Republic of the Philippines

NORTHERN NEGROS STATE COLLEGE OF SCIENCE & TECHNOLOGY

Old Sagay, Sagay City, Negros Occidental

Awareness and practice of breast self-examination among women in reproductive age in

Poblacion 1 & 2, Sagay City

In Partial Fulfillment
of the Requirements in
HENCM 111 (Nursing Research)

By:
Caballeda, Rhea E.

Hulleza, Johnrey O.

Legario, Lechele M.

Maculado, Ezy B.

Mamon, Kate L.

Tolentino, Rachel Ann B.

 CHAPTER I

INTRODUCTION

BACKGROUND OF THE STUDY

Breast cancer is the most frequently diagnosed cancer worldwide in women, with

nearly two million new cases diagnosed in 2018. In the Philippines, breast cancer is the most

common cancer among women. Remains a worldwide public health dilemma and is currently

the most common tumor in the globe. Breast cancer is becoming more common, accounting

for one-third of all female malignancies, according to recent reports. The biggest issue is late-

stage breast cancer, which should have been clearly detectable in the majority of cases. Early

diagnosis is an essential alternative to explore for breast cancer control. Breast self-

examination has been considered as a safe and easy to perform screening procedure to detect

breast lumps and swelling. This study was conducted to determine knowledge on breast

cancer and breast self-examination among woman reproductive age.

Awareness surrounding breast cancer is incredibly important as early detection, often

through public attentiveness, and advancement in breast imaging has made a positive impact

on recognition and screening of breast cancer can catch the disease when it is most treatable.

If breast cancer is diagnosed and treated early, many fatalities can be averted. Breast

self-examination (BSE) is a simple, low-cost instrument that may be used on a regular basis

to detect breast cancer in its early stages. As a result, the goal of this study was to analyze

adolescent females' awareness and practice of breast self-examination.

Since the breast cancer is one of the public health dilemmas in the Philippines. The

researcher wants to determine the awareness and practice among women reproductive age

towards Breast Self-Examination (BSE) and also to explore their level of awareness and

frequency. Also, to develop necessary plans according the results of this study.
 According to Dinegde NG, Demie et al. (2020). Breast cancer is the top cancer among

women both in the developed and the developing world. Many deaths can be avoided if

breast cancer can be detected and treated early. The practice of breast self-examination (BSE)

is convenient, no-cost that can be used regularly for detecting breast cancer at early stage.

The knowledge and practice of BSE could be considerably lower in communities having a

more diversified female population and living in remote areas in the country.

Implementations are needed in addressing young females, making awareness and advocacy

campaigns about BSE to increase early diagnosis of breast cancer, which raises the chances

for successful treatment in Ethiopia

STATEMENT OF THE PROBLEM

The main purpose of this study is to determine the awareness in breast cancer and

practice of breast self-examination in Poblacion 1 & 2, Sagay City

SPECIFICALLY, THIS STUDY WILL SEEK TO ANSWER THE FOLLOWING

QUESTIONS:
1. What is the profile of respondents in terms of:

1.1; Age

1.2; Educational Attainment

1.3; Financial Income

1.4; Practice of Breast Self-examination

2. Is there any significant difference on the respondents level of breast cancer awareness

when group according to:

2.1; Age

2.2; Educational Attainment

2.3; Financial Income

 2.4; Practice of Breast Self-examination

3. Is the level of awareness (knowledge) of women on breast cancer and how frequently they

woman perform breast self-examination when group according to:

2.1; Age

2.2; Educational

2.3; Financial Income

2.4; Practice of Breast Self-examination

4. Based on the results of the study, what specific program should be developed?

CONCEPTUAL FRAMEWORK OF THE STUDY

Input Process Output

Researcher-made Recommendation
Level of Knowledge of
questionnaire
breast cancer & practice of Create a necessary plan
breast self-examination according to the results
among women in of the study
reproductive age
a. Age
b. Educational
Attainment
c. Family Income
d. Practice of Breast
Self-examination
THEORETICAL FRAMEWORK OF THE STUDY

The framework used in our study is Health Belief Model. Using the five stages of this

theory can help us to promote the health and disease prevention program for all women under

reproductive age in the community of Baranggay Poblacion 1&2, Sagay City. This

framework will help all reproductive women to be more aware with regards of breast cancer

and will know how to conduct self-breast examination. Motivating women to be mindful of

what breast cancer is and thus, healthy lifestyle is a need to be practice. In this theory it can

help to promote awareness of a breast cancer and disease prevention for all women in

reproductive age in the community of Poblacion 1&2, Sagay City.

SIGNIFICANCE OF THE STUDY

This study will be conducted to raise awareness and practice of breast self-

examination among women in reproductive age in Poblacion 1&2, Sagay City.

Benefiting are the various sectors as follows:

The Respondents

This study will be beneficial to the respondent of Poblacion 1 & 2, Sagay City since

this can help them gain awareness with regards to breast cancer and breast self-examination.

With this study they will be able to know the importance of breast self-examination.

