowledge of
Women regarding Breast Self-Examination in selected Rural area of Surat.” is abonafide
and genuine research work carried out by us under the guidance of Ms.Krinal P. Patel M.sc
Nursing in Community Health Nursing.

Date: Signature of the

Candidates

Place:

ACKNOWLEDGEMENT
We express our joyful enthusiasm and happiness on the successful completion of our thesis.
First of all, We would like to express our sincere and heartfelt thanks to the Almighty God
for giving us the necessary strength and courage to complete this study.We are greatly
honoured to express our sincere thanks to Mr.KamleshbhaiJagani, Provost of Vibrant
Nursing College, Masma, who has given us the opportunity to do our Bachelor of science in
Nursing.

We are deeply privileged to express our profound gratitude and heartfelt thanks to our
esteemed research guide Mrs.AlkaTajne, Principal, Vibrant Nursing College, Veer Narmad
South Gujarat University, Surat, for her expert guidance, encouragement, valuable
suggestions and timely corrections in the successful completion of the thesis.We feel
gratitude to our HOD, Ms.Krinal Patel, Assistant Professor, Community Health Nursing, for
her guidance, suggestion, support and motivation for the completion of the study.

We are extremely thankful to Dr.Mitesh Patel, Medical Officer, community health

center,sachin, Surat for extending their cooperation and permitting us to conduct our
research work in the rural area of the Surat. We express my sincere thanks to the Anganwadi
Workers and Women of rural area of Sachin for helping us during our research work. We
are extremely thankful to Mr.SatishbhaiVithalbhai Patel, the Statistician, who has done the
data analysis of the study.We would like to thankMr. Jigarsinh B. Parmar and
Mrs.ChandrakalaValvi who have done language translation, language re-translation of the
tool and Structure Teaching Programme and English editing of the study.

We extend thanks to our friends and classmate for their continuous support and help
throughout this study. We express our heartfelt thanks to our beloved parents and family
members for their constant prayers and support during our entire research study.

Name of the Candidates

MS.KOMAL PATEL
MS.RUPA PAL
MS.CHHAYA PARGI
MS.DRASHTI PATEL
MS.HASMITA SOLANKI
NAMEOF CANDIDATES MS.KOMAL PATEL
MS.RUPA PAL
MS.CHHAYA PARGI
MS.DRASHTI PATEL

MS.HASMITA SOLANKI

NAME OF INSTITUTE VIBRANT NURSING COLLEGE,

MASMA, SURAT, GUJARAT

NAME OF GUIDE

NAME OF CO-GUIDE

NAME OF COURSE BACHELOR OF SCIENCE IN NURSING

ACEDEMIC YEAR 4TH YEAR BASIC B.SC NURSING

PROBLEM STATEMENT:

“A STUDY TO ASSESS EFFECTIVENESS OF STUCTURED TEACHING

PROGRAMME ON THE KNOWLEDGEOF WOMEN REGARDING BREAST

SELF-EXAMINATION IN SELECTEDRURAL AREA OFSURAT.”

 INDEX
SR.NO CONTENT PAGE NO.

1. INTRODUCTION

 Background of the study

 Need of the study
 Problem Statement
 Objectives of the study
 Operational definition
 Assumptions / hypothesis
 Delimitations
 Conceptual framework
2. REVIEW OF LITERATURE

3. RESEARCH METHODOLOGY

 Research approach
 Research design
 Variables
 Schematic representation of the study
 Setting of the study
 Population
 Sample and sampling technique
 Inclusion criteria
 Exclusion criteria
 Development / selection of the tool
 Description of the tool
 Content validity
 Reliability of the tool
 Ethical consideration
 Pilot Study
 Data collection process
 Plan for data analysis

4. ANALYSIS AND INTERPRETATION OF

DATA

5. DISCUSSION
SUMMARY
MAJOR FINDINGS OF THE STUDY
CONCLUSION
IMPLICATIONS
RECOMMENDATIONS
REFERENCE
LIST OF ANNEXURES
 LIST OF TABLES
SR NO. CONTENT PAGE NO.
1. Frequency and distribution of samples by their characteristics:
Age, Religion, Education, Occupation, Marital status,
Numbers of children, Types of family and Income

2. Mean, Median, Standard deviation of knowledge score of the

women

3. Significance of mean difference of pre-test and post test

knowledge score of the women
 LIST OF FIGURES
SR NO. TITLE OF FIGURE PAGE NO.
1. Conceptual framework on knowledge of the women regarding
Breast Self-Examination based on Imogene king’s goal
attainment theory

2. Schematic representation of one group pre-test post-test pre-

experimental research design

3. Schematic representation of research process

 ABSTARCT

Background:
Breast cancer begins when healthy cells in the breast change and grow out of
control, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or
benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of
the body. A benign tumor means the tumor can grow but will not spread. Breast cancer
spreads when the cancer grows into other parts of the body or when breast cancer cells move
to other parts of the body through the blood vessels and/or lymph vessels.This is called a
metastasis, which includes stages I, II, and III. The stage of breast cancer describes where
the cancer is located, how much the cancer has grown, and if or where it has spread.
Although breast cancer most commonly spreads to nearby lymph nodes, it can also spread
further through the body to areas such as the bones, lungs, liver, and brain. This is called
metastatic or stage IV breast cancer. According to the National Cancer Institute and the
American Cancer society in 2018; over 2,65,000 new cases of breast cancer diagnose each
year in women; approximately 40,000 women and 480 men will die; over 3.1 million breast
cancer survivors in the United States; the 5-year survival for all breast cancer patients is
nearly 90%; Breast cancer is the most frequent among women impacting 2.1 million women
each year. In 2018, it is estimated that 6,27,000 women died from breast cancer that is
approximately 15% of all cancers deaths among women.

Problem Statement:

“A study to assess Effectiveness of Structured Teaching Program on the Knowledge of

Women regarding Breast Self-Examination in selected Rural area of Surat.”
Objectives of the study:

1. To assess the Knowledge of Women regarding Breast Self-Examinationamong before

and after the Structured Teaching Program.
2. To assess the effectiveness of Structured Teaching Programmeon Knowledge regarding
Breast Self-Examination among Women.

Hypothesis:

H1: The mean post test score of Knowledge regarding Breast Self- Examination will be
significantly higher than 0.05 of significance.
H2: There will be significant relationship between post-test Knowledge, score with their
selected demographic variables of Women.

Conceptual Framework:

Imogene king’s conceptual framework theory of goal attainment was applied to assess the
effectiveness of Structured Teaching Programme on Breast Self-Examination among
women in a selected rural area of Surat.

Research Methodology:

A Pre-experimental, one group pre-test post-test design with a quantitative research

approach was utilized to test the proposed hypotheses.Independent variable in this study was
Structured Teaching Programme on knowledge regarding Breast Self-examination.
Dependent variable in this study was knowledge on Breast Self-Examination. Structured
knowledge questionnaire was prepared to determine the level of knowledge of women
before and after Structured Teaching Programme. For Structured teaching programme,
lesson plan was prepared regarding Breast Self-Examination. The tool was tested for
reliability by using Test re-testmethod and applying Karl Pearson’s coefficient of correlation
formula. The ‘r’ was found to be 0.8, hence the tool was found statically reliable for the
study. Pilot study was done under the 6 women at Masma,Olpad. Pilot study revealed that
the tools were feasible for conduction of the study and the structured teaching programme
was effective. The main study sample consisted of 30 women residing in a rural area of
Sachin. The research setting was Masma and Sachin, Surat, Gujarat. The Non-Probability
convenience sampling technique was used for the study. The data were analyzed and
hypothesis were tested using descriptive and inferential statistics.

Result:

The knowledge mean score of pre-test was 11.36%, Standard deviation was 5.05%
and post-test mean knowledge score was 18 % and Standard deviation was 3.38%.
Structured Teaching Programme was effective in improving knowledge statistically at 0.05
level.
Limitations:

 The study was delimited to rural area of Sachin only.

 The study was delimited to the Women between age groups of 15-49 years only.

Recommendations:

1. A similar study for replication of this study is indicated with a larger sample size to
generalize the findings.

2. The research tool can be updated and can be used as evaluation criteria for the
Knowledge of the women regarding Breast Self-Examination.

3. The content of the Structure Teaching Programme can be updated and used to teach
women for improving knowledge regarding Breast Self-Examination.

4. The findings of the study can be used as an evidence-based result in implementing

policies and health care measures by the Government agencies and Non-Government
Agencies for the education of women.

5. An exploratory study can be carried out to identify various factors responsible for lack of
knowledge of the women regarding Breast Self-Examination.

6. A study can be conducted using other strategies such as manual, information booklet,
self-learning packages and video shows.

7. A true experimental research design can be conducted using intervention.

8. A comparative study can be carried out between the urban and rural area of the women.

Conclusion:

Overall pre-test knowledge score was less which suggests the need for structured
teaching programme for women regarding Breast Self-Examination. Post-test results
showed that there was a significant improvement in the level of knowledge. Hence, it was
concluded that structured teaching programme was an effective method of teaching the
women regarding Breast Self-Examination.

Key Words:

Knowledge, Effectiveness, Women, Breast Self-Examination, Structured Teaching

Programme, Selected, Rural area
CHAPTER-1
 CHAPTER -1

INTRODUCTION

BACK GROUND OF THE STUDY

“The true beauty of a woman is in health, in her ability to be active.”

Woman plays a critical role in any society. Women's reproductive and sexual

health has a distinct difference compared to men's health, due to unique biological, social
and behavioural conditions. Women are the most vulnerable populations in the world,
suffering the most from illness, poverty, and disparity.1

Breast cancer begins when healthy cells in the breast change and grow out of
control, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or
benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of
the body. A benign tumor means the tumor can grow but will not spread. Breast cancer
spreads when the cancer grows into other parts of the body or when breast cancer cells move
to other parts of the body through the blood vessels and/or lymph vessels. 2 This is called a
metastasis, which includes stages I, II, and III. The stage of breast cancer describes where
the cancer is located, how much the cancer has grown, and if or where it has spread.
Although breast cancer most commonly spreads to nearby lymph nodes, it can also spread
further through the body to areas such as the bones, lungs, liver, and brain. This is called
metastatic or stage IV breast cancer.3

There are many risk factors that increase the chance of developing breast cancer.
Some of the risk factors include; age, family history of breast cancer, personal history of
breast cancer in one breast, diagnosed with certain benign breast conditions , menstrual
cycle start at a younger age or went through menopause, women with dense breast tissue,
exposure to previous chest radiation or use of diethylstilbestrol, having no children or the
first child after age 30, overweight, use of oral contraceptives, hormone therapy, alcohol
consumption.4 Signs and symptoms of Breast cancer include; a lump in the breast or armpit,
bloody nipple discharge, inverted nipple, orange-peel texture or dimpling of the breast's
skin, breast pain or sore nipple, swollen lymph nodes in the neck or armpit, a change in the
size or shape of the breast or nipple.5

According to the National Cancer Institute and the American Cancer society in 2018;
over 2,65,000 new cases of breast cancer diagnose each year in women; approximately
40,000 women and 480 men will die; over 3.1 million breast cancer survivors in the United
States; the 5-year survival for all breast cancer patients is nearly 90%; Breast cancer is the
most frequent among women impacting 2.1 million women each year. In 2018, it is
estimated that 6,27,000 women died from breast cancer that is approximately 15% of all
cancers deaths among women.6

Breast Self-Examination is a procedure performed by an individual to physically &

visually examine herself for changes in breast, under arm areas of the body.Providing
education & encouraging the women to perform Breast Self-Examination is recommended
to decrease the mortality rates from breast abnormality /disorders. The ideal time to perform
Breast Self-Examination is 2 or 3 days after the menstruation ends, at that time breasts are
least likely to be tender or swollen. 7 Breast Self-Examination is a very simple, very low cost
non-invasive, comfortable, adjuvant screening. It can be done by a pregnant women,
lactating mother & women’s with breast implants. There is evidence that women who
correctly practice Breast Self-Examination monthly & more likely to detect lump at the
early stages of its development & early diagnosis has been reported to influence early
treatment & to yield a better survival rate. Breast self - examination also helps to detect
other breast problems such as change in appearance & other conditions which required
medical attention as mastitis, fibro adenoma etc.8
Nurses plays a vital role in teaching the Breast Self-Examination to the women’s to
identify the Breast abnormalities. The nurses who can promote monthly Breast Self-
Examination should be perfect by supporting realistic believes about early detection &
prevention of breast abnormalities as well as demonstrating Breast Self-Examination, so that
the women can do it themselves without consulting physician.9

NEEDS OF THE STUDY

“A strong women doesn’t give up even through her heart feel heavy, she takes one
more step then another and another’’.
One of the recent concerns among the globe is breast cancer among both sex which is the
most common cancer and the leading cause of cancer related death. Breasts are the
important organs for each woman as these are the symbols of motherhood and women hood.
Breast cancer is probably the most feared cancer in women because its frequency and
psychosocial impact. It affects the perception of sexuality and self-image to a degree great
than any other cancer.10
The incidence of breast cancer is rising in every country of the world especially in
developing countries such as India. This is because more and more women in India are
beginning to work outside their homes which allow the various risk factors of breast cancer
to come into play. These include late age at first childbirth, fewer children and shorter
duration of breast-feeding. In addition, early age at menarche and late age at menopause add
to the risk to some extent.11 Based on National Cancer Registry Programme report of 2001-
2003, about 25% of the total cancer cases among Indian women constitutes of Breast cancer.
The crude incidence rate of Breast cancer at India level is about 85 per 100,000 women per
year. It is estimated that about 85000 new cases of Breast cancer are occurring in India,
every year. The mortality rate is around 7 per 1,00,000 cases per year.12

A study was conducted to investigate factors and beliefs that may be related to the
practice of the Breast Self-Examination among a group of Jordanian women in 2018 .A total
of 519 women’s were selected from two major universities in Jordan by using a stratified
Random sampling method. The study result indicated that although the majority sample
population that is 67% had heard or read about Breast Self-examination. The study
concluded that the benefits, susceptibility and motivation influenced the intention to perform
Breast Self-examination in the future.13

A Study to assess the knowledge on Breast Self-Examination among the women of

reproductive age groups. A survey approach with descriptive design was used for the study.
The sample consisted of 60 rural women of reproductive age group that is 18-45years,
selected by non-probability convenient sampling method. Data was collected by
administering structured knowledge questionnaire on Breast Self-Examination prepared by
the researchers. The collected data was analyzed using descriptive and inferential statistics.
Result of the study reveals that 1.66 percentage of the women had very good knowledge,
3.33 percentage of women had good knowledge, 53.33 percentage of women had average
knowledge and 41.66 percentage of women had poor knowledge. The mean percentage of
knowledge of rural women regarding Breast Self-Examination was 9.23. The association of
the knowledge score with demographic variable i.e. Age χ2 =0.098,P>0.05, Education χ2
=0.081,P>0.05, Occupation χ2 =0.617,P>0.05, Marital status χ2 =1.465,P>0.05, Monthly
income χ2 =3.056,P>0.0, Source of information χ2 =0.002,P>0.05.The result of the study
shows that there is no significant association between the knowledge score with selected
demographic variable.
Breast abnormalities are most commonly seen in women, Presently millions of women’s do
not perform Breast Self-Examination for a variety of reasons, including lack of confidence,
not knowing what to look for, limited tactile sensitivity with a bare hand, fear of finding an
abnormality and discomfort in touching their own breast. The researcher felt that a well-
planned structured teaching program of Breast self-examination provides adequate
knowledge and develops skills needed for Breast self-Examination which will make them
capable of identifying the change at the earliest so it is necessary to teach women’s about
Breast Self-Examination.14

PROBLEM STATEMENT

“A study to assess Effectiveness of Structured Teaching Program on the Knowledge of

Women regarding Breast Self-Examination in selected Rural area of Surat.

