RESEARCH PROJECT

FACTORS INFLUENCING SELF-BREAST EXAMINATION

AS RELATED TO BREAST CANCER AMONG WOMEN OF

REPRODUCTIVE AGE (15-49YRS) IN NANDIHILLS SUB-

COUNTY HOSPITAL.

CONDUCTED BY:

ANN GATWIRI

KRCHN STUDENT D/NURS/20049/3982

A RESEARCH REPORT SUBMITTED TO THE

DEPARTMENT OF HEALTH SCIENCES IN PARTIAL

FULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF THE DIPLOMA IN KENYA REGISTERED

COMMUNITY HEALTH NURSING (KRCHN) IN KENYA

MEDICAL TRAINING COLLEGE.

 DECLARATION

The research project by Ann Gatwiri submitted to the faculty of Nursing Kenya

Medical training College, Kaptumo campus in Partial fulfillment of the requirements

for the award of a Diploma in Kenya Registered community Health Nursing

(KRCHN).

I hereby declare that this is my original work that has not been presented before for

academic purpose.

Name…………………………………………..

Signature………………………………………

Date……………………………………………

SUPERVISOR

Name………………………………………………..

Signature.................................................................

Date.....................................................................

ii
 ACKNOWLEGEMENT

I give all the glory to the almighty God for this abundant grace which has seen me through

my study period. He renewed my strength each day and this far he is worthy of my praise.

The success of this study depended on a team of people who have contributed

psychologically, materially and theoretically. I hereby wish to express my heartfelt gratitude

to my supervisor for his guidance and advice throughout the project may God bless him

abundantly. I also pass my gratitude to my class tutors for taking me throughout lectures on

research.

I would also wish to pass my regards to the team that helped me in data collection. Finally I

thank the staff of Nandi hills sub-county hospital for according me co-operation during this

period.

iii
 DEDICATION

This desertification is dedicated to my family and friends for their prayers,

encouragement, understanding and financial support during the entire process for this

research. Thanks for your concern

MAY GOD BLESS YOU

iv
 ABSTRACT

The study was cross sectional study design. The main purpose of the study was to determine
knowledge, attitude and practice of self-breast examination among women of child bearing
age attending MCH/FP Clinic at Nandi hills sub-county hospital, Nandi County. The study
targeted women of child bearing age. A total of 80 women were selected and interviewed
using systematic sampling method. From the study self-breast examination was known by
majority of women attending MCH/FP Clinic as it was represented by 78%. Also the study
revealed that majority of the women attending MCH/FP clinic in Nandi hills sub-county
hospital practiced self-breast examination as represented by 60%. Those who practiced BSE
practiced it at any time which was attributed by lack of proper health education on the
appropriate time for BSE. I have explained the five steps carried out by a woman in order to
rule out any abnormality especially the development of a lump. The study therefore
recommends the world health organization to make BSE a public policy so that there is
community mobilization through creating awareness. I would also make an appeal to MOH to
incorporate BSE as one of the services among the services offered in MCH/FP services in
order to reach the 40% of women who do not practice BSE. This will help in early detection
of breast cancer hence reduce mortality.

5
 OPERATIONAL DEFINATIONS

Knowledge – Level of awareness on information about self-breast examination as related

to breast cancer.

Attitude – Attendance to think or behave in a certain way.

Practice: - The method used to the examination

Breast Cancer: Malignant disease that affect the mammary glands

6
 LIST OF ABBREVIATIONS

BSE – Breast Self-Examination

MCH/FP – Maternal Child Health and Family Planning

MOH – Medical Officer of Health

CME – Continuous Medical Education

SVD – Spontaneous Vaginal Delivery.

C/S – Cesarean Section.