Midwives/BHWs:

The result of the study benefits the midwives/BHWs by providing the respondents with

evidence-based information about the awareness in breast self-examination. They can also

create advocacy that can help encourage the respondents to practice the breast self-

examination.
Nursing Students

The result will help them realize whether the knowledge and skills developed in the

research would be useful to them in their future careers. It can also be the basis for their

future research study.

Future Researchers

The findings of the study will serve as a reference material and a guide for future

researchers who wish to conduct the same experimental study or any study related to breast

cancer and breast self-examination.

SCOPE AND LIMITATION OF THE STUDY

This study aims to raise awareness and practice of breast self-examination among

women in reproductive age. The scope of the study limits to the women ages 20 - 24 of

Poblacion 1 and 2, Sagay City. The researchers will prepare a self-made questionnaire as

main source of data analysis. Researchers will observe strict confidentiality measures and

preventive measures against COVID-19 during the investigation. The research is limited to

whether the interviewee is willing to participate in the research, so the possibility of rejection

is accommodated.

DEFINITION OF TERMS

Breast cancer – is a type of cancer that most common in women in which cells in the

breast grow out of control. There are different kinds of breast cancer when breast cancer

spreads to other parts of the body, it is said to have metastasized. Operationally, breast cancer

most commonly presents as a painless lump or thickening in the breast non-painful lumps or
masses, lumps or swelling under the arms, nipple skin changes or discharge, noticeable

flattening or indentation of the breast.

Cancer - is a disease in which some of the body’s cells grow uncontrollably and

spread to other parts of the body. Operationally breaks down, and abnormal or damaged cells

grow and multiply when they shouldn’t. These cells may form tumors, which are lumps of

tissue.

Practice- to do (something) regularly or constantly as an ordinary part of your life.

Operationally this can help to enhance the lifetyle and their knowledge about breastcancer

awareness by practicing breast-self examination

Practice of breast self-examination- is the practice procedure wherein a woman

examines the parts of the breast to detect the normal and abnormal findings. Operationally,

women do some procedure to check their breast to check the entire breast and armpit area

pressing down with light, medium, and firm pressure. Check both breasts each month feeling

for any lump, thickening, hardened knot, or any other breast changes.

Reproductive age- in women, those years of life between menarche and menopause,

roughly from ages 12 to 49. Operationally, since some women can become pregnant and bear

children at younger or older ages.

 CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter involves a review of related literature about a relevant ideas and concepts

associated to the existing research study.

The current study shows that there was a high statistically significant relationship

between sociodemographic variables and women’s knowledge on BSE, as the highly

knowledgeable women immediately after the program were found to be the following:

women aged between 20 and 30 years, not married, employed, and university educated. In the

same line, a study by Ayed et al. (2015) on BSE

According to Journal of family medicine and primary care, (2017). Breast cancer

cases is about 115,000 per year and this is expected to rise to 250,000 new cases per year by

2015. It needs to be noted that breast cancer is leading in the age groups of 15–34 years

which is a cause of concern as this denotes the need for educative and awareness programs

targeting younger members of the society, to implement early practices of breast

examination. This study was carried out with the intention of assessing the level of

knowledge and awareness of carcinoma breast and breast self-examination (BSE) in female

college students.

The mean age of the study group was 36.9±8.8 years. Eighty percent were literates.

Most of the women 178 (89%) were aware of breast cancer. Only 26% of the women were

aware of BSE. Only 18% of the females had ever checked their breast and 5% practiced it

regularly. Awareness of BSE was found to be significantly associated with age and

educational attainment. Journal of mid-life health 8 (2), 84, 2017

 Breast cancer has overtaken lung cancer as the most prevalent form of cancer in the

Philippines. It has been also noted that the Philippines has the lowest survival rate of people

with breast cancer among 15 countries in Asia. 3 out of 100 Filipino women get breast cancer

before 75 years old and 1 out of 100 will die before reaching 75 years old. 15 % of cancer

cases in the Philippines come from breast cancer for not just women but also for men. 8 % of

the Filipino cases die. With the distressing statistics presented, breast selfexamination is

being advised to be done every month (Tubeza, 2012).

According to Henderson JA, Duffee D, Ferguson T, (2019). The National

Comprehensive Cancer Network screening guidelines suggest that women between 25 and 40

years old who are asymptomatic and have no special risk factors for breast cancer undergo a

clinical breast exam every 1 to 3 years.

There are some obstacles that prevent female individuals from practicing BSE, as

reported by El-lassy and Abd Elaziz (2015), which include not having time and being too

busy, forgetting, not believing that it is beneficial, thinking it is wrong to touch the breast,

anxiety about the possibility of recognizing a breast mass, and embarrassing procedures.

As for most young adult women who’s aware of BSE but fails performing BSE on

regular basis, they consider their fear of finding a lump that could indicate cancer (Takeda,

2012).