OBJECTIVES OF THE STUDY

3. To assess the Knowledge of Women regarding Breast Self-Examinationamong before
and after the Structured Teaching Program.
4. To assess the effectiveness of Structured Teaching Programmeon Knowledge regarding
Breast Self-Examination among Women.

Operational definitions

ASSESS:
In this study assess means to identify the Knowledge and Practice regarding Breast Self-
Examination.15

EFFECTIVENESS:
In this study Effectiveness means change in the mean score of Knowledge, Practice and
Attitude regarding Breast Self-Examination.16

STRUCTURED TEACHING PROGRAMME:

In this study structured teaching program means a formal interaction between researcher and
women using a prepared teaching plan in the following areas:17

Breast Cancer
 Introduction
 Anatomy & Physiology of breast
 Etiology
 Risk factors
 Types
 Sign and symptoms
  Treatment
 Prevention
 Breast self-examination

KNOWLEDGE
In this study knowledge means the correct responses given by the women regarding Breast
self- examination, which will be elicited using a structured interview schedule.18

WOMEN
In this study Women means, a female person of reproductive age group between 15- 49
years, who is having risk of breast cancer.19

BREAST SELF-EXAMINATION
In this study Breast Self-examination means self-examination ofbreast for early detection
and prevention of breast abnormalities.20

RURAL AREA
In this study Rural area means the selected villages coming under the Surat district.21

ASSUMPTIONS

 Women’s may have some knowledge regarding Breast Self-Examination.

 Structured Teaching Programme may enhance the knowledge of women regarding
Breast Self-Examination.

HYPOTHESIS
H1: The mean post test score of Knowledge regarding Breast Self- Examination will be
significantly higher than 0.05 of significance.
H2: There will be significant relationship between post-test Knowledge, score with their
selected demographic variables of Women.

Delimitations
 The study was delimited to rural area of Sachin only.
 The study was delimited to the Women between age groups of 15-49 years only.

Conceptual framework
 The conceptual framework presents logically constructed concepts to provide a
general explanation of the relationships among concepts of the research study. The
Conceptual framework is a written or visual presentation that explains the main things to be
studied in either graphically or narrative form the key factors, concepts, or variables and the
presumed relationship among them by Miles and Hubernan, 1994.22

Conceptual model of the present study is based on Imogene King's Goal attainment
theory.

Imogene King's Theory of Goal attainment:

The theory of goal attainment was developed in 1960 by Imogene King. She Published
"Toward a theory of nursing: general concepts of human behaviour" in 1971. She proposed
"A theory for nursing: systems, concepts and process" in 1981.

Basic assumptions of King's theory are:

o Nursing focus is the care of human being.
o The nursing goal is the health care of individuals & groups.
o Human beings are open systems interacting constantly with their environment.
o The basic assumption of goal attainment theory is that nurse and client
communicate information, set goal mutually and then act to attain those goals, is
also the basic assumption of the nursing process.
o Each human being perceives the world as a total person in making transactions
with individuals and things in the environment.
o The transaction represents a life situation in which perceiver & thing perceived
are encountered and in which person enters the situation as an active participant
and each is changed in the process of these experiences

The model has three interacting systems and each of these systems has its own set of
concepts.

1. Personal system/individual or personal

2. Interpersonal system/group or interpersonal

3. Social system/society or social

1.Personal system:

Each individual is a personal system. King designated an example of a personal system as a

patient or a nurse. King specified the concept of body image, growth, and development,
perception, self, space, and time in order to comprehend human beings as persons.

2. Interpersonal system:

These are formed by human beings interacting. Two interacting individuals form a dyad;
three form a triad, and four or more form small or large groups . As the number of
interacting individuals increases, so does the complexity of the concepts of the interactions.
Understanding the interpersonal system requires the concepts of communications,
interaction, role, stress, and transaction.

5. Social systems

A more comprehensive interacting system consists of groups that make up society, referred
to as the social system. Religious, educational, and health care system are examples of
social systems. The influential behaviour of an extended family on an individual’s growth
and development is another social system example. Within a social system, the concepts of
authority, decision making, organization, power, and status guide system understanding.

In this study, King's conceptual framework and theory of goal attainment were
applied to assess the effectiveness of structured teaching programme on the Knowledge, of
women regarding breast Self examination in selected rural area of Surat. Communication is
the main key for facilitating mutuality and trust between women and researcher because of
that King's interacting systems framework or theory of goal attainment applied in this
study.23
 FEEDBACK

PERCEPTION: Lack of
knowledge regarding Breast self-
examination.
MUTUAL REACTION: TRANSAC
JUDGMENT: Readiness to TION:
learn about Breast Self- GOAL
WOMEN PRE-TEST:
Examination.. SETTING:
POST-
[Age15-49years] Structured TEST:
To improve
ACTION: Consent and the knowledge GOAL
readiness for receiving questionnaire. Structured ATTAIN
knowledge
information. knowledge MENT:
regarding Assess the questionnaire
breast self knowledge.
INTRACTION . Improve
examination
knowledge
women. Assess the about
ACTION: Plan and implement knowledge. Breast Self-
Structured Teaching Programme
Examinatio
n
JUDGEMENT: Structured
RESEARCHER
Teaching Programme improves
the knowledge about Breast Self-
Examination

PERCEPTION: Need for health

education on Breast Self- FEEDBACK
Examination

KEY:

: Included in study.

--- : Not included in the study.

Figure 1: Conceptual framework on knowledge of women regarding breast self-
examination based on Imogene King’s theory of goal attainment

CHAPTER-2
 CHAPTER-2

REVIEW OF LITERATURE

A review of literature is a description and analysis of the literature relevant to a

particular field or topic. It helps to motivate for new research ideas and to help to the basic
idea of the study. It provides information regarding the significance of the fresh study to be
carried out and provides a background for better learning and understanding the existing
knowledge on the area of study. The beginning of the literature of review is through the
selection of a research problem that continues through several stages of research process.

In the process of carrying out the present study, the researcher has reviewed the following
literature which has been categorized under the following headings:

1. Studies related to the Breast cancer.

2. Studies related to the Breast self-examination.23
3.
1) STUDIES RELATED TO THE BREAST CANCER.

A cross-sectional study was conducted on “Breast cancer awareness in India” among

women in selected area in 2018 by Lalitha Subramanian, Heber anandan. The study
objective was to assess the awareness about risk factors screening, diagnosis and treatment
among the general public in south India. More than 90% of the population believe that
breast cancer is hereditary and had little knowledge about other risk factor majority of the
people are not aware that breast cancer can be cured if detect early although 80% of the
population believe that breast self-examination helps in early detection, <50% of them are
practising if regularly <2% of the population are aware of the mammogram and the
treatment modalities. This study concluded that socio demographic factors such as level of
education, income and marital status influence the percentage of people practising breast
self-examination. People with a family history of breast cancer and higher level of education
had better knowledge about the diagnostic method and treatment modalities.24

A cross-sectional study was conducted on “Awareness about Breast carcinoma and

practice of Breast Self-Examination among basic science college students of Bengluru” in
2017 by SuwarnamadukumaruthraR.thambiran. The study objective was to assess the level
of knowledge and awareness of breast carcinoma and Breast self-Examination in college
female students. To determine the effectiveness of planned teaching program among female
college students of Breast self-Examination. Most of them were aware of breast carcinoma,
but half of them thought breast cancer affects the elderly. Regarding different aspects
studies,58% had a knowledge of at least one of the symptoms and 59% a knew at least one
of the risk factors for breast carcinoma. Only 18% women knew about breast self-
examination and lots of women are participants. The study concluded that the awareness of
the breast cancer was the good but the knowledge of breast self-examination was poor,
which is most important for early detection and in reduction for mortality.25

A quasi-experimental study was conducted on “Effectiveness of planned teaching

Programme on Knowledge of early detection of breast cancer among school teachers” in
September-October 2016 by Ms.salomychacko. A study objective was to determine the
level of knowledge of early detection of breast cancer among school teachers using
structured knowledge questionnaires, to find the effectiveness of planned teaching
programme on early detection of breast cancer among school teachers in-terms of again in
knowledge score. And to find the association between the pre- test knowledge score and
selected baseline characteristics includes age, marital status, number of children if married
and previous score of information. A study concluded that the knowledge of teachers was
average before the administration of the Planned Teaching Programme. The post -test
knowledge score showed significant increase the level of knowledge of teachers. Hence the
Planned Teaching Programme is an effective teaching method for providing information and
improving the knowledge of teachers.26

A longitudinal study was conducted on “Effectiveness of planned teaching

programme in terms of knowledge regarding breast cancer” in 2015 by
Artimishra,jyotsanagovil. Broadly 53.4% women were aware about various aspect of 49.1%
women believed that breast cancer was incurable and 73.9% women believed pain to be an
initial breast cancer symptoms.Only 34.9% women performed breast self-examination and
6.9% women had under gone clinical breast examination\mammography 40.5% women had
higher awareness It is awareness score > median score of 19,which was associated with
education A study conclude that awareness must be drastically increase via community
outreach and use of media as a first step in the fight against breast cancer.27

A cross-sectional study was conducted on “Awareness level about breast cancer risk
factors early warning signs, screening and therapeutic approaches among Iranian adult
women” in 2014 by mabditazhibi and awatfeizi. A large population based study using latent
class analysis”. Lack of awareness and early detection programme in developing country is
a main reason for escalating the mortality. The mean and range of age for the study
participants were 36.8(+9.1) and 15-67 years. 51.9% of study participants had university
educational attainment and 81.9% of them were married.92.5% and 81.9% of study
participants had no personal breast problems history and first relatives family history
respectively. The nature of each class can easily be interpreted in-terms of awareness levels
about the screening approaches. The results also indicated that the women with higher
educational attainments, attending screening and public educational programs, personal
problem, family history of breast cancer, had higher levels of awareness.Developing of
public screening and educational program through health care system more emphasis on low
educated, single, younger women and those without family history are needed among
Iranian women.28

A Study was conducted on “A study on risk factors of breast cancer among patients
attending the tertiary care hospital in Udupi district” in 2013 by Ramchandrakamath,
kamleshwar s.Mahajan. The study objective was to study the factor associated with breast
cancer, to study the association between breast cancer and selected exposure variable and to
identify risk factors for breast cancer. Total 188 participants were include in the study, 94
cases and 94 controls. All the study participants were between 25-69 years of age group.
The cases and control were matched by ± 2 year age range. Non vegetarian diet was one of
the important risk factors. More than 7 to 12 years of education had 4.84 times risk of breast
cancer as compared with illiterate women. The study concluded that study suggested that
non vegetarian diet is the important risk factor for breast cancer and the risk of breast cancer
is more than educated women as compared with the illiterate women.29

2) STUDIES RELATED TO THE BREAST SELF-EXAMINATION.

A cross-sectional descriptive questionnaire study was conducted on “Breast Self-

Examination: Knowledge, Attitude and Practice among Panineeya Institute Dental Students
in Hyderabad City, Andhra Pradesh, India” in 2012. The aim was to assess the knowledge,
attitude and practice among the Dental Students in Hyderabad City regarding breast self-
examination in a cohort of Indian female dental students. Data were analyzed using SPSS
software Chi-square test was used for analysis of categorical variables. Correlation was
analyzed using Karl Pearson's correlation coefficient. The total scores for Knowledge,
Attitude and Practice were categorized into good and poor scores based on 70% cut-off
point out of the total expected score for each Knowledge, Attitude and Practice scores upon
correlation revealed a significant correlation between knowledge and attitude scores.The
study highlights the need for educational programs to create awareness regarding regular
breast cancer screening behaviour.30

A study was conducted on “Assessment of knowledge and practice of breast self-

examination among reproductive age women in Akatsi South district of Volta region of
Ghana” in 2010. Breast cancer is the primary cause of cancer death among women globally,
responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge
and practices of breast self-examination as a method of prevention and early diagnosis of
breast cancer among reproductive aged women in Akatsi South district in Volta region of
GhanaThe mean age of the women was 24.54±7.19. Only 3.1% of women had no formal
education and 58.9% were single. Although 88.3% of the respondents were aware of breast
cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and
only 94 that is 37.6% practice Breast Self-Examination. The findings in this study have
shown significant low levels of awareness and practice of breast self-examination among
women in Akatsi South district of the Volta region. This pattern may be similar to other
rural communities across the region. The need to create awareness and to educate women,
especially rural women, on importance of breast self-examination as preventive measure for
breast cancer is paramount.31

A study to effect of training on the knowledge levels and beliefs regarding breast self-
examination on women attending a public education centre in 2008.The aim of this study
was to evaluate the effect of subject training on the level of knowledge about breast self-
examination and breast cancer in women attending a public education centre. This research
was structured according to pre-test–post -test, one group research design principles. In pre-
test questions, the rate of correct answers was between 13.2% and 68.1%. After training, the
rate of correct answers increased to between 79.1% and 96.7% and attends demonstrated an
increase in the accuracy of their beliefs about breast cancer, health risk and susceptibility.
The perception of self-efficacy, an important variable in the process of behaviour change, is
a necessary component of changing and maintaining the practice of Breast Self-
Examination. The results of this work and others demonstrate that education administered
by nurses can increase positive perceptions about Breast Self-Examination self-efficacy.
Education in Breast Self Examination is easily administered, requires no special tools, could
lead to early diagnosis of breast cancer if performed regularly and should be taught to all
women aged 20 years and above.32
 A study to assess the effect of Knowledge, attitude, and practice of breast self-
examination among female of IT professionals in Silicon Valley of India.A total of 356
women were included in the study. The response and completion rates were 100%. All 356
women were aware of breast cancer. Women spanning from 18 to 55 years of age
participated in this study. Majority, i.e., 60.11% belonged to 18–28 years of age and only
1.68% were between 48 to 58 years.All women in the study were graduates at minimum and
the qualifications ranged up to Ph.D. Monthly income of most of the participants was
between Rs. 20,000–50,000a total of 44 women that is 12.35%.
CHAPTER-3
 CHAPTER-3

RESEARCH METHODOLOGY

This chapter deals with the description of the research methodology adopted by the
researcher to study and analyze the outcome of structured teaching programme on
knowledge of women regarding breast self-examination inselected rural areas of Surat.34

The steps which were under taken to conduct the study include: research approach,
research design, research setting, population, sample and sampling technique, development
and description of tool, validity, reliability, pilot study procedure and technique of data
collection and a plan for data analysis.