7
 TABLE OF CONTENT

Contents

DECLARATION...................................................................................................................ii
ACKNOWLEGEMENT...........................................................................................................iii
DEDICATION......................................................................................................................iv
ABSTRACT............................................................................................................................5
OPERATIONAL DEFINATIONS....................................................................................6
LIST OF ABBREVIATIONS.............................................................................................7
TABLE OF CONTENT.............................................................................................................ii
APPENDICES..........................................................................................................................iv
CHAPTER ONE....................................................................................................................5
1.0 Introduction.............................................................................................................................5
1.1 Problem Statement................................................................................................................6
1.2 Purpose of the Study..............................................................................................................6
1.3 Justification of the Study.....................................................................................................6
1.3.1 Client (Community)..............................................................................................................7
1.3.2 Health Workers.....................................................................................................................7
1.3.3 Nation.....................................................................................................................................7
1.3.4 The Researcher.....................................................................................................................7
1.4 Objective of the Study..........................................................................................................8
1.4.1 Broad Objective................................................................................................................8
1.4.2 Specific Objective..............................................................................................................8
1.5 Research Questions................................................................................................................8
CHAPTER TWO.......................................................................................................9
2.0 Literature Review...................................................................................................................9
2.1 Attitude towards Self Breast Examination in Women of Child Bearing Age.
...........................................................................................................................................................10
2.2 Practice on Self Breast Examination.............................................................................11
2.3 Step in Performing Self Breast Examination.............................................................11
2. PALPATION.......................................................................................................12
2.4 Role Played By Health Workers In Self Breast Examination...............................12
CHAPTER THREE..................................................................................................... 13
3.0 Methodology...........................................................................................................................13
3.1 Study Area..............................................................................................................................13
3.2 Study Design...............................................................................................................................13
3.3 Definition of Variable.........................................................................................................13
3.4 Inclusion and Exclusion Criteria....................................................................................14
Study Population......................................................................................................14
3.5 Samples Size Determination.............................................................................................14

ii
3.6 Sampling Method.................................................................................................................14
3.7 Technique Method of Data Collection.........................................................................14
3.8 Data Collection Instrument..............................................................................................14
3.9. Study Limitations.................................................................................................................15
3.10 Data Analysis And Presentation...................................................................................15
3.10.1 Ethical Consideration...................................................................................................15
CHAPTER FOUR...................................................................................................16
4.0 Research Finding..................................................................................................................16
4.1 Demographic Information................................................................................................16
Table 2: MARITAL STATUS..............................................................................16
Figure 1: EDUCATION LEVELS OF RESPONDENTS..............................17
Figure 2: OCCUPATIONS OF RESPONDENTS...........................................18
4.3 Knowledge...............................................................................................................................18
Figure 4: SOURCE OF INFORMATION.........................................................18
Figure 6: KNOWLEDGE ON ABNORMALITIES CHECKED FOR......20
Figure 7: RESPONSE ON WHETHER THE RESPONDENTS HAVE
BEEN T0UGHT ON BSE.....................................................................................20
4.3 Practice.............................................................................................................21
Figure 8: RESPONSE ON APPROPRIATE TIME TO CONDUCT BSE
..................................................................................................................................... 21
Figure 9: SHOWING RESPONSES ON WHY RESPONDENTS DO
NOT PRACTICE BSE..........................................................................................22
4.4 Attitude....................................................................................................................................23
Figure 12: SHOWING WHY IT IS NOT POSSIBLE TO DO SELF-
BREAST EXAMINATION AS RECOMMENDED......................................24
Table 5: RESPONSE ON WHETHER SELF-BREAST EXAMINATION
HELPS IN EARLY DETECTION OF BREAST CANCER........................25
CHAPTER FIVE......................................................................................................... 26
5.0 Discussion.................................................................................................................................26
5.1 Demographic..........................................................................................................................26
5.2 Knowledge...............................................................................................................................26
5.3 Practice....................................................................................................................................26
5.4 Attitude....................................................................................................................................27
CHAPTER SIX............................................................................................................28
6.0 Conclusion..................................................................................................................................28
6.1 Recommendation.......................................................................................................................28
REFERENCES............................................................................................................ 30
WORK PLAN..............................................................................................................31
BUDGET...................................................................................................................32
QUESTIONNAIRE................................................................................................ 33
SECTION 1....................................................................................................................................33
SECTION 2....................................................................................................................................35
MAP OF NANDIHILLS SUB-COUNTY HOSPITAL..................................... 39
iii
APPENDICES