Research approach

Research Approach are plans and the procedures for research .That span the steps
form broad assumption to detailed method of data Collection, analysis, and interpretation.35

In this research study quantitative research approach was used.

Research design

A research design is the framework or guide used for the planning,

implementation and analysis of a study. It includes the descriptions of the research
approaches, dependent and independent variables, sampling design and a planned format for
data collection, analysis and presentation.36

The research design used for the study was pre-experimental one group pretest
post-test design.

Symbolic representation of one group pre-test post-test design.

The main focus of the study was to test knowledge of women regarding Breast Self-
Examination through one group pre-test post-test pre-experimental research design which
are depicted as O1 and O2 respectively. The experimental variable administered was
structured teaching programmeon women. The schematic representation of research design
used by the researcher is given below.
 Structured
EXPERIMENTAL
Pre-test Teaching Post-Test
GROUP
Programme
O1 X s

Figure 2: Schematic representation of one group pre-test post-test pre experimental

research design

Key:

O1 = Pre-test for assessing the knowledge through structured knowledge questionnaire.

X = Intervention through Structured Teaching programme

O2 = Post-test for assessing the knowledge through structured knowledge questionnaire.

Variable

Independent variable:

The part of the experiment that is being changed on purposes to test the results of that
changes.37

Independent variable in the study was Structured Teaching Programmeon knowledge

regarding breast self-examination.

Dependent variable:

Dependent variables are not controlled or manipulated in any way, but instead are simply
measured or registered.38

Dependent variable in this study was knowledge regarding breast self- examination
 Identificatio- “A study to assess Effectiveness of Structured Teaching Program on the Knowledge of
n of research Women regarding Breast Self-Examination in selected Rural area of Surat.
problem

Review of 10 literature reviews related to the breast cancer, Knowledge, Practice and Awareness

literature regarding Breast Self examination of 15-49 years old women.

‘;;

• Research approach: Quantitative approach

Research
• Research design: Pre-experimental one group pre-test post design
methodology
• Population: women age between 15-49 years of rural areas of Sachin Surat.
• Sample: Selected women age between 15-49 years of rural areas of Sachin
Surat.

Preparation • Tool -1 : Socio-demographic Variables

of Tool • Tool- 2: Structured knowledge questionnaire

Validity and Validation of tool by 4 experts.

reliability Test Re-test method is used in Structured Knowledge Questionnaire.

Pilot Study 6 women who has age between 15-49 years at Masma village, Surat.

30 women age between 15- 49 years at Sachin, Surat.

Data
gathering Pre-Test: Administration of structured knowledge questionnaire.
process Intervention: Structured Teaching Programme.
Post-Test: Administration of structured knowledge questionnaire.

Analysis and
Analysis of findings with the use of descriptive and inferential statistics.
interpretation
of findings.

Figure 3: Schematic representation of research process.

Setting of study

Research setting refers to the area where the study was conducted. 39The present
study was conducted all selected rural areas Sachin, Surat District, Gujarat.
Population

Population is the set of people or entities to which the results of a research are to be
generalized.40

The population for this study was the women age between 15-49 years in rural areas
of Sachin, Surat district, Gujarat.

Sample

Sample maybe defined as representative units of a target population, which is to be

worked upon by researchers during their study.41

The participants of the study were selected women of age 15-49 years, who fulfilled
the inclusion criteria, in the selected rural area of Sachin, Surat district, Gujarat.

Sample size

The sample size for the study was 30 women age between 15-49 years in the
selected rural area of Lajpor and Sachin,Surat district, Gujarat.42

15 subjects were from Lajporvillage, 15 subjects were from Sachin village, they
were selected based on the inclusion criteria.

Sampling Technique

Non probability convenience sampling technique used in this study.

Convenience sampling is probably the most common of all sampling technique

because it is fast, inexpensive, easy and sometimes subjects are readily available.

Criteria for sample selection

Inclusion criteria:

1 Women age between 15-49years residing in rural area of Olpad.

2 Women age between 15-49years who willing to participate in the research study.
3 Women age between 15-49years, who can understand, comprehend and respond to
Gujarati or English language.

Exclusion criteria:

1. Women age between 15-49years, who had undergone health education programme on

Breast Self-Examination.
 2. Women age between 15-49years who are sick during the time of data collection.

3. Women age between 15-49 years, who are not available during data collection.

Tool and Technique for data collection

The data collection tool consisted of structured knowledge questionnaire regarding

the breast self- examination.

Development of the tool

The purpose, objectives, research questions and hypothesis of the research was
examined thorough literature search was done. The selection of the subjects and their ability
was also considered. Discussion was also done with the experts and guide.

After understanding the research background, the content for lesson plan was made
and questionnaire were developed. The researcher developed knowledge questionnaire and
regarding the breast self- examination.

Description of Tool

Tool -1: Socio-demographic Variables

Tool-2: Structured Knowledge Questionnaire

Tool-1: Socio-demographic data: It consisted of 8 items. It contains Demographic data of

Women. Demographic data of women include age15-49years, religion, education of women,
occupation, types of family, marital status, number of children and family income.

Tool-2: Structured Knowledge Questionnaire: It consisted of 30 questions on knowledge

regarding breast self-examination and breast cancer.

BREAST CANCER

 Introduction
 Anatomy and physiology of breast
 Etiology
 Risk factors
 Types
 Sign & symptoms
 Treatment
  Prevention
 Breast self-examination

Structured Teaching programme

Structured Teaching Programme was prepared by the researchers to give the

information and practices in organized and systemic manner. For the present study, in order
to maintain and organize the content of Structured Teaching Programme, some books of
Medical Surgical Nursing, community health nursing, literature related to breast self-
examination of women age between 15-49years. Opinion and suggestion from experts has
also been taken to improve the Structured Teaching Programme contents. The Structured
Teaching Programmeincluded the following content:

BREAST CANCER

 Introduction
 Anatomy and physiology of breast
 Etiology
 Risk factors
 Types
 Sign & symptoms
 Treatment
 Prevention
 Breast self-examination

Validation of the tool

Validity is the extent to which a testmeasures what it claims to measure. It is vital for
a test to be valid in order for the results to be accurately applied and interpreted. 43

Structured knowledge questionnaire with 30 questions was validated by 3 experts

from community health nursing and 1 expert from obstretrics and gynecology. The
agreement of demographic item was 100% and knowledge question was also 100%. Rest of
the questions was modified as per suggestion of expert and 5 questions were added in tool to
make it 30 questions. Thus content validity of the knowledge questionnaire was established.

Translation of the tool was done by Gujarati language editor and re-translation was
done by English editor, and English editing was done by English editor. As per suggestion
of the editor content was modified. Structured teaching programmewas edited by Gujarati
Editor.
Reliability of the tool

Reliability is the extent to which the outcomes are consistent when the experiment is
repeated more than once.44

Reliability of the tool was done on 30 women of age 15-49years at Sachin village, Surat,
Gujarat. Reliability was calculated by using Karl Pearson‘s coefficient of correlation. The

n(Σxy)−(∑ x)(∑ y )
formula r = Where x= Test, y=re-test, n=30. And formula to estimate
√¿ ¿ ¿
reliability of entire test r1 = 2 r/ 1+ r. The normal value of r = 0.7 and the calculated value of
r = 4.23. The obtained value was more than normal value, hence the tool was found
statically reliable for the study.

Pilot study

Study carried out at the end of the planning phase of research in order to explore and test the
research elements to make relevant modifications in research tools and methodology.45

The researchers conducted a pilot study atMasmavillage,Olpad road, Surat, Gujarat. A

formal letter of permission was obtained for conducting a pilot study from Vibrant nursing
college. Permission was taken from Mrs.Rekha Patel the Sarpanch of MasmaVillage,Olpad.
The study was carried out from 28/02/2020 to 07/03/2020. The researchers took the consent
of women age between 15-49 years, who meet the inclusion criteria for the study. The
researchers selected 6 women age between 15-49 years for the pilot study. On 28/02/2020
pre-test was conducted by using the structured knowledge questionnaire. On the same day,
Structured Teaching Programme was administered in a session of 25 minute regarding
Breast Self-Examination. After the gap of 7 days, on 13/04/2019 post-test was conducted
using of same structured the pilot study did not show any major flaw in the tool design by
the researchers. It revealed that the tools were feasible for the conduction of the study. Also
proved that the structured knowledge questionnaire structured teaching programme was
effective and confirmed that the final study was feasible.

Data gathering process for main study

Ethical clearance permission was obtained from committee of Vibrant Nursing

College, Olpad,Surat. Study setting permission was obtained from Dr. Mitesh Patel, the
Medical Officer of community health center, Sachin, Surat.
 The main study was conducted on 30/01/2021 to 07/02/2021 at Lajpor and sachin
village.

The researchersgathered information from women age between 15-49years. The

researchers approached the women by the house to house survey with the help of
Anganwadi worker.

During the data collection, the researchers introduced herself to the women
agebetween15-49 years and explained the purposes of the study, once they consented for the
study; Researchers obtained written consent from the women age between 15-49 years. This
was conducted using of structured knowledge questionnaire on uses ofBreastself
examination.

After that on 2nd day researchers administrated structured teaching programme

regarding breast self examination in Gujarati language with the use of chart as A.V aids.
The time of the session was 25min.

After the completion of the 7th day researchers conducted a structured knowledge
questionnaire for the post-test to assess the knowledge regarding breast self-examination.
This
CHAPTER-4
 CHAPTER-4

ANALYSIS AND INTERPRETATION

The main purpose of this chapter is to organize and summarize the data for easy
interpretation.

An analysis is a process of organizing and synthesizing data to answer the research

question and test hypothesis. (Polit and Hungler,1999)

Interpretation refers to study the results of the analysis, make inferences about its
occurrence of relation, and draw conclusions about the relation. (Basavanthappa, 2007)

This chapter deals with the analysis and interpretation of the data collected during
the study from 30 samples as the study deals to assess the effect of structured teaching
programme on knowledge of the women regarding breast self-examination in a selected area
of Sachin, Surat, Gujarat. After collecting data, the researcher is faced with the task of
organizing the individual pieces of information so that the meaning is clear. The descriptive
and inferential statistics were used for analysis. The data collected was analyzed on the basis
of objectives and hypothesis of the study.

ANALYSIS AND INTERPRETATION OF DATA

The obtained data are organized presented in the following section.

Section-1: Deals with description of Socio-demographic variables of the women.

Section-2: Deals with Mean, Median, Mode and Standard Deviation of pre-test and post-test
knowledge of women.

Section-3: Deals with comparison of mean knowledge scores of pre-test and post-test of the
women.
Section-1Deals with Description of Socio-Demographic variables of the women.

Table 1: Frequency and Percentage distribution of samples by their characteristics: Age,

Religion, Education, Occupation, Marital status, Number of children, Type of family and
Income.

Socio-demographic data Frequency Percentage

Age in years
15-25 08 26.66%
26-35 10 33.33%
36-45 11 36.66%
46-48 01 3.33%
Religion
Muslim 00 0%
Hindu 30 100%
Education Status
No formal education 01 3.33%
Primary education 09 30%
Higher secondary education 17 56.66%
Graduation and above 03 10%
Occupation
Housewife 17 56.66%
Employee (Private/Govt.) 05 16.66%
Agriculture 00 0%
Daily Wages workers 05 16.66%
Marital status
Married 23 76.66%
Unmarried 07 23.33%

Cont…

Numbers of children
1 07 23.33%
 2 12 40%
3 05 16.66%
More than three 01 3.33%
Type of family
Nuclear 09 30%
Joint 22 73.33%
Others 00 0%
Income
Below Rs.1,500 01 3.33%
Rs.1,500-2,000 02 6.66%
Rs.2,001-2,500 11 36.66%
Above Rs.2,500 17 56.66%

The above table deals with the description of Socio-demographic variables of the women.

The data presented in the Table 1 denotes that out of 30 women 11 women’s majority
(36.66%) of them were in the age group of 36-45 years and 3.33% of them each were in the
age group of 45-48 years. Religion of the women are majority to Hindus.3.33 percent of the
women had No formal education,30 percent of the women had Primary education,56.66
percent of the women had Higher Secondary education,10 percent of the women are
graduated and above.56.66 percent of the women are Housewives,16.66 percent of the
women are Employee,0 percent of the women is come under Agriculture,16.66 percent of
the women are Daily Wages worker.76.66 percent of the women are Married and 23.33
percent of the women are Unmarried.23.33 percent of the women have 1 child,40 percent of
the women have 2 child,16.66 percent of the women have 3 children and 3.33 percent of the
women have more than three childrens.30 percent of the women comes from Nuclear
family,73.33 percent of the women comes from Joint family and no any women are comes
under the other types of family. With regard to income majority(56.66%)were earning above
Rs.2,501, 3.33% of them were earning more than Rs. 1,500,36.66% of them were earning
between Rs.2,000-Rs,2,500,6.66% of them were earning between Rs.1,500-Rs. 2,000.

SECTION-2

Table 2: Mean, Median, Standard deviation of knowledge score of the women.

 Knowledge Mean Median Mode Standard Range
deviation
Pre-test 11.36 16 16 5.05 20
Post-test 18 16 24 3.38 11
Difference 6.64 00 08 1.71 09

(n=30)

In the above table 2 deals with mean, median, mode, standard deviation and range of pre-
test and post-test knowledge score of the women. The mean pre-test score was 11.36% and
the mean post-test score was 18%, so the difference between the mean pre-test score and
post-test score was 6.64%.The median pre-test score was 16% and the median post-test
score was 16%,so the difference between the median pre-test score and post-test score was
0%. The mode pre-test score was 16% and the mode post-test score was 24%,so the
difference between mode pre-test score and post-test score was 08%.The standard deviation
score of the pre-test was 5.05% and standard deviation score of post-test was 3.38%,so the
difference between the standard deviation pre-test score and post-test score was 1.71%.The
range pre-test score was 20% and the range score of post-test was 11%,so the difference
between the range pre-test score and post-test score was 09%.

SECTION 3:

Deals with comparison of mean knowledge score of pre-test and post-test of the
women.

For testing the hypothesis paired t-test is applied to find the significant difference
between two means. The following formula is used for computing the paired t-test.

∑d
Paired t-test=
√ n¿ ¿ ¿ ¿

Here,

d = difference between the pre-test and post-test observation

d2 = square of difference

n = number of subject
Degree of freedom for paired subject (df = n-1)

df=59, 0.05 significance

Table 3: Significance of mean difference of pre-test and post-test knowledge score of the
women.

T-test
Standar
Mean
Knowledg Mea d SD Significanc
deviatio
e Score n deviatio D e
n Tabulate Calculate
n
d Value d Value

Pre-test 11.36 5.09

6.64 1.71 2.05 4.23 S
Post-test 18 3.38

From above table it is evident that the pre-test knowledge score of the women age
between 15-49 years was 11.36 % and post-test knowledge scores of the women age
between 15-49 years were 18%, with a mean difference is 6.64%. The calculated value is
4.23 was greater than tabulated value of t, 2.05 at df 59 and 0.05 level of significance.
Hence, the obtained difference is a true difference and not by chance. Therefore, H0 is
rejected and H1 is accepted. Structure Teaching Programme was effective in improving the
knowledge of thewomen age between 15-49 years statistically.
CHAPTER-5
 CHAPTER-5

DISCUSSION, SUMMARY, MAJOR FINDINGS AND CONCLUSION

This chapter present a brief summary of the study undertaken along with its major
findings, implication and conclusion drawn from findings recommendations for further in
the field also presented.

Discussion

This study addressed to assess the effectiveness of a Structured Teaching

Programme on the knowledge regarding Breast Self-Examination in selected rural area of
Surat. The researchers used an pre-experimental study for assessment of knowledge among
women. In this study, 30 women participated. It indicates that the Structure Teaching
Programme was effective in increasing the knowledge of women on breast self-examination.
The discussion about the study findings was presented in this chapter to arrive at a
conclusion based on the objective, the related literature and hypothesis.

Summary

A research summary is a professional piece of writing that describes research to

some prospective audience. The main priority of a research summary is to provide a brief
overview of the whole study. The main aim of this study was to assess the effectiveness of
structured teaching programme on knowledge regarding Breast Self-Examination of women
in selected rural area of Surat, Gujarat. A pre-experimental approach was used for this
study. The main study sample consisted of 30 women in the selected rural area of the Surat.
The main objective of the study was to assess the knowledge before and after administration
of structured teaching programme. Non-probability convenient sampling technique was
adopted for the sample selection. They selected as per criteria laid down for the study.

Structured knowledge questionnaire was prepared to determine the level of

knowledge among the women before and after Structured Teaching Programme. For the
Structured Teaching Programme, the lesson plan was prepared regarding Breast Self-
Examination. The tool was tested for reliability by using Karl Pearson’s coefficient of
correlation formula. The “r” was found to be 0.8, hence the tool was found statistically
reliable for the study. A pilot study revealed that the tools were feasible for conduction of
the study and the Structured Teaching Programme was effective.
The objectives of the study were:

 To assess the Knowledge of Women regarding Breast Self-Examinationamong

before and after the Structured Teaching Programme.
 To compare the pre-test and post-test Knowledge, scores regarding Breast Self-
Examination among women.

Based on the objectives, an extensive search for literature was made to

determine and develop the conceptual framework, research approach and
methodology to conduct the study. Conceptual framework was based on a general
system model, as a guide for development, utilization and evaluation.
The researchers collected the data by establishing the rapport with the subject
confidentiality of their response was assured. The data was analyzed and interpreted
in terms of objectives of the study. Descriptive and inferential statistics were utilized
for the data analysis.

MAJOR FINDINGS OF THE STUDY

Findingsrelated to Socio-demographic variables of the women:

In this study findings shows that , The data presented denotes that out of 30 women
11 women’s majority (36.66%) of them were in the age group of 36-45 years and 3.33% of
them each were in the age group of 45-48 years. Religion of the women are majority to
Hindus.3.33 percent of the women had No formal education,30 percent of the women had
Primary education,56.66 percent of the women had Higher Secondary education,10 percent
of the women are graduated and above.56.66 percent of the women are Housewives,16.66
percent of the women are Employee,0 percent of the women is come under
Agriculture,16.66 percent of the women are Daily Wages worker.76.66 percent of the
women are Married and 23.33 percent of the women are Unmarried.23.33 percent of the
women have 1 child,40 percent of the women have 2 child,16.66 percent of the women have
3 children and 3.33 percent of the women have more than three childrens.30 percent of the
women comes from Nuclear family,73.33 percent of the women comes from Joint family
and no any women are comes under the other types of family. With regard to income
majority(56.66%)were earning above Rs.2,501, 3.33% of them were earning more than Rs.
1,500,36.66% of them were earning between Rs.2,000-Rs,2,500,6.66% of them were
earning between Rs.1,500-Rs. 2,000.
CONCLUSION

The following conclusion can be drawn from the study findings:

Knowledge deficit exits in all the area of Breast Self-Examination. The structured
teaching programme was found to be effective in enhancing the knowledge of sample
regarding Breast Self-Examination. Thus, the structured teaching programme can be used
for the large population in different settings.
The researchers concluded that there was significance increase in the mean post-test
score as compared to mean pre-test score knowledge after administration of structured
teaching programme. In knowledge the calculated t-value was greater than tabulated t-value
at 0.05 level of significance which was statistically significant the null hypothesis were
rejected and research hypothesis were accepted so, researcher concluded that women in
selected rural area of surat gain significant increase in knowledge that structured teaching
programme was effective.

IMPLICATION AND UTILIZATION OF THE STUDY

The findings of the study have several Implication for Nursing Practice, Nursing
Education, Nursing Administration and Nursing Research.

Nursing Practice:
Womenhave the responsibility of improving the knowledge level of themselves. In
the management of practice the nurse play a vital role.Nursing practice will benefit for the
development of guidelines that are universal for educational programs and competency
checks for the utilization of the Structured Teaching Programme regarding Breast Self-
Examination among women. The present study will help women to know that Structured
Teaching Programme is more effective.

Nursing Education
The professional is involved at all levels to evaluate the need for courses; to
determine the effectiveness of the information being taught; to assist in evaluating the
knowledge level of others; and also to assist with the ongoing work to develop the needed
standards of care for proper implementation at various health care settings. Active and
dedicated efforts should be made to include theory and practical aspects of educating
strategies by various health care providers like Community health workers, Anganwadi
workers, Community Health Nurses and Health Assistants to educate the women.
Nursing Administration
The management of institutions that offer care to the community settings, whether it
is in the rural or the urban area has the ability to rectify the knowledge deficit regarding
Breast Self-Examination. In collaboration with the national professional bodies like Indian
Nursing Council, Trained Nurses Association of India, and other National Health
Organizations the nurse administrators should insist on mandatory skills training programme
for the Primary Health Care Providers regarding Breast Self-Examination residing in the
rural area. The nurse administrators have pivotal responsibility to provide the nurses with
substantive materials and training to motivate them to create awareness regarding Breast
Self-Examination, written policies, standardized protocols and procedures related to the
protection of health issues of women.

Nursing Research
The study will be valuable reference for further research. There is need to conduct
further research in India regarding appropriate use of various teaching methods in the
education sector. Other researchers, conducting further studies in the same fields, can utilize
the suggestions and recommendations. Research can be conducted in different setting, in
different criteria in large a sample.
The findings of the study would help to expand the scientific body of the
professional knowledge upon which further research can be conducted.

LIMITATIONS
 The study was delimited to rural area of Sachin only.
 The study was delimited to the Women between age groups of 15-49 years only.

RECOMMENDATIONS

1. A similar study for replication of this study is indicated with a larger sample size to
generalize the findings.

2. The research tool can be updated and can be used as evaluation criteria for the
Knowledge of the women regarding Breast Self-Examination.
3. The content of the Structure Teaching Programme can be updated and used to teach
women for improving knowledge regarding Breast Self-Examination.

4. The findings of the study can be used as an evidence-based result in implementing

policies and health care measures by the Government agencies and Non-Government
Agencies for the education of women.

5. An exploratory study can be carried out to identify various factors responsible for lack of
knowledge of the women regarding Breast Self-Examination.

6. A study can be conducted using other strategies such as manual, information booklet,
self-learning packages and video shows.

7. A true experimental research design can be conducted using intervention.

8. A comparative study can be carried out between the urban and rural area of the women.

REFERENCE

1. https://thoughtcatalog.com/charlie-morrigan/2013/04/30-greatest-quotes-about-women/

2. Ross and Wilson, Waugh Anne, Grant Allison, editors. Anatomy and physiology in health
and illness.12th edition, Elsevier publisher, 2014.

3. Brunner and Suddharth’s, Hinkle J.L., Cheever K.H editors. Medical and Surgical
Nursing.13th edition, volume 2, Wolters and Kluwer publisher, 2016.

4. Williams L.S., Poual P.H. editor. Medical Surgical Nursing.Fifth edition, The Health
science Publisher, 2015.

5. Black J.M., Hawks J. H., MalavizhisR.K.editors, Medical Surgical Nursing, Clinical

management for positive outcomes. First South Asian edition.volume 1, Elsevier publisher.

6.https://www.medicinenet.com/breast_cancer_facts_stages/article.htm#what_cause_breast_
cancer.

7. Jacob A., Rekha R, Tarachand S. editors. Clinical Nursing Procedures, The art of nursing
procedure. 3rd edition.JaypeeThe Health Science Publishers, New Delhi; 2015

8. Sharma J.B., Midwifery And Gynecological Nursing. First edition.Avichal publishing

company.
9. Dutta’s D.C., Textbook of Gynecology. 7 th edition, Jaypee Brothers Medical Publisher,
Kolkatta; 2016

10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931014/

11.https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

12.https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/canjclin.51.1.15

13.https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-
20393237#:~:text=A%20breast%20self%2Dexam%20for,discuss%20these%20with
%20your%20doctor.

14.https://www.healthline.com/health/breast-cancer#risk-factors

15. https://medical-dictionary.thefreedictionary.com/assess

16.https://en.wikipedia.org/wiki/Effectiveness#:~:text=Effectiveness%20is%20the
%20capability%20of,produces%20a%20deep%2C%20vivid%20impression.

17.https://www.google.com/search?
rlz=1C1CHBF_enIN920IN920&ei=tmg_YLfsENiAyAOJu5agAg&q=structured+teaching+
programme+meaning&oq=structured+teaching+programme+meaning&gs_lcp=Cgdnd3Mtd
2l6EAMyAggAMgUIABCGAzIFCAAQhgMyBQgAEIYDOgcIABBHELADUOozWOozY
N88aAFwAngAgAG3AYgB7QKSAQMwLjKYAQCgAQGqAQdnd3Mtd2l6yAEIwAEB&
sclient=gws-wiz&ved=0ahUKEwi3n53c-JPvAhVYAHIKHYmdBSQQ4dUDCA0&uact=5

18. KP Neerja. Textbook Of Nursing Education. 1 st edition, Jaypee Brothers Medical

publishers, Nagpur Mumbai; 2003.

19.https://www.dictionary.com/browse/women

20. Dutta’s D.C., Konar H., Textbook of Obstretrics. 8 th edition, JaypeeThe Health science
Publisher; 2015.

21. Park K. Park’s Textbook Of Preventive And Social Medicine. 24 th edition, M/s
BanarasidasBhanot Publishers, Jabalpur, India; 2017.

22.https://www.sagepub.com/sites/default/files/upm-binaries/48274_ch_3.pdf

23. Sharma S.K. Nursing Research And Statistics. 3rd edition, Elsevier publisher,
Uttarakhand, India; 2014.

24. Indian Journal of community medicine 2013, apr-june, v.38 (2)

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3714949/.

25.JMFPC journal of family medicine and primary care article,year 2017,volume

www.JFMPC.com/article.asp?
issn=22494863,year=2017,volume=6,issue=3spage=487,epage=490,aulst=madhukumar.

26. ..IOSR journal of nursing & health science (IOSR-JNHS),volume 5,issue 5,(sep-oct
2016)page no:49-54
Isorjournals.org/iosr-jnhs/papers/vol5-issue5/version-5/H0505054954.PDF.
www.isorjournals.org.
27. Asian pacific journal of cancer prevention:APJCP(16)(13):5243-5251-july 2015.
.Researchgate.net/publication/280621385_breast_cancer_awareness_at_the_community_lev
el_among_women_in_delhi_india.
28.Biomedreserchinternational,volume 2014,article ID 306352,9 page.
https://www.hindwi.cpm/Journals/bmri/2014/306352.
29. .International journal of scientific study,august 2018,vol 6,issue 5. https://www.ijss-
sn.com/uploads/2/0/1/5/20153321/ijss_aug_oa08_-_2018.PDF.