Appendix 1 work plan....................................................................................pg 32

Appendix 2 budget..........................................................................................pg 33

Appendix5 Research Questionnaire ...........................................................pg 34-38

Appendix 4 Map of Nandi County.....................................................................pg 40

iv
 CHAPTER ONE

1.0 Introduction

Breast disorders may be non-cancerous (benign) or cancerous (Malignant). Most of

them are non-cancerous and not life threatening often they do not require treatment. In

contrast breast cancer can mean a loss of a breast or life. However, potential problems

can be detected early enough when women regularly examine their breast themselves

and have mammograms. Common problems include breast pain, lumps and a discharge

from the nipple.

Breast symptoms do not necessary mean that women has breast cancer or another

serious disorder. However if a woman has any of the following symptoms, she should

see her doctor. A lump feels distinctly different from other breast tissue or that does

not go away. Dimpling in the skin of the breast scaly skin around the nipple, changes

in the shape of the breast. Changes in the nipple such as turning inward discharge from

the nipple especially if it is bloody. Many women experience breast pain. Breast pain

may be related to normal changes for example, it may occur during or just before

menstrual period (as part of the premenstrual syndrome) or early in pregnancy. Women

who take oral contraceptive or who take hormone therapy after menopause commonly

have this kind of pain. The pain is due to growth of breast tissue such pain is usually

diffuse making the breast tender to touch. Pain related to menstrual period may come

and go for months or years. Other causes of breast pain include breast cysts, infections

and abscesses. Breast pain that persists for more than one month should be evaluated.

Lumps in the breast are relatively common and are usually not cancerous, but because

they may be cancerous, they should be evaluated by a doctor without delay.

5
One or both nipple sometimes discharges a fluid. A nipple discharge occurs normally

during milk production (lactation). After child birth or as a result ofmechanical

stimulation of the nipple by fondling, suckling or irritation (Beer B mark Fietcher),

Andrew (2003).Self breast examination help in early detection of breast cancer.

1.1 Problem Statement

In the world breast cancers causes 10,000 deaths annually. It is said that 1:17 female born

will develop breast cancer in their life time (Beer B mark Fitcher J. Adrew 2003).

Self-breast examination remains the most reliable method of detecting the signs of

breast cancer. Early detection and diagnosis remains the most important of obtaining a

prime diagnosis in most cancer patients.

However, though many women notice a lump on the breast they do not seek medical

advice because it is painless and they do not know its implication. In Africa the rate of

breast cancer is lower than the Western countries. However women in Africa presents

at advanced stages hence high mortality rate.

1.2 Purpose of the Study

This is to assess the knowledge, attitude and practice on self-breast examination among

women of child bearing age. Create awareness on development of cancer of the breast

among women of child bearing age. Also address the importance of self- breast

examination since it help in early detection of breast cancer.

1.3 Justification of the Study

Since breast cancer is a major health problem which can occur to any woman, self-

breast examination remains the most affordable and simple way of early detection of

breast lumps. Therefore the research will benefit the following:

6
1.3.1 Client (Community)
By assessing their knowledge, attitude and practice on self-breast examination, more

health education will be provided to them on breast cancer. They will see the need to

examine their breast monthly to rule out or detect breast lumps early. They will also

seek medical assistance early before the cancer will invade other breasttissue. This

will reduce cost and suffering to the victim, family and community because when one

member of the family is affected the whole community is affected.

When large number of clients, become aware of self-breast examination, they will

spread news to their family members which will result to the whole community getting

informed about the benefits of self-breast examination.

1.3.2 Health Workers

The research on self-breast examination will help the health workers as well because

after identifying the knowledge, attitude and practice on self-breast examination

among their clients they will know the effectiveness of their service and hence the need

to work more towards improving their services.

1.3.3 Nation
When clients detect breast lumps and seek medical interventions before cancer cell

invade other breast tissues, the nation will benefit because the cost of treatment will be

reduced. Treatment of advanced cancer is very expensive.

The nation will also have healthy women hence a healthy working nation this will

reduce the morbidity and mortality rate among women of child bearing age.