30. www.ncbi.nlm.nih.gov>article>p.

31. Journals.plos.org>plosone>article

32. journal.wacop.org.

33. bmcrenotes.biomedicentral.com.

34. Kaur S., Singh A., Walia I., Ratha P. editors. Simplified Nursing Research And
Statistics For Undergraduates. CBS publisher;2016.

35. Sharma S.K. Nursing Research And Statistics. 3rd edition, Elsevier publisher,
Uttarakhand, India; 2014.

36. Sharma S.K. Nursing Research And Statistics. 3rd edition, Elsevier publisher,
Uttarakhand, India; 2014.

37.https://nces.ed.gov/nceskids/help/user_guide/graph/variables.asp#:~:text=Answer%3A
%20An%20independent%20variable%20is,might%20be%20an%20independent
%20variable.

38.https://www.verywellmind.com/what-is-a-dependent-variable-2795099

39.https://www.editage.com/insights/what-is-meant-by-the-setting-of-the-study#
40. Basavanthappa B.T. Essentials of Community Health nursing. Jaypee Brothers Medical
Publisher; 2011.

41. Polit D. F. Tatano B. C., Nursing Research.Tenth edition, Wolters and Kluwer Publishe;
2016.

42. Park K. Park’s Textbook Of Preventive And Social Medicine. 24 th edition, M/s
BanarasidasBhanot Publishers, Jabalpur, India; 2017.

43.https://dictionary.cambridge.org/dictionary/english/sample

44. Kaur S., Singh A., Walia I., Ratha P. editors. Simplified Nursing Research And
Statistics For Undergraduates. CBS publisher;2016.

45. Elizabeth A.M. editor. The Oxford Dictionary of Nursing.Seventh edition; 2017.
 TOOL

Purpose: This tool enables the researcher to gather information about the socio
demographic data and knowledge of Breast self -examination of women.
Instruction to use:

 Please read the following questionscarefully.

 Give appropriate answer in the given box against eachquestions.
 The information collected from you will be keptconfidential.
CodeNo:
SECTION-1
DEMOGRAPHIC DATA OF WOMEN
1. Age
a) 15-25years
b) 25-35years
c) 35-45years
d) 45-49years

2. Religion
a) Muslim
b) Hindu

3. Education ofwomen
a) No formaleducation
b) Primaryeducation
c) Secondary and high secondaryschool
d) Graduation andabove

4. Occupation
a) Housewife
b) Employee (government and private )
c) Agricultural
d) Daily wagesworker
5. Maritalstatus
a) Married
b) Unmarried

6. Number ofchildren
a) One
b) Two
c) Three

7. Types offamily
a) Nuclear
b) Joint
c) Others

8. Familyincome
a) 1500rs
b) 1500rs-2000rs
c) 2000rs-2500rs
d) Above 2500rs

SECTION-2

STRUCTURE KNOWLEDGE QUESTIONNAIRE

1. What do you mean bybreast?

a) It is the part of digestive system
b) An organ designed to producedblood
c) An Organ designed to producedmilk
d) It is the part of respiratorysystem

2. Which is the part ofbreast?

a) Nipple
b) Alveola
c) Diaphragm
d) Bronchioles
3. Which parts of the breast producesmilk?
a) Lobules and ducts
b) Areola andBronchioles
c) Alveoli and Nipple
d) Diaphragm andAlveola

4. When does the breast tissues, vary inconsistency?

a) Duringmenstruation
b) Beforemenstruation
c) Afterovulation
d) Beforeovulation

5. What do you mean by breastcancer?

a) Infectious disease of thebreast
b) Normal growth of breasttissue
c) Uncontrolled multiplication of cell inbreast
d) Inflammation of thebreast

6. What do you mean by benigntumor?

a) Mass/lump, dangerous tohealth
b) Mass/lump, not dangerous to health and not spreading to otherparts
c) Mass/lump, is spread to otherparts
d) Mass/lump, non-dangerous to health

7. What do you mean by malignanttumor?

a) Mass/lump,potential to be dangerous and spread to otherparts
b) Mass/lump,non dangerous tohealth
c) Mass/lump,not spreading to otherparts
d) Mass/lump,dangerous tohealth

8. Who are at the high risk for developing of breastcancer?

a) Women who has breast feed herinfant
b) Women who had complication duringpregnancy.
c) Women having family history of breastcancer.
d) Women who is suffering from infectiousdisease
 9. What is the cause of breastcancer?
a) Obesity
b) Earlyage
c) Overexercise
d) Underweight
.
10. Which method of contraception induces breastcancer?
a) Prolonged use of oral contraceptives
b) Intrauterine contraceptivedevices
c) Barriermethod
d) Other physicalmethod.

11. Which are the following hormonal changes can increase the risk of breast cancer
aftermenopause?
a) Lower estrogenlevel
b) Higher estrogenlevel
c) Higher progesteronelevel
d) Lower progesteronelevel.

12. What type of diet will induce breastcancer?

a) High fat diet(oil,meat)
b) High protein (milk,cereals)
c) High carbohydrate (rice , cakes, sugar)
d) High fiberdiet

13. What are the clinical manifestation of breastcancer?

a) A mass/lump in thebreast
b) Abnormal nippledischarge
c) Painful, tenderness in thebreast
d) All ofabove

14. What was the simplest method to detect breast abnormalities by the
personherself
?
a) Breast selfexamination
 b) Clinical breastexamination
c) Mammogram
d) X-ray

15. What are the clinical diagnosis procedure to screen the breast lump?
a) Angiography
b) X-ray
c) Mammogram
d) CT-scan

16. Which age group is eligible for screening mammogram?

a) 40-55years
b) before18years
c) before 40years
d) 18-30years

17. What are the treatment of breast cancer?

a) Surgery of the breastcancer
b) Chemotherapy
c) Radiation therapy
d) All ofabove

18. What do you meanmastectomy?

a) Removal thebreast
b) Removal of thelungs
c) Removal of theheart
d) Removal of thenipple

19. How many years once mammogram should be performed in the 40-49years?
a) 4years
b) 3years
c) 2years
d) 5years.
20. What do you mean by breast self-examination?
a) To examine the wholebreast
b) It helps to the breast growth
c) It helps to improve the bloodcirculation
d) It helps to develop breastdisease

21. What is the purpose of breast self-examination?

a) Increase the production of breastmilk
b) decrease the production of breastmilk
c) Early detection of breastcancer
d) It helps to the breastgrowth

22. How often a women should practice breast self examination?

a) Everyweek
b) Everyday

c) Every month aftermenarche

d) Everymonth

23. When should the post menopausal women practice breast self examination?
a) Monthly
b) Bimonthly
c) 3 Monthly
d) 4 monthly
24. How many steps are there in breast sel f examination?
a) 9
b) 7
c) 5
d) 8

25. Which are the fingers you will use during palpation of thebreast?
a) Index finger, middle finger & ringfinger
b) Middle, ring &small
c) Index, middle, ring&small
d) Own middle,ring
 26. Which position is use to perform breast self-examination?
a)Rightlateral
b) Standing
c)Sitting

27.While inspecting breast in front of the minor what you should beobserved?
a) Size, shape of thebreast
b) Breastgrowth
c) Mass in thebreast
d) All ofabove

28. What are the changes you will observe during breast self examination if you have breast cancer?

a)Dimpling

b) Tingling sensation

c) Itching
d)Discharge from the nipple

29. Which of the following cancer is mostly occur in women?

a) Breast cancer
b) Intestine cancer
c) Bone cancer
d) None of above

30. What is the benefit of breast self examination?

a) It is easy, non-invasive and inexpensivemethods
b) It invasive method
c) It is required hospitalization
d) It is painful
 ૂ
સંશોધનપ્રોજેકટ મા વપરાયેલટલ

હેત ુ :આસાધનસંશોધનકર્તાનેસામાજિકવસ્તીવિષયકડેટાઅનેમહિલાઓનો સ્તનસ્વપરીક્ષણ

વિશેનીમાહિતીએકત્રિતકરવામાટેસક્ષમકરે છે.

સ ૂચનાઓ :

1) કૃપાકરીનેનીચેનાપ્રશ્નોનેકાળજીપ ૂર્વકવાંચો.

2) દરે કપ્રશ્નોસામેઆપેલખાના માંયોગ્ય જવાબઆપો.

3) તમારીપાસેથીએકત્રિતકરવામાઆવેલીમાહિતી ગપ્ુ તરાખવામાઆવશે.

વિભાગ-૧

જનસંખ્યાનીવિવિધતા

૧. ઉંમર
અ) ૧૫-૨૫ વર્ષ
બ) ૨૬-૩૫વર્ષ
ક) ૩૬-૪૫વર્ષ
ડ) ૪૬-૪૯વર્ષ
૨. ધર્મ
અ) મુસ્લિમ
બ) હિન્દુ

૩. શિક્ષણ

અ) કોઈઔપચારીકશિક્ષણનથી
બ) પ્રાથમિકશિક્ષણ
ક) માધ્યમિકઅનેઉચ્ચમાધ્યમિકશિક્ષણ
ડ) સ્નાતકઅનેતેથી વધુ

4. વ્યવસાય
અ) ગૃહિણી
બ) કર્મચારી
ક) કૃષિ
ડ) દૈ નિક વેતનકામદાર

5. વૈવાહિકસ્થિતિ
અ) પરણીત
બ) અપરણીત

6. બાળકોનીસંખ્યા

અ) એક
 બ) બે
ક) ત્રણ
ડ) ત્રણથીવધુ

7. પરિવારનોપ્રકાર

અ)વિભક્ત
બ) સંયક્ુ ત
ક) અન્ય

8. કુટુંબનીઆવક

અ) ૧૫૦૦રૂપિયાથીઓછા
બ) ૧૫ 00-૨ 000 રૂપિયા
ક) ૨ 00 ૧-૨૫ 00 રૂપિયા
ડ) ૨૫૦૧રૂપિયાથીઉપર
 વિભાગ-૨
જ્ઞાનઆધારિતપ્રશ્નોતરી

૧) સ્તનએટલેશ ું ?

અ) તેપાચકતંત્રનોભાગછે
 બ)લોહીપેદાકરવા માટેરચાયેલએકઅંગ
ક) દૂ ધઉત્પન્નકરવા માટે રચાયેલએકઅંગ
ડ)તેશ્વસનતંત્રનોભાગછે

૨. સ્તનનોભાગકયોછે ?
અ) સ્તનનીડીંટડી
બ) એલ્વોલા
ક) ઉદરપટલ
ડ) શ્વાસનળી

૩. સ્તનનાંકયાભાગોથીદૂ ધઉત્પન્નથાયછે ?
અ) લોબ્યુલ્સઅનેનળીઓ
બ) સ્તનનીડીંટડીઅનેનળી
ક) ફેફસાઅનેશ્વાસનળી
ડ) ઉરોદરપટલઅનેયકૃત

૪. ક્યારે સ્તનપેશીનીસુસગ
ં તતામાંભિન્નતાજોવામળે છે ?
અ) માસિકસ્રાવ દરમિયાન
બ) માવસકસ્રાવપહેલા
ક) અંડપતનપછી
ડ) અંડપતનપહેલા
૫. સ્તનકેન્સરએટલે શુ?ં
અ) સ્તનનોચેપીરોગ
બ) સ્તનપેશીઓનીસામાન્યવ ૃદ્ધિ
ક) સ્તનનાકોષોર્નુંઅનિયંત્રિતવ ૃદ્ધિ
ડ) સ્તનનીબળતરા

૬. કેન્સરવિહિનગાંઠએટલેશ?ું
અ) સમ ૂહ/ ગાંઠ,આરોગ્યમાટેજોખમી
બ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમીનથીઅનેઅન્યભાગોમાંફેલાતનથી
ું
ક) સમ ૂહ/ ગાંઠ, અન્યભાગોમાંફેલાતનથી
ું
ડ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમીનથી

૭. કેન્સરયુકતગાંઠએટલેશ?ું
અ) સમ ૂહ/ ગાંઠ, સંભવિતજોખમીછે અનેઅન્યભાગોમાંફેલાયછે
બ) સમ ૂહ/ ગાંઠ, સ્વાસ્થ્યમાટેબિન-જોખમી
ક) સમ ૂહ/ ગાંઠ, અન્યભાગોમાંફેલાતનથી
ું
ડ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમી

૮. સ્તનનુકેં ન્સરસૌથીવધારે કોનેથવાની શક્યતાછે ?

અ) સ્ત્રી,જે પોતાના બાળકને સ્તનપાન કરાવે છે
બ) સ્ત્રી,જેને પ્રસ ૂતિ દરમિયાન જટિલતા આવી હોય
ક) સ્ત્રી,જેના કુટુંબમાં સ્તનકેન્સરની બિમારીથઈ હોય.
ડ) સ્ત્રી,જેને સ્તનની અન્ય કોઈ બિમારી હોય

૯. સ્તનકેન્સરનુકારણશુ
ં છ ં ે?
અ) જાડાપણું
બ) નાનીઉંમર
ક)વધુકસરતકરવી
ડ) ઓછુ વજન

૧૦. ગર્ભનિરોધક ની કઈ પદ્ધતિથી સ્તન કેન્સર થાય છે ?