1.3.4 The Researcher

The researcher will develop skills, which will help in future research. It will also act as

a partial fulfillment in award of Diploma in registered community Health Nursing.

7
1.4 Objective of the Study

1.4.1 Broad Objective.

To determine the knowledge, attitude and practice on self-breast examination as related

to breast cancer among women of child bearing age attending MCH/FP clinic in

Nandihills sub-county hospital,Nandi county.

1.4.2 Specific Objective.

i. To assess knowledge on self-breast examination in women of child bearing age.

ii. To determine the attitude towards self-breast examination in women of child

bearing age.

iii. To assess the practice on self-breast examination among women of

childbearing age MCH/FP Clinic in Nandi hills sub-county hospital, Nandi

County.

iv. To establish the role played by health workers in self-breast examination.

1.5 Research Questions.

i. What factors contribute to breast cancer?

ii. What is the level of knowledge of the respondents about breast cancer?

iii. How do respondent perceive self-breast examination?

8
 CHAPTER TWO

2.0 Literature Review

Breast cancer appears to be a disease of both developing and developed countries. Among

Turkish women, breast cancer is the second leading cause of cancer related deaths.

A study carried out among Turkish women revealed that they used self-breast examination as

a tool for early detection of breast cancer. Level of breast cancer knowledge was the only

variable significantly associated with the self-breast examination (Parkin, DM 2005).

Studies from around the world have shown that the incidence of breast cancer is rising both

in developed and developing nations and that it is common in women of child bearing age

(Bird, 1992; Person, 1995).

This could result from changes in lifestyles, especially in those of African women (Amir;

1998).In the past, women had started child bearing early, they bore many children and

breastfed children for longer periods but there were no cases of breast cancer.

In countries south of the Sahara, breast cancer is the second most common malignancy in

women. In Uganda the incidence is 16.4 percent (Akhtar, 1993) and in Tanzania breast

cancer represented 8.1. Percent of all female cancer, with peak prevalence in the group of 15

– 49 years (Nzarubara, 1999). Identified risk factors for breast cancer include early

menarche, null parity, late menopause, poor diet and lack of physical exercise (Amir, 1994)

In Addition, studies have shown that alcohol intake is associated with breast cancer and the

risk increases slightly in women who consume even one alcoholic drink daily (Amir, 1998;

Dorsay, 2001) smelter (2002) has also suggested that smoking increases that risk of breast

cancer.29% believed that pain in the breast is the warning sign for breast cancer and 11.1%

9
has never heard of breast cancer. In response to a question regarding breast cancer screening

over 60% of the women either did not respond or did not know about the breast cancer

screening test. 7% of the respondent believed that screening is a painful examination that

burns cancer.

Jebbin NJ and Adotey J M, conducted a study on attitude, knowledge and practices of breast

self-examination (BSE) in Port Harcourt, Nigeria and found that 85.5% of the respondent had

heard of Breast self-examination but 39.0% practiced BSE only occasionally. The news

media, nurses and physicians were the commonest sources of information on BSE.

Early detection and prompt treatment offer the greatest chance of long term survival.

Mammography, clinical breast examination and breast self-examination (BSE) are the

secondary preventive methods used for screening in the early detection of breast cancer.

Cancer screening tests play pivotal role in reducing breast cancer related mortalities. (Lee

EH: Breast self – examination performance among Korean nurses. Journal for nurses in staff

development.2003)

2.1 Attitude towards Self Breast Examination in Women of Child Bearing

Age.

Many women belief that the size and shape of their breast determine their sexuality

desirability or lack of it. The breast also defines their acceptability as women in society

eyes. The loss of a breast therefore threatens the fundamental components of a

woman’s identity that is her feminist, her self-image and her measure of self as a

person.

Accordingly women are often reluctant to do anything even if they suspect a lump in

their breast yet it has long been recognized that one of the best means of obtaining an

10
early diagnosis in breast cancer in periodical self-breast examination (Smelter c

Suzanne 2000)

2.2 Practice on Self Breast Examination

It is estimated that only 25% to 30% of women perform self-breast examination

proficiently each month. Some find breast examinations to be exciting, others find it

too difficult to differentiate between normal changes and worrisome findings. Younger

women may find self-breast examination particularly difficult because of the density of

their breast tissue.

Even women who perform self-breast examination and detect a change may delay

seeking medical attention because of fear, economic factors, lack of education and

modesty. (Brunner Suddaths, 2007)

Cancer of the breast can be detected early through self-breast examination, doing it

regularly will help a woman learn what is normal for her breast and she will be able to

notice changes.

Self-breast examination should be performed at least once in a month land at the same

time even after menopause. If the breast has been removed self-breast examination

should be done on the site of the surgery. Self-breast examination does not involve

many parties and no cost is involved.

2.3 Step in Performing Self Breast Examination

1. INSPECTION

The client should stand in front of a mirror with arms at sides and check both breasts

for any discharge from the nipple, dimpling and discolored area of the skin. Also the

11
client raises her hands over the head and observes for any change in the contour of the

breast.

The client can also put her hands on her hips, press against her hips which tightens the

muscle underneath the breast. She observes again for dimples or flattered places which

look different between the two breasts. The client observes for any ulcers, rashes or

discharge. Observes if one nipple is inverted and the other one is not.

2. PALPATION

The breast is divided into four quadrants with the tail extending into the axilla (under arm).

Using three or four finger of the right hand, palpate thoroughly with the flat, moving the

fingers in small circles around the breast. Begin at the outer edge and gradually more in

towards the nipple, press gently but firmly feeling for any unusual lump or mass under the

skin, the woman should be sure to check the whole breast.

2.4 Role Played By Health Workers In Self Breast Examination

The nurse plays an important role in breast examination (BSE) Education, a modality

used for early detection of breast cancer. BSE can be taught in a variety of setting

either on one basis or in a group. It can also be initiated by a health care practitioner

during a patient’s routine physical examination.

Variations in breast tissue occur during the menstrual cycle, pregnancy and the onset of

menopause. Women on hormone therapy can also experience fluctuations. Normal

changes must be distinguished from those that may signal disease. Most women notice

increase tenderness and lumpiness before their menstrual periods; therefore, BSE is the

best performed after menses (Brunner Suddath, 2007).

A study carried out among Turkish women reported that they had acquired information
12
on BSE from health professionals, (Parkin DM 2005).

13
 CHAPTER THREE

3.0 Methodology
This chapter will presented the research design that was used by the researcher in

establishing factors influencing the practice on self-breast examination as related to breast

cancer. It specifically discuss the research design used, the target population, the sample size

and sampling products that was used, the research instruments that was employed and the

procedure for collecting and analyzing data.

It also addresses itself to the issues of validity and reliability of the research instrument and

finally it also addresses the ethical considerations that arised during the collection of the

research.

3.1 Study Area

Nandi hills Sub-County Hospital was the study area. It is located in Kaplelmet

Location, Nandi hills Division, Nandi East District, Tinderet constituency in Nandi

county.

The hospital has an out patients department in which there is casualty department,

consultation rooms and maternal child Health clinic whereby integrated services are

carried out. These services include immunization as per KEPI schedule, family

planning; antenatal care which includes prevention of mother to child transmission of

HIV. Postnatal checkup is also done.

3.2 Study Design

Descriptive study was used to determine knowledge, attitude and practice of self-

breast examination among women of child bearing age.

3.3 Definition of Variable

Dependent variable – breast examination

14
Independent variables – knowledge, practices and attitude.

3.4 Inclusion and Exclusion Criteria.

Inclusion criteria – Women of child bearing between 15 – 49yrs Exclusion

Criteria – Clients aged below 15years and above 49 years.

Study Population

The study populations were women of child bearing age 15 – 49 years.

3.5 Samples Size Determination

Maternal child health records and family planning had a total 452 clients who had been

seen at the clinic for the last three months. To determine sample size 10 of the study

population will be taken i.e.

10 x 452

_______

100

= 45.2

That is: 45 clients

3.6 Sampling Method

Systemic sampling method was used whereby the first 20 clients were picked every

day and were interviewed.