અ) લાંબા સમય થી મૌખિક ગર્ભનિરોધક ગોળીઓનો ઉપયોગ
બ) ગર્ભનિરોધક ઉપકરણો
ક) અવરોધ પદ્ધતિ
ડ) અન્ય પદ્ધતિ

૧૧.નીચેઆપેલપૈકીકયાસ્ત્રાવ નાફેરફારનાકારણેમેનોપોઝપછીસ્તનકેન્સરથવાનુવધુ
ં જોખમછે ?
અ) નીચુ ં ઈસ્ટ્રોરોજનનુ ં સ્તર
બ) ઉચ્ચઈસ્ટ્રોરોજનનુસ્તર
ં
ક) ઉચ્ચપ્રોજેસ્ટેરોન નુસ્તર
ં
ડ) નીચુપ્રોજેસ્ટે
ં રોનનુસ્તર.
ં
૧૨. કયાપ્રકારનોખોરાકલેવાથીસ્તનકેન્સરથવાનીશક્યતાવધારે છે?
અ) ચરબીયુક્તઆિાર(તૈલી, માંસ)
બ) વધુપ્રોટીન(દૂ ધ, અનાજ)
ક)વધુકાર્બોહાંઇડ્રેટ(ચોખા, કેક, સુગર)
ડ) વધુરેસાવાળોખોરાક(ફળ, શાકભાજી)
૧૩. સ્તનના કેન્સરન લક્ષણો/ચિંહો કયા છે ?
અ)સ્તન માં ગાઠ થવી
બ) સ્તન ની દીં મથિ અસામન્ય સ્ત્રાવ
ક) સ્તન મ દુ:ખાવો
ડ) ઉપરોક્તતમામ

૧૪. એવી કઈ સાદી અને સરળ પદ્ધતિ છે જેના દ્વારા આપણે સ્તન ની ખામી જાણી શકીએ છે ?
અ) સ્તન સ્વપરીક્ષણ
બ)દવાખાના મા સ્તનનુ ં સ્વપરીક્ષણ
ક) મેમોગ્રામ
ડ) એક્સ-રે

૧૫. મેમોગ્રાફી એતલે શુ?

અ)સ્ત્નના પરીક્ષણ ની પદ્ધતિ
બ)ફેફસાના પરીક્ષણ ની પદ્ધતિ
ક)હાદ્કા ના પરીક્ષણ ની પદ્ધતિ
ડ)આંખના પરીક્ષણ ની પદ્ધતિ

૧૬. સ્ત્રીઓ સ્તનની તપાસ માટે મેમોગ્રામ કઈ ઉમરમાં કરાવી શકે છે ?

અ) ૧૫વર્ષ પછી
બ) ૧૮ વર્ષપછી
ક) ૩૦ વર્ષપછી
ડ) ૪૦ વર્ષપછી

૧૭. સ્તન કેન્સર માટે કઈ સારવાર કરવામા આવે છે ?

અ) કેન્સરની શસ્ત્ર્ ક્રિયા
બ) કીમોથેરાપી
ક) રે ડીયેશન થેરાપી
ડ) ઉપરોક્ત તમામ
૧૮. માસ્ટેકટોમી નો અર્થ શુ છે ?
અ) સ્તનને કાઢવુ ં
બ) ફેફસાંને દૂ ર કરવુ ં
ક) હૃદયને દૂ રકરવુ ં
ડ) સ્તનની ડીંટી દૂ ર કરવી
૧૯. મેમોગ્રામ કેટ્લા વર્ષ ના અંતરે કરી શકાય છે ?
અ) ૪ વર્ષ
બ) ૩ વર્ષ
ક) ૨ વર્ષ
ડ) ૫ વર્ષ

૨૦. સ્તન સ્વપરીક્શન એટલે શુ?

અ)આખા સ્તનની તપાસ કરવી
બ) તેસ્તન વ ૃદ્ધિ માટે મદદ કરે છે
ક) રક્તના પરીભ્રમણને વધારવા માં મદદ કરે છે
ડ) તે સ્તનના રોગને સુધારવા માં મદદ કરે છે

૨૧. સ્તન સ્વપરિક્શા નો હેત ુ શુ છે ?

અ) સ્તન કેન્સરની તપાસ માટે
બ) સ્તન કેન્સર નિારણ માટે
ક) વહેલી તકે સ્તન કેન્સરને શોધવા માટે/ જાણવા માટે
ડ) સ્તન રોગ અટકાવવા માટે

૨૨. સ્ત્રીઓએ સ્તન પરીક્ષણ ક્યારે કરવુ ં જોઈએ?

અ) મેનોપોઝની નજીક
બ) મેનોપોઝ પછી
 ક) દરે ક મહિને માસિકચક્ર પછી
ડ) દરમહિને

૨૩. પોસ્ટમેનોપોઝલ સ્ત્રીઓએ ક્યારે સ્તન ની તપાસની પ્રેક્ટિસ જોઈએ?

અ) માસિક
બ) દ્વીમાસિક
ક)ત્રિમાસિક
ડ) ચોથા માસિક

૨૪. સ્તન સ્વપરીક્ષણ માં કેટલા પગલા છે ?

અ) ૯
બ) ૭
ક) ૫
ડ) ૮

૨૫. સ્તનના તપાસ દરમિયાન તમે કઈ આંગળીઓનો ઉપયોગ થાયછે ?

અ) તર્જની આંગળી, મધ્યમ આંગળી અને રિંગ આંગળી
બ) મધ્યમ આંગળી, રિંગ અને નાની
ક) તર્જની, મધ્યમ, રિંગ અને નાની
ડ) ફક્તમધ્યમઆંગળી
૨૬. સ્તનનુ સ્વપરીક્ષણ ક્યાં કરવુ ં જોઇયે?
અ)બાથરૂમમાં
બ)સ્નાન કરતાં સમયે
ક)સાબુ લગાવતા સમયે
ડ)અન્ય

૨૭. જ્યારે સ્તનનુ ં પરીક્ષણ કાચની સામે ઊભા રહીને કરવામા આવે ત્યારે શુ અવલોકન કરવામા આવે છે ?
અ) સ્તનનો કદ અને આકાર
બ) સ્તન વ ૃદ્ધિ
ક) સ્તનમાસ
ડ) ઉપરોક્ત તમામ

૨૮. સ્તન સ્વ પરીક્ષણ દરમિયાન તમે કયા ફેરફારો કરો છો?
અ) ડિમપ્લિન્ગ
બ) કળતર સનસનાટી ભર્યા
ક) સ્તન માં દુ:ખાવો
ડ) સ્તનની ડીંટી માથી સ્ત્રાવ થવો

૨૯. નીચેના માંથી કયા પ્રકાર નુકેં ન્સર સૌથી વધારે જોવા મળે છે ?
અ) સ્તન કેન્સર
બ) આંતરડા ના કેન્સર
 ક) હાડકાનુ ં કેન્સર
ડ) કરોડરજ્જૂ નુ ં કેન્સર

૩૦. સ્તન પરીક્ષણનો ફાયદો શું છે ?

અ) સ્ત્રીઓમાં સ્તન કેન્સર શોધવુ
બ) સ્તન કેન્સરની વ ૃદ્ધિમાં વધારો
ક) સ્તન કેન્સર નો અટકાવો
ડ)અન્ય
 ANSWER KEY FOR STRUCTURE
KNOWLEDGE QUESTIONNAIRE

QUESTION ANSWER SCORE QUESTION ANSWER SCORE

1 C 1 16 A 1
2 A 1 17 D 1
3 A 1 18 A 1
4 B 1 19 C 1
5 C 1 20 A 1
6 B 1 21 C 1
7 A 1 22 C 1
8 C 1 23 A 1
9 A 1 24 A 1
10 A 1 25 A 1
11 B 1 26 D 1
12 A 1 27 D 1
13 D 1 28 D 1
14 A 1 29 A 1
15 C 1 30 A 1
STRUCTURED TEACHING PROGRAMME LESSON PLAN
VIBRANT NURSING COLLEGE, MASMA, SURAT
STRUCTURED TEACHING PROGRAMME ON BREAST SELF EXAMINATION
GUIDED BY,
MS.KRINAL PATEL
NURSING TUTOR
VIBRANT NURSING COLLEGE PREPARED BY,
MS. KOMAL PATEL
MS. RUPA PAL
MS. CHHAYA PARGI
MS.DRASHTI PATEL
MS.HASMITASOLANKI

Name of the student : Ms.Komal patel

: Ms.Rupa pal

: Ms.Chhaya pargi

: Ms.Drashti patel

: Ms.Hasmita solanki

Subject : Community Health Nursing

Topic : Breast self examination

Group : women

Venue : Selected rural area ofSurat

Number of participants : 30women

Duration : 30minutes

Method of Teaching : Lecture cum Discussion

Audio-Visual Aids : Chart, Cut outs, Flashcards.

General objective :

After completion of the Structured teaching programme group will be able to know about the Breast Self Examination.
Specific Objectives:
At the end of the structured teaching programme women will be able to,

 To introduce breastcancer.
 To discuss anatomy & physiology of breast
 To enlist etiology of breastcancer
 To describe Types of breastcancer
 To explain signs and symptoms of breast cancer
 To describe treatment of breast cancer
 To prevention of breast cancer
 To explain breastself-examination
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
(min) OBJECTIVE LEARNING ACTIVITY AIDS
TEACHER LEARNER
3 MIN To introduce INTRODUCTION By Listen, _ What is the
breast Explaining. Ask the incidences rate
Cancer. Breast cancer is the most common cancer diagnosed in doubts and of breast cancer
women, accounting for more than 1 in 10 new cancer answer in India?
diagnoses each year. It is the second most common cause of the questions
death from cancer among women in the world.
Incidence rate of Breast cancer at India level is about
85 per 100,000 women per year. It is estimated that about
85000 new cases of Breast cancer are occurring in India, every
year. The mortality rate is around 7 per 100,000 cases per
year.
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
OBJECTIVE LEARNING ACTIVITY AIDS
TEACHER LEARNER
4 MIN To discuss ANATOMY AND PHYSIOLOGY By See the Chart What is the
anatomy & The breast are medically known as the mammary discussion diagram, anatomy &
physiology glands. the mammary glands are made up of lobules, milk- ask the physiology of
of breast producing glandular structures. it is supported by and attached doubts and breast?
to the front of the chest wall on either side of the sternum by answer
ligament. the question.
Positioned over the pectoral muscles of the chest wall
and attached to the chest wall by fibrous strands called coopers
ligaments.
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
OBJECTIVE LEARNING ACTIVITY AIDS
TEACHER LEARNER
2 MIN To enlist ETIOLOGY AND RISK FACTORS By list out Listen and _ Which are the
etiology of the points ask the etiological
breast cancer  Oldage doubts. factors of breast
 geneticmutations cancer?
 reproductivehistory
 having densebreasts
 personal history of breastcancer
 family history of breast cancer
 previous treatment using radiationtherapy
 women who took the drug diethystilbestrol
 not being physicallyactive
 being overweight or obese aftermenopause
 takinghormones
 drinkingalcohol
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
OBJECTIVE LEARNING ACTIVITY AIDS
TEACHER LEARNER
2 MIN To describe TYPES By Listen, ask _ How many
Types of explaining the doubts types of breast
breast cancer  Angio-sarcoma and answer cancer?
 Ductal carcinoma in situ(DCIS) The question
 Inflammatory breastcancer
 Invasive lobularcarcinoma
 Lobular carcinoma in situ(LCIS)
 Male breastcancer
 Paget's disease of thebreast
 Recurrent breastcancer
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
OBJECTIVE LEARNING ACTIVITY AIDS
TEACHER LEARNER
3 MIN To explain SIGN AND SYMPTOMS By See the Cut Enlist the sign
signs and explaining pictures ,ask outs & symptoms of
symptoms of  Swelling of all or part of a breast (even if no lump isfelt the doubts the breast
breast cancer  Skin dimpling (sometimes looking like an orangepeel) and answer cancer
 Breast or nipple pain the question
 Nipple retraction (turninginward)
 Nipple or breast skin that is red, dry, flaking or thicken
 Nipple discharge (other than breastmilk)
 Swollen lymphnodes
 Appearance of a lump or mass in thebreast.
 Redness of the breast ornipple.
 discharge from thebreast.
TIME SPECIFIC CONT TEACHING AND A.V. EVALUATIO
ENT N
OBJECTIV LEARNING AID
ACTIVITY
E S
TEACHER LEARNER
5 MIN To describe TREATMENT By Listen, ask Which
treatment of explaining the doubts _ type of
breast cancer  Radiotherapy and answer treatment
 hormonetherapy thequestion you provide in
 chemotherapy breast cancer?
 surgery
 Total/simplemastectomy
 Total mastectomy with axillaryclearance
 Modified radicalmastectomy
 radical mastectomy
 Breast conservative surgeries
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
5 MIN To PREVENTION By See the _ Which types of
prevention  Limit alcohol : the more alcohol you drink, the greater discussion diagram and preventing
of breast your risk of developing breastcancer. ask the measures you
cancer  Don’t smoke : evidence suggests a link between smoking doubts. take in breast
and breast cancer risk, particularly in premenopausal cancer?
women.
 Control your weight : being overweight or obese increases
the risk of breastcancer.
 Be physically active : physical activity can help you
maintain a healthy weight, which helps prevent breast
cancer.
 Breast feed : breast feeding might play a role in breast
cancer prevention.
 Limit dose and duration of hormone therapy : combination
hormone therapy for more than three to five years
increases the risk of breastcancer.
 Avoid exposure to radiation and environmental :medical
– imaging methods such as computerized tomography.
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
6 MIN To explain BREAST SELF-EXAMINATION By Listen, ask _ What is breast
breast self- explaining the doubts self-
examination A breast self examination is a check-up a woman does at and answer examination?
home to look for changes or problems in the breast tissue. thequestion How many
Many women feel that doing this is important to their health. steps you
the best time to do a monthly self- breast exam is about 3 to 5 perform in
after period starts. do it at same time every month. breast self-
examination?
BENEFITS

 Awareness of breastanatomy.
 potential to find a mass or other symptoms that results
in cancer detection.
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
STEPS See the Flash
Step-1 : once a month, 2 – 3 days after periods. diagrams, ask cards
the doubt and
Step-2 : examine breast and armpit with raised arm. answer the
question
Step-3 : use fingerpads with massage oil or shower gel.

Step-4 : up and down.

Step-5 : wedges.

Step-6 : circles.

Step-7 : examine breasts in the mirror for lumps or skin dimping

Step-8 : change in skin color ortexture.

Step-9 : nipple deformation, color change or leaks of any fluids.

TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
To SUMMARY Summarize Listen
summarize the topic
the topic Using an accessible format, communicate the need
for regular mammogram to your patient with disabilities.
Identify fully accessible mammography centers in your area.
Alter them to a patient’s mobility or communication issues
before the patient goes to the screening adapt the clinical
breast exam to meet the special needs of your patient’s
With disabilities. Teach your patient’s how to modify the
Breast-Self Exam to accommodate their particular disability.
Help ensure that accommodations are made for your
patient’s with disabilities so they have successful breast
biopsies.
TIME SPECIFIC CONTENT TEACHING AND A.V. EVALUATION
LEARNING ACTIVITY
OBJECTIVE AIDS
TEACHER LEARNER
To conclude CONCLUSION Conclude Listen
the topic the topic
All women age 20 years and older perform Breast
Self Examination on a monthly basis, beginning in
their 20’s,women should be told about the benefits and
limitations of Breast –Self Examination. the importance in
prompt reporting of any new breast symptoms to a health
professional should be emphasized all women age 15-49
should have clinical examinations every 3 years preferably
be part of a periodic health examination. All women age
40 years age and older have regularmammograms.
BIBLIOGRAPHY

Book references:

 Brunner and suddarth’s,”Textbook of medical surgical nursing;volume 1;published by wolter kluwer; page no: 1910
 Ross and wilson; anatomy and physiology in health and illness;13th edition; published by elsevier; page no: 508,509

Net reference:

https://images.app. https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

https://www.medicinet.com/breast_anatomy/article.htm#what_should_i_know_about_breast

https://www.slideshare.net/mobile/sridevirajeeve/breast-carcinoma-management

https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-cancer-prevention/art-20044676

https://medlineplus.gov/ency/article/00193.htmgoo.gl/59uM1R4hvSByzwHB6

https://images.app.goo.gl/xGhr4ZDKScUKXAB8A

https://www.mayoclinic.org/disease-conditions/breast-cancer/symptoms-causes/syc-20352470

https://www.cancer.org/cancer/breast-cancer/about/breast-cancer-sign-and-symptoms.html

https://images.app.goo.gl/46QoZi1GnuF3Vn84A
સમય નિશિત વિષય પ્રવ્રતિ એ. મ ૂલ્યાંકન
(મિનિ શિક્ષક શિખનાર
લક્ષ્ય વી
ટ)
એડ્

સ
છાતી ના કેં સર
00 : ૩ સ્તન સ્વ પરીક્ષણ સમજાવીને સાંભળો
ની ઓળખાણ
શંકાઓ પૂછો
કરાવવી ભારતમાં સ્તન
વિષય નો પરિચય અને પ્રશ્નનો
કેન્સરના બનાવ
જવાબ આપો
નો દર કેટલા છે
સ્તન એ સ્ત્રી નો મહત્વ નો ભાગ છે . સ્તન એ અનેક પ્રકાર ના

કોષો નુ ં બનેલ ું છે જે છાતી ના સ્નાયુ થી ઘેરાયેલ ું હોય છે .સ્ત્રી નુ ં

સ્તન વિશિષ્ટ કોષો નુ ં બનેલ ું હોય છે જે દૂ ધ ઉત્પન્ન કરે

છે .ચરબી નુ ં પ્રમાણ સ્તન નુ ં કદ નક્કી કરે છે .સ્તન ની

આસપાસ આવેલા ઘેરા ભાગ ને સ્તન ની ડીંટી કે હવાય.

છે .રુધિર્વહિની, લસિકવણીની અને લસિકગાંઠ સ્તન માં આવેલા

હોય છે . ચેતા સ્તન ને ઉત્તેજના પ્રદાન કરે છે .

સ્તન કેન્સર એ સ્ત્રીઓમાં સૌથી સામાન્ય કે ન્સર હોવાનુ ં નિદાન છે ,

જે દર વર્ષે 10 નવા કેન્સર નિદાનમાં 1 કરતા વધારે હોય છે , તે

વિશ્વની સ્ત્રીઓમાં કે ન્સરથી થતાં મ ૃત્યુન ુ ં બીજુ સૌથી સામાન્ય
કારણ છે .

ભારત સ્તરે સ્તન કેન્સરનો દર વર્ષે 100,000 સ્ત્રીઓમાં આશરે 6

છે . એવો અંદાજ છે કે ભારતમાં દર વર્ષે સ્તન કેન્સરના લગભગ

85000 નવા કેસો થાય છે . દર વર્ષે 100,000 કેસોમાં મ ૃત્યુ દર 7 ની

આસપાસ હોય છે .
સમય નિશિ વિષય પ્રવ્રતિ એ. મ ૂલ્યાંકન
(મિનિ શિક્ષક શિખનાર
ત વી
ટ)
લક્ષ્ એડ્

ય
સ
સ્તન
શરીરરચના અને શરીરવિજ્ઞાન ચર્ચા દ્વારા આકૃતિ જુઓ ચાર્ટ
00 : ૩
શરીરરચના શંકાઓ પ ૂછો સ્તન

અને અને પ્રશ્નનો શરીરરચના

સ્તન તબીબી રીતે સ્તનધારી ગ્રંથીઓ તરીકે ઓળખાય છે .
શરીરવિજ્ઞાન અને
જવાબ આપો
વિષે ચર્ચા સ્તન્ય પ્રાણીઓમાં ગર્ભમાં રહેલા બચ્ચાની રક્ષા માટે ન ુ ં આચ્છાદન શરીરવિજ્ઞાન શુ ં
છે ?
કરવી છે લોબ્યુલ્સ, દૂ ધ ઉત્પાદક ગ્રંથિની રચનાઓથી બનેલ ું છે . તે
આધારભ ૂત

છે અને અસ્થિબંધન દ્વારા સ્ટર્નમની બંને બાજુ છાતીની દિવાલની

આગળની બાજુ એ જોડાયેલ છે .

છાતીની દિવાલના પેક્ટોરલ સ્નાયુઓ પર સ્થિત અને કોપર

અસ્થિબંધન તરીકે ઓળખાતા તંત ુમય સેર દ્વારા છાતીની દિવાલ

સાથે જોડાયેલ છે .
સમય નિશિ વિષય પ્રવ્રતિ એ. મ ૂલ્યાંકન
(મિનિ શિક્ષક શિખનાર
ત વી
ટ)
લક્ષ્ એડ્

ય
સ
સ્તન કારણો અને જોખમી પરિબળો  ચાર્ટ
00 : ૩ બહાર યાદી સાંભળો અને
શરીરરચના પ્રશ્ન પ ૂછો સ્તન કેન્સર ના
 વ ૃદ્ધાવસ્થા દ્વારા
અને કારણો કયા છે
 આનુવશિ
ં ક પરિવર્તનાં ?
શરીરવિજ્ઞાન

વિષે ચર્ચા
 પ્રજનન ઇતિહાસ

કરવી છે  ઘટ્ટ સ્તન હોવા

 સ્તન કેન્સરનો વ્યક્તિગત ઇતિહાસ
 સ્તન કેસરનો કૌટુંબિક ઇતિહાસ
 રે ડિયેશન થેરેપીનો ઉપયોગ કરીને અગાઉની સારવાર
 મહિલાઓ કે જેમણે ડ્રગ ડાયથિસ્ટિલેબસ્ટ્રોલ લીધું હત ું
 શારીરિક રીતે સક્રિય નથી
 મેનોપોઝ પછી વધુ વજન અથવા મેદસ્વી થવું
 હોર્મોન્સ લેતા ,દારૂ પીવો
સમય નિશિત વિષ પ્રવ્રતિ એ. મ ૂલ્યાંકન
(મિનિ ય મિક્ષક મિખિયર
લક્ષ્ય વી
ટ)
એડ્

સ્તિ કારણો અને જોખમી પરરબળો બહયર સયભળો - સ્તિ

યયદી અિે કેન્સરિય

કેન્સર  વદ્ધૃ યિસ્થય િકયઓ

દ્ વયરય કયરણો કયય
પછો.
િય છે?
 આનિ માં િક પહરિતવિ
કયરણો

િી

િોંધણી
કરિી

 પ્રજિિ ઇમતહયસ

 ઘટ્ટ સ્તિ હોિય

 સ્તિ કેન્સરિો વ્યસ્ક્તગત ઇમતહયસ

 સ્તિ કેસરિો કૌટ ાંબબક ઇમતહયસ

 રેહડયેિિ થેરેપીિો ઉપયોગ

 કરીિે અગયઉિી સયરિયર

 મહહલયઓ કે જેમણે ડ્રગ ડયયમથસ્સ્ટલેબસ્રોલ લીધ

ાં હત ાં

 િયરીહરક રીતે સહિય િથી

 મેિોપોઝ પછી િધ િજિ અથિય

મેદસ્િી થવ ાં

 હોમોન્સ લેતય ,દયરૂ પીિો

સમય મિમ મિષ પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ ય મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ

સ્તિ પ્રકારો
કેન્સરિ
ય

સમજાિી સયભળો, સ્તિ

પ્રકયરો  એન્ીયોસયકોમય
િે કેન્સરિય

િણવિિય
િકયઓ કેટલય પ્રકયરો
 મસચ્ય મયાં ડક્ટલ કયમસિિોમય (ડીસીઆઈએસ)
પછો
અિે છે ?
 બળતરય સ્તિ કેન્સર
પ્રશ્નિો
જિયબ આપો
 આિમક લોબ્યલ ર કયમસિિોમય

 લોબ્યલ ર કયમસિિોમય મસટ (એલસીઆઈએસ) મયાં

 પર ષ સ્તિ કેન્સર

 સ્તિિો પેજટ રોગ

 િયરાંિયર સ્તિ કેન્સર
સમય મિમ મિષ પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ ય મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ

સ્તિ લક્ષણો કટ સ્તિ

વ્યયખ્યય બચત્રો જ ઓ,
 સ્તિિય બધય ભયગ અથિય ભયગિી સોજો (ભલે આઉ કેન્સર
આપીિે
િકય
કેન્સર કોઈ ગઠ્ ઠો િ અનભ િયય) ટ િય
પછો
િય બચન્હો

બચહ્નો અિે

અિે લક્ષણો કયય છે ?

અિે
લક્ષણો  ત્િચય હડમ્પબલિંગ (ક્યયરેક િયરાંગીિી છયલ
પ્રશ્નિો
જેવ ાં લયગે છે)

જિયબ
 સ્તિ અથિય સ્તિિી ડીંટીમયાં દ ખયિો
સમજા આપો

િિય.

 સ્તિિી ડીંટડી પયછાં ખેંચવ ાં

(અંદરિી તરફ િળવ) ાં
 સ્તિિી ડીંટડી અથિય સ્તિિી ત્િચય
લયલ, સકી જાડી

 સ્તિિી ડીંટડીમયથી સ્રયિ (સ્તિ દૂ ધ

મસિયય)

 લમસકય ગયઠમયાં સોજો

 સ્તિમયાં ગયઠાં અથિય સમહૂ િો દેખયિ.

 સ્તિ અથિય સ્તિિી ડીંટડીિી લયલયિ.

 સ્તિમયથી સ્તર્ યિ
સમય વિષય પ્રવ્રતિ એ. મ ૂલ્યાંકન
(મમમિ શિક્ષક શિખનાર વી
ટ)
એડ્

સારવાર સમજાવીને સાંભળો સ્તન કેંસર માટે

સ્તન કેંસર ની શંકાઓ પ ૂછો કઈ સારવાર
સારવાર નુ અને પ્રશ્નનો કરવામા આવે
વર્ણન કરવા જવાબ આપો છે ?
માટે

 ક્ષ-કિરણ

 હોર્મોન ઉપચાર

 રસાયણ ચીકીત્સા

 શસ્ત્રક્રિયા

 કુલ/ સરળ માસ્ટે ક્ટોમી

 એક્સેલરી ક્લિયરન્સ સાથેની કુલ માસ્ટે ક્ટોમી

 સંશોધિત રે ડિકલ માસ્ટે ક્ટોમી

 રોકી આમ ૂલ માસ્ટે ક્ટોમી

  સ્તન સરક્ષણ શસ્્રક્રિયાઓ

િણવિ છે ?
કરિય

મયટે

 સ્તિ સરક્ ષણ િસ્ત્રહિયયઓ

સમય મિમ મિષ પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ ય મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ

વનવારણ સ્તિ
સ્તિ ચચયવ આકૃ મત જ
 આલકોહોલ મયયવહદત કરો: કેન્સરમયાં
દ્ વયરય ઓ
કેન્સરન ાં
તમે જેટલ ાં આલકોહોલ પીિો એટલયમયાં તમે કયય
અિે
મિિયરણ તમયરય સ્તિન ાં કેન્સર થિયન ાં પ્રકયરિયાં
િકયઓ

જોખમ િધયરે છે. અટકયિિયિયાં

પછો.
ઉપયય કરો છો?

 ધમ્રપયિ િ કરો:

પર યિય ધમ્રપયિ અિે સ્તિ

કેન્સરિય જોખમ િચ્ચેન ાં

જોડયણિે સચિે છે, ખયસ કરીિે

-----------------------------------------સ્ત્રીમયાં

 તમયર ાં િજિ મિયમત્રત કરો:

િધયરે પડતય િજિિયળય અથિય મેદસ્િી
થિયથી સ્તિ

કે ન્સરન ાં જોખમ િધી જાય છે .

 િયરીહરક રીતે સહિય રહો:

િયરીહરક પ્રવમૃ ત્ત તમિે આરોગ્યપ્રદ િજિ

જાળિિયમયાં મદદ કરી િકે છે, જે સ્તિ

કેન્સર રોકિયમયાં મદદ કરે છે.

સમય મિમ મિષય પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ

સ્તનનું સ્વ પરીક્ષણ : સયભળો,

સ્તિિી સ્તિિી
િકયઓ
સ્િ- સ્તિિી સ્િયાં તપયસએ એક એિી સ્િ-
તપયસ છે કે જેમયાં સ્ત્રી પછો
પરીક્ષય પરીક્ ષય શ ા
સ્તિિી પેિીઓમયાં થતયાં ફેરફયર અથિય અિે પ્રશ્નિો ં છે?
સમજાિિય સમસ્યયઓ િોધિય ઘરે કરે છે. ઘણી સ્ત્રીઓએ જિયબ આપો
તમે
લયગે છે કે આ કરિયન ાં તેમિય સ્િશ્થય સ્તિિી

મયટે
મયટે સ્િ-
મહત્િપણવ છે.આત્મ –સ્તિ પરીક્ષણ કરિયિો શ્રેષ્ઠ
પરીક્ષયમયાં
સમય લગભગ
કેટલય
મયમસક િરૂ થિયિય 3 થી 5 હદિસ પછીિો છે
પગલયાં
અિે દર મહહિે તે જ
હોય છે ?
સમયે કરવ ાં જોઈએ.
ફયયદયઓ:

 સ્તિ િરીરરચિય મિષે જાણકયરી મળી

િકે છે.