3.7 Technique Method of Data Collection

The method of data collection was by interviewing clients attending MCH/FP clinic

3.8 Data Collection Instrument

The instrument / tool for data collection was an interview schedule which consisted of

4 sections; demographic data, knowledge, practice and attitude.

15
3.9. Study Limitations
Time to collect data was too short, harsh weather condition; data was collected during

winter season. Lack of enough resources in terms of money to train more people to

collect data making data collection difficult.

3.10 Data Analysis And Presentation.

The interview schedule were checked for error and corrected. The data was manually

analyzed and findings, were presented in tablets, bar charts histograms and

percentages.

3.10.1 Ethical Consideration

Permission to collect data was obtained from KMTC Kaptumo. Further permission to

collect data was obtained from MOH Nandihills Sub-County hospital and lastly

permission was also obtained from nursing officer in charge MCH/FP clinic

Nyandihills Sub-County Hospital,Nandi county.

16
 CHAPTER FOUR

4.0 Research Finding

The chapter presents the findings and analysis interpretation and presentation of

the researcher findings. Presentation are in form of tables figures numbers and

percentages.

4.1 Demographic Information

Table 1: AGE OF RESPONDENTS

AGE NUMBER PERCENTAGE(%)

15 – 21YRS 10 13

22 – 28YRS 36 45

29 – 35YRS 27 33

36-42 YRS 5 6

43-49 YRS 2 3

TOTAL 80 100

The table below shows that 46.5% of the respondents were in a group 22 – 28yrs

while 3% fell in the age group 43 – 49 yrs.

Table 2: MARITAL STATUS

MARRITAL STATUS NUMBER PERCENTAGE

Married 42 52

Single 30 38

Divorced /Separation 5 6

Windowed 3 4

TOTAL 80 100
17
 The table above shows that 52% of the respondents were married while 4% were

windowed

Figure 1: EDUCATION LEVELS OF RESPONDENTS

The above figure shows that most of the respondents had acquired formal education

represented by 60%

18
 Figure 2: OCCUPATIONS OF RESPONDENTS

The above figure shows that most of the respondent were self-employed as represented by

45%

4.3 Knowledge

Figure 3: KNOWLEDGE ON SELF BREAST CANCER EXAMINATION

77% of the respondents had heard about BSE 23% had no knowledge on BSE

Figure 4: SOURCE OF INFORMATION

o. of Respondents in

19
The figure shows that the largest number of respondents who had heard about

breast examination heard from the health facility

Figure 5: RESPONSE ON WHETHER IT'S IMPORTANT TO BSE

20
 The figure shows that 90% of the respondents said that it's important to do BSE

Figure 6: KNOWLEDGE ON ABNORMALITIES CHECKED FOR

Most of the respondents said breast lumps is what is checked for when doing BSE

Table 3: RESPONSE ON HOW OFTEN BSE SHOULD BE DONE

RESPONSE NUMBER PERCENTAGE

Monthly 28 35

Annually 10 12.5

Anytime 42 52.5

Total 80 100

Most of the respondents said that BSE should be done anytime as represented by

52.5%

Figure 7: RESPONSE ON WHETHER THE RESPONDENTS HAVE

BEEN T0UGHT ON BSE

21
Most of the respondents had been tought on how to carry out BSE as represented by 82%

4.3 Practice

Table 4: SHOWING PRACTICES ON BSE

Practice on BSE Number Percentage

Yes 48 60

No 32 40

TOTAL 80 100

22
 Most of the respondents practice self-breast examination as represented by 60%

Figure 8: RESPONSE ON APPROPRIATE TIME TO CONDUCT BSE

Most of the respondents said that self-breast examination should be done anytime as

represented by 52.5%

Figure 9: SHOWING RESPONSES ON WHY RESPONDENTS DO NOT

PRACTICE BSE.

23
 Most of the respondents do not practice BSE for it is uncomfortable as represented

by 52%

4.4 Attitude

Figure 10: RESPONSE ON THE FEELING TOWARDS SELF-BREAST

EXAMINATION IN PERCENTAGE

24
Most of the respondents felt that its important to do self-breast examination as represented

by 95%.

Figure 11: RESPONSE ON WHETHER IT’S POSSIBLE TO DO SELF-

BREAST EXAMINATION AS RECOMMENDED.

Most of the respondents felt it’s possible to do self-breast examination as

recommended as represented by 75%.

Figure 12: SHOWING WHY IT IS NOT POSSIBLE TO DO SELF-BREAST

EXAMINATION AS RECOMMENDED.

25
Most of the respondents felt that it’s uncomfortable to do self-breast examination as

recommended as represented by 60%.

Figure 13: RESPONSES ON WHETHER HEALTH WORKERS INSIST

ON SELF BREAST.

Health workers insist on self-breast examination as represented by 90%

Table 5: RESPONSE ON WHETHER SELF-BREAST EXAMINATION

HELPS IN EARLY DETECTION OF BREAST CANCER.

RESPONSE NUMBE PERCENTAGE

Yes 66 82.5

No 14 17.5

Total 80 100

Most of the respondents felt that self-breast examination helps in early detection of

breast cancer as represented by 82.5%.

26
 CHAPTER FIVE

5.0 Discussion

This chapter discusses study findings mentioned in the previous chapter. The data was

collected from 80 respondents and they were all female of child bearing age (15 – 49

years)

5.1 Demographic

45% of the respondent was aged between 22 – 28 years and they were the majority.

The study also revealed that 52% of the respondents were married and 4 % of the

respondents were widowed. Majority of the respondents were represented by 60%. The

study also revealed that 45% of the respondents earn their living on self- employed.

5.2 Knowledge

According to the study most of the respondents had heard about self-breast

examination as represented by 77.5% , majority of the respondents heard through heal

in facility as represented by 52% this shows that healthcare providers are disseminating

much information to the women. 90% said it is important to do self- breast

examination.

57% of the respondents know that what to check for. Most of the respondents said that

self-breast examination should be done any time as represented by 52.5%.Most of the

respondents had been taught on self-breast examination as represented by 82.5%

5.3 Practice

60% of the respondents practice self-breast examination. Most of the respondents

performed self-breast examination any time as represented by 52.5%.Most of the

respondent did not practice self-breast examination because it is uncomfortable.

27
5.4 Attitude

95% of the respondents felt that self-breast examination is important. 75% also felt that

is possible to do self-breast examination as recommended.

According to the study 60% of the respondents felt that it is uncomfortable to do self-

breast examination. Health workers insist on self-breast examination as represented by

90%. Most of the respondents felt that self-breast examination helps in early detection

of breast cancer as rep resented by 82.5%

28
 CHAPTER SIX

6.0 Conclusion
The study showed that women of child bearing age (15 -59) years attending MCH/FP

clinic in Nandihills sub-county hospital had a lot of knowledge on self- breast

examination.

Most of those who practices self-breast examination knew what they were checking

for. However, most of the respondents practices self-breast examination any time.

Only 35% practiced self-breast examination monthly as recommended. Health care

providers in Nandihills sub-county hospital are disseminating information on self-

breast examination since most of the women heard about self-breast examination

through health facility.

6.1 Recommendation
Health care provider continue disseminating information on self-breast examination so

to help change altitude of those who felt that self-breast examination is not important.

Women of child bearing age attending Nandihills sub-county hospital MCH/FP clinic

should be clarified as to when self-breast examination should be performed. They need

to be told that it should be once a month after menses.

A continuous medical education (CME) for nurses working should be held every

month to help refresh the health workers skills. Media has been seen to reach 23% of

people hence should prepare more programmes on self-breast examination.

Health care providers in MCH/FP Nandi hill sub-county hospital were doing quite a

lot on self -breast examination and deserves to be congratulated. If all woman of

child bearing age practices self-breast examination cancer of the breast would be

29
detected early hence reduce maternal mobility and mortality rate.

30
 REFERENCES

Baillieres Nurses Dictionary revised by Barbara F. Weller Richard J Wells. 21st

Edition.

Diana M Fraser and co-oper A Margaret Myeles (2003) textbook for midwives 14th
Edition.

Medical Surgical Nursing by Bruner/Suddanths 9th Edition, 11th Edition (2001)

Wolter Kluwer.