 સમહૂ અથિય અન્ય લક્ષણો(બચન્હો) કે

જે કેન્સર મયાં

પહરણયમે છે તેિય મિષે જાણકયરી મેળિી

િકયય.
સમય મિમ મિષય પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ

પગલાઓ:

પગલ ં ુ 1: મહિના મા એક વાર માસિક ના 2 થી 3 દિવસ

પછી

પગલું 2: હાથ ઊચો કરી સ્તન અને બગલ ની તપાસ

કરવી

પગલું 3:મસાજ તેલ અથવા કુવારો જેલ સાથે

આંગળીના પદનો ઉપયોગ કરો.

પગલું 4:ઉપર અને નીચે

પગલ ં ુ 5:ફાચર

પગલું 6:વર્તુળો (ગોળાકાર

)

ુ :
પગલ 7

સ્તિ િી તપયસ કરો

પગલું 8:ત્િચય રાંગ અથિય રચિય મયાં
બદલયિ

પગલું 9: સ્તિિી ડીંટીડી મયાં મિકૃ મત,

રાંગ બદલયિો અથિય કોઈ
પણ પ્રિયહી ન ાં િીકળવ ાં
સમય મિમ મિષય પ્રવમૃ ત એ. મલૂ યયકિ
(મમમિ મિક્ષક મિખિયર
િ િી
ટ)
ત એડ્

લક્ષ્ય સ
 ૂ
સંશોધનપ્રોજેકટ મા વપરાયેલટલ

હેત ુ :આસાધનસંશોધનકર્તાનેસામાજિકવસ્તીવિષયકડેટાઅનેમહિલાઓનો
સ્તનસ્વપરીક્ષણ વિશેનીમાહિતીએકત્રિતકરવામાટેસક્ષમકરે છે.

સ ૂચનાઓ :

1) કૃપાકરીનેનીચેનાપ્રશ્નોનેકાળજીપ ૂર્વકવાંચો.

2) દરે કપ્રશ્નોસામેઆપેલખાના માંયોગ્ય જવાબઆપો.

3) તમારીપાસેથીએકત્રિતકરવામાઆવેલીમાહિતી ગપ્ુ તરાખવામાઆવશે.

વિભાગ-૧
જનસંખ્યાનીવિવિધતા

૧. ઉંમર
અ) ૧૫-૨૫ વર્ષ
બ) ૨૬-૩૫વર્ષ
ક) ૩૬-૪૫વર્ષ
ડ) ૪૬-૪૯વર્ષ
૨. ધર્મ
અ) મુસ્લિમ
બ) હિન્દુ

૩. શિક્ષણ

અ) કોઈઔપચારીકશિક્ષણનથી
બ) પ્રાથમિકશિક્ષણ
ક) માધ્યમિકઅનેઉચ્ચમાધ્યમિકશિક્ષણ
ડ) સ્નાતકઅનેતેથી વધુ

4. વ્યવસાય
અ) ગૃહિણી
બ) કર્મચારી
ક) કૃષિ
ડ) દૈ નિક વેતનકામદાર

5. વૈવાહિકસ્થિતિ
અ) પરણીત
બ) અપરણીત

6. બાળકોનીસંખ્યા

અ) એક
 બ) બે
ક) ત્રણ
ડ) ત્રણથીવધુ

7. પરિવારનોપ્રકાર

અ)વિભક્ત
બ) સંયક્ુ ત
ક) અન્ય

8. કુટુંબનીઆવક

અ) ૧૫૦૦રૂપિયાથીઓછા
બ) ૧૫ 00-૨ 000 રૂપિયા
ક) ૨ 00 ૧-૨૫ 00 રૂપિયા
ડ) ૨૫૦૧રૂપિયાથીઉપર

વિભાગ-૨
જ્ઞાનઆધારિતપ્રશ્નોતરી

૧) સ્તનએટલેશ ું ?

અ) તેપાચકતંત્રનોભાગછે
 બ)લોહીપેદાકરવા માટેરચાયેલએકઅંગ
ક) દૂ ધઉત્પન્નકરવા માટે રચાયેલએકઅંગ
ડ)તેશ્વસનતંત્રનોભાગછે

૨. સ્તનનોભાગકયોછે ?
અ) સ્તનનીડીંટડી
બ) એલ્વોલા
ક) ઉદરપટલ
ડ) શ્વાસનળી

૩. સ્તનનાંકયાભાગોથીદૂ ધઉત્પન્નથાયછે ?
અ) લોબ્યુલ્સઅનેનળીઓ
બ) સ્તનનીડીંટડીઅનેનળી
ક) ફેફસાઅનેશ્વાસનળી
ડ) ઉરોદરપટલઅનેયકૃત

૪. ક્યારે સ્તનપેશીનીસુસગ
ં તતામાંભિન્નતાજોવામળે છે ?
અ) માસિકસ્રાવ દરમિયાન
બ) માવસકસ્રાવપહેલા
ક) અંડપતનપછી
ડ) અંડપતનપહેલા
૫. સ્તનકેન્સરએટલે શુ?ં
અ) સ્તનનોચેપીરોગ
બ) સ્તનપેશીઓનીસામાન્યવ ૃદ્ધિ
ક) સ્તનનાકોષોર્નુંઅનિયંત્રિતવ ૃદ્ધિ
ડ) સ્તનનીબળતરા

૬. કેન્સરવિહિનગાંઠએટલેશ?ું
અ) સમ ૂહ/ ગાંઠ,આરોગ્યમાટેજોખમી
બ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમીનથીઅનેઅન્યભાગોમાંફેલાતનથી
ું
ક) સમ ૂહ/ ગાંઠ, અન્યભાગોમાંફેલાતનથી
ું
ડ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમીનથી

૭. કેન્સરયુકતગાંઠએટલેશ?ું
અ) સમ ૂહ/ ગાંઠ, સંભવિતજોખમીછે અનેઅન્યભાગોમાંફેલાયછે
બ) સમ ૂહ/ ગાંઠ, સ્વાસ્થ્યમાટેબિન-જોખમી
ક) સમ ૂહ/ ગાંઠ, અન્યભાગોમાંફેલાતનથી
ું
ડ) સમ ૂહ/ ગાંઠ, આરોગ્યમાટેજોખમી

૮. સ્તનનુકેં ન્સરસૌથીવધારે કોનેથવાની શક્યતાછે ?

અ) સ્ત્રી,જે પોતાના બાળકને સ્તનપાન કરાવે છે
 બ) સ્ત્રી,જેને પ્રસ ૂતિ દરમિયાન જટિલતા આવી હોય
ક) સ્ત્રી,જેના કુટુંબમાં સ્તનકેન્સરની બિમારીથઈ હોય.
ડ) સ્ત્રી,જેને સ્તનની અન્ય કોઈ બિમારી હોય

૯. સ્તનકેન્સરનુકારણશુ
ં છ ં ે?
અ) જાડાપણું
બ) નાનીઉંમર
ક)વધુકસરતકરવી
ડ) ઓછુ વજન

૧૦. ગર્ભનિરોધકનીકઈપદ્ધતિથીસ્તનકેન્સરથાયછે ?
અ) લાંબાસમયથીમૌખિકગર્ભનિરોધકગોળીઓનોઉપયોગ
બ) ગર્ભનિરોધકઉપકરણો
ક) અવરોધ પદ્ધતિ
ડ) અન્યપદ્ધતિ

૧૧.નીચેઆપેલપૈકીકયાસ્ત્રાવ નાફેરફારનાકારણેમેનોપોઝપછીસ્તનકેન્સરથવાનુવધુ
ં જોખમછે ?
અ) નીચુઈસ્ટ્રોરોજનનુ
ં ં સ્તર
બ) ઉચ્ચઈસ્ટ્રોરોજનનુસ્તર
ં
ક) ઉચ્ચપ્રોજેસ્ટેરોન નુસ્તર
ં
ડ) નીચુપ્રોજેસ્ટે
ં રોનનુસ્તર.
ં
૧૨. કયાપ્રકારનોખોરાકલેવાથીસ્તનકેન્સરથવાનીશક્યતાવધારે છે?
અ) ચરબીયુક્તઆિાર(તૈલી, માંસ)
બ) વધુપ્રોટીન(દૂ ધ, અનાજ)
ક)વધુકાર્બોહાંઇડ્રેટ(ચોખા, કેક, સુગર)
ડ) વધુરેસાવાળોખોરાક(ફળ, શાકભાજી)

૧૩. સ્તનના કેન્સરન લક્ષણો/ચિંહો કયા છે ?

અ)સ્તન માં ગાઠ થવી
બ) સ્તન ની દીં મથિ અસામન્ય સ્ત્રાવ
ક) સ્તન મ દુ:ખાવો
ડ) ઉપરોક્તતમામ

૧૪. એવી કઈ સાદી અને સરળ પદ્ધતિ છે જેના દ્વારા આપણે સ્તન ની ખામી જાણી શકીએ છે ?
અ) સ્તન સ્વપરીક્ષણ
બ)દવાખાના મા સ્તનનુ ં સ્વપરીક્ષણ
ક) મેમોગ્રામ
ડ) એક્સ-રે

૧૫. મેમોગ્રાફી એતલે શુ?

અ)સ્ત્નના પરીક્ષણ ની પદ્ધતિ
બ)ફેફસાના પરીક્ષણ ની પદ્ધતિ
ક)હાદ્કા ના પરીક્ષણ ની પદ્ધતિ
ડ)આંખના પરીક્ષણ ની પદ્ધતિ

૧૬. સ્ત્રીઓ સ્તનની તપાસ માટે મેમોગ્રામ કઈ ઉમરમાં કરાવી શકે છે ?

અ) ૧૫વર્ષ પછી
બ) ૧૮ વર્ષપછી
ક) ૩૦ વર્ષપછી
ડ) ૪૦ વર્ષપછી

૧૭. સ્તન કેન્સર માટે કઈ સારવાર કરવામા આવે છે ?

 અ) કેન્સરની શસ્ત્ર્ ક્રિયા
બ) કીમોથેરાપી
ક) રે ડીયેશન થેરાપી
ડ) ઉપરોક્ત તમામ

૧૮. માસ્ટેકટોમી નો અર્થ શુ છે ?

અ) સ્તનને કાઢવુ ં
બ) ફેફસાંને દૂ ર કરવુ ં
ક) હૃદયને દૂ રકરવુ ં
ડ) સ્તનની ડીંટી દૂ ર કરવી
૧૯. મેમોગ્રામ કેટ્લા વર્ષ ના અંતરે કરી શકાય છે ?
અ) ૪ વર્ષ
બ) ૩ વર્ષ
ક) ૨ વર્ષ
ડ) ૫ વર્ષ

૨૦. સ્તન સ્વપરીક્શન એટલે શુ?

અ)આખા સ્તનની તપાસ કરવી
બ) તેસ્તન વ ૃદ્ધિ માટે મદદ કરે છે
ક) રક્તના પરીભ્રમણને વધારવા માં મદદ કરે છે
ડ) તે સ્તનના રોગને સુધારવા માં મદદ કરે છે

૨૧. સ્તન સ્વપરિક્શા નો હેત ુ શુ છે ?

અ) સ્તન કેન્સરની તપાસ માટે
બ) સ્તન કેન્સર નિારણ માટે
ક) વહેલી તકે સ્તન કેન્સરને શોધવા માટે/ જાણવા માટે
ડ) સ્તન રોગ અટકાવવા માટે

૨૨. સ્ત્રીઓએ સ્તન પરીક્ષણ ક્યારે કરવુ ં જોઈએ?

અ) મેનોપોઝની નજીક
બ) મેનોપોઝ પછી
 ક) દરે ક મહિને માસિકચક્ર પછી
ડ) દરમહિને

૨૩. પોસ્ટમેનોપોઝલ સ્ત્રીઓએ ક્યારે સ્તન ની તપાસની પ્રેક્ટિસ જોઈએ?

અ) માસિક
બ) દ્વીમાસિક
ક)ત્રિમાસિક
ડ) ચોથા માસિક

૨૪. સ્તન સ્વપરીક્ષણ માં કેટલા પગલા છે ?

અ) ૯
બ) ૭
ક) ૫
ડ) ૮

૨૫. સ્તનના તપાસ દરમિયાન તમે કઈ આંગળીઓનો ઉપયોગ થાયછે ?

અ) તર્જની આંગળી, મધ્યમ આંગળી અને રિંગ આંગળી
બ) મધ્યમ આંગળી, રિંગ અને નાની
ક) તર્જની, મધ્યમ, રિંગ અને નાની
ડ) ફક્તમધ્યમઆંગળી
૨૬. સ્તનનુ સ્વપરીક્ષણ ક્યાં કરવુ ં જોઇયે?
અ)બાથરૂમમાં
બ)સ્નાન કરતાં સમયે
ક)સાબુ લગાવતા સમયે
ડ)અન્ય

૨૭. જ્યારે સ્તનનુ ં પરીક્ષણ કાચની સામે ઊભા રહીને કરવામા આવે ત્યારે શુ અવલોકન કરવામા આવે
છે ?
અ) સ્તનનો કદ અને આકાર
બ) સ્તન વ ૃદ્ધિ
ક) સ્તનમાસ
ડ) ઉપરોક્ત તમામ

૨૮. સ્તન સ્વ પરીક્ષણ દરમિયાન તમે કયા ફેરફારો કરો છો?
અ) ડિમપ્લિન્ગ
બ) કળતર સનસનાટી ભર્યા
ક) સ્તન માં દુ:ખાવો
ડ) સ્તનની ડીંટી માથી સ્ત્રાવ થવો

૨૯. નીચેના માંથી કયા પ્રકાર નુકેં ન્સર સૌથી વધારે જોવા મળે છે ?
અ) સ્તન કેન્સર
બ) આંતરડા ના કેન્સર
 ક) હાડકાનુ ં કેન્સર
ડ) કરોડરજ્જૂ નુ ં કેન્સર

૩૦. સ્તન પરીક્ષણનો ફાયદો શું છે ?

અ) સ્ત્રીઓમાં સ્તન કેન્સર શોધવુ
બ) સ્તન કેન્સરની વ ૃદ્ધિમાં વધારો
ક) સ્તન કેન્સર નો અટકાવો
ડ)અન્ય