Olive M Mugenda and Abel G Mugenda (2003) Researcher Methods Quantitative and
Qualitative approaches revised (2003) ACTS Nairobi Kenya.

Rober Berkow and Mark H.Beers The Mark Mannual of medical information Home
Edition (1997)

Rose and Wilson (2001) Anatomy and Physiology in health and illness 9th Edition

31
 WORK PLAN

Augus Septemb Octobe

November December January
Activity t er r
2022 2022 2023
2022 2022 2022
Identification of
research topic
Formulation of
objectives
Purpose of the
study
Justification of
the study
Literature review
Research
methodology
Formulation of
questionnaire
Retesting of
questionnaire
Data collection

Data analysis

Discussion

Conclusion

Recommendation

Report, typing
and

handing over

32
 BUDGET

items quantity cost total

Foolscaps 1 ream 1 x 350 Kshs 350

Duplicating papers 1 ream 1 x 400 Kshs 400

Spring file 1 1x 50 50

Biro pens 3 3 x 20 60

Pencils 1 1 x 10 10

rubber 1 1 x 10 10

Training of interviews 2 300 per person 600

Computer services 1500

Binding and photocopying 3 copies 200 per copy x 3 +100 700

Sub total 3,680

Contingency 550

TOTAL 4230

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QUESTIONNAIRE

RESEARCH QUESTIONNAIRE ON FACTORS INFLUENCING SELF-

BREAST EXAMINATION AS RELATED TO BREAST CANCER

AMONG WOMEN OF CHILD BEARING AGE 15 – 49 YEARS IN

NANDIHILLS SUB-COUNTY HOSPITAL IN NANDI COUNTY.

INFORMED CONSENT

1. Information obtained will only be used for research study and will remain confidential.

2. Answer questions in the spaces provided/ tick the appropriate answer in the spaces

provided.

3. Do not write your name on the questionnaire.

SECTION 1

TO DETERMINE THE RESPONDENTS DEMOGRAPHIC DATA.

1. How old are you?

(a) 15 – 19 years

(b) 20 – 24 years

(c) 25 – 29 years

(d) 30 – 34 years

34
 (e) 35 and above years

2. What is your marital status?

(a) Married

(b) Separated

(c) Single

(d) widowed

3. How many children do you have?

(a) One

(b) Two

(c) Three

(d) Four

35
(e) 5 and above childr en

4. What is your level of education?

(a) Primary

(b) Secondary

(c) College

(d) university

5. What was the mode of delivery?

(a) SVD

(b) C/S

6. Where was the place of birth?

(a) Hospital

(b) Home

SECTION 2

ASSESSING CLIENTS KNOWLEDGE AND PRACTICES

7. What is breast examination?

(a) Its washing of breast

36
 (b) Its breast feeding

(c) It’s the method of taking care of the breast or monitoring for any

abnormality

8. Is it important to do breast examination?

(a) Yes

(b) No

9. If yes, how many times a woman is supposed to do breast examination?

(a) One times

(b) Two times

(c) Three times

(d) Regularly

10. Starting B.E early is it beneficial?

(a) Yes

(b) No

11. If no, why?

(a) Those starting early waste time and energy

(b) Those starting early have nothing to do

37
 (c) Only those women have given birth should start ea rly.

(d) Those starting early and late are all the same

12. What is breast cancer?

(a) A disease that affect milk

(b) A disease that hinder milk

(c) A disease that affect children not to breast feed

(d) A growth in the breast

13. Have you ever been screened for cancer?

(a) Yes

(b) No

14. If yes, what was the result?

(a) Positive

(b) negative

15. Were thought on how to detect breast cancer early?

(a) Yes

(b) No

16. If yes, how were you taught?

38
 (a) Through breast examination

(b) Through breast feeding

17. Have you ever heard of breast cancer there before?

(a) Yes

(b) No

18. If yes, through which means?

(a) Through seminars

3

(b) Through magazines

(c) Through cancer campaigns

(d) Through media

(e) From a friend who had it

39
MAP OF NANDIHILLS SUB-COUNTY HOSPITAL

40