Breast screening is an essential health maintenance activity, is very important in

reducing mortality, and helps to detect BC at an earlier stage. Women who are familiar with

their own normal breast characteristics can easily discover any abnormalities early and can be

effectively treated. Each woman and girl should be aware of her own risk factors for BC

(Aghamolaei et al., 2011).

 Health education on BSE practice is lacking and the knowledge deficit can contribute

negatively to early detection of breast cancer and compound late detection. Interventions

should go beyond just campaigns on awareness creation but to ensure young females know

the procedures involved BSE. (GRACE SELASIE Fiador University of Ghana, 2018)

The results of the current study showed that during the preprogram, three-quarters of

the study participants have correct knowledge about the importance of BSE, and most of the

participants know that it helps early detection of BC, and know the appropriate time and

frequency of performing BSE immediately after the program implementation. The highest

percentage of the respondents obtained their source of information throughout the program

phases from the social media. In the same line, a study by Ahmed et al. (2017)

Approximately one million new cases of BC are diagnosed each year worldwide. It is

the commonest malignancy in women and comprises 18% of all female cancers; it accounts

for nearly one in four cases of cancer among all women (Moodi et al., 2011; Loh and Chew,

2011). It is the most common cause of cancer morbidity and mortality among women in low-

income and middle-income countries, as most women who have BC are diagnosed in late

stages due to lack of awareness on early detection and BSE. Therefore, WHO (2016)

recommended the use of BSE as an early screening method to detect BC in low-income and

middle-income countries. Early diagnosis affords a better chance of survival and better

prognosis in the absence of an etiological agent for BC; the most appropriate way of

controlling it will be early detection and treatment. Regular BSE can identify any abnormal

changes in the breast to establish good prognosis. The baseline data provided in this study

will be used to develop strategies to increase the efficacy of BSE among women, and hence

help in early screening of cancer with effective treatment, which in turn is useful to the

nursing profession and the community. Reduced cost of cancer treatment will be a significant

effect of the current study to the community and will give an opportunity to nursing staff to
develop educational programs to teach female individuals about BSE. For research purpose,

the results of the current study give indicators about female individual’s awareness, and thus

can help in investigating barriers to implement the procedure, and make an improvement plan

for nursing staff and female individuals to maximize the effect of BSE.

Breast cancer (BC) is one of the most prevalent and aggressive women’s cancer in

both low- and middle-income countries and its incidence in these countries is on increase due

to adoption of Western lifestyles (Pengpid & Peltzer, 2014).

According to Arch Public Health 78, (2020) Breast cancer (BC) is a non-

communicable disease with increased morbidity and mortality. Early detection of BC

contributes to prompt linkage to care and reduction of complications associated with BC.

Breast self-examination (BSE) is useful for detecting breast abnormalities particularly in

settings with poor access to healthcare for clinical breast examination and mammography.

Therefore, we mapped evidence on women’s knowledge, attitude, and practice of BSE in

sub-Sahara Africa (SSA).

Breast cancer typically produces no symptoms when the tumor is small and most

treatable. Therefore, it is very important for women to follow recommended screening

guidelines for detecting breast cancer at an early stage, before symptoms develop. The only

way to control this disease is early detection, that it can be treated in about 90% of women

with breast cancer. The best way for early detection of breast cancer is screening, and the best

accessible way is breast self-examination (BSE) (Reisi et al., 2013)

Early detection plays a crucial role for BC. Breast self-examination (BSE),

mammography, and clinical breast examination are screening methods, which are used to

detect BC early. In addition, special attention should be paid to BSE to enhance the

possibility of early detection of any changes in breast tissue. Although BSE alone is not
sufficient for early detection of BC, it allows women to be responsible for their own health, to

recognize breast tissus well as to adopt the preventive health behavior (Fotedar, et al., 2013;

Akhtari-Zavare, Juni, Said & Ismail, 2013).

Breast self-examination involves the woman herself looking at and feeling the breast

for lumps or other abnormalities. There is evidence that, women who correctly practice BSE

monthly are more likely to detect a lump in the early stage, with early diagnosis and

treatment yielding better survival (verma, et al., 2013). However, despite these benefits, few

women regularly perform BSE and many do not even know how to perform it. Meanwhile,

there is evidence that women are more likely to perform BSE effectively when taught by

physicians or a nurse. Unfortunately, in one study, only 19% of the nurses reported teaching

BSE, and the major reason for not teaching was the belief that it was not relevant to their

work (Sulik & Zierkiewicz, 2014).

Breast self-examination (BSE) is a self-inspection of the breasts. During a breast

exam, eyes are used to observe the appearance, and hands are used to feel the breast. BSE

gives a greater awareness of the condition of breasts and helps identify potential breast

problems. Because many women experience tenderness and lumpiness in their breasts before

menstruation, many healthcare providers advise women to perform BSE regularly every

month, 5–7 days after menses (Hinkle and Cheever, 2014)

The American Cancer Society supports the BSE as an early detection behavior.

Research suggests that women who receive personal instruction on BSE from a healthcare

professional demonstrate greater knowledge and confidence and are more likely to practice

routine BSE than those who become aware of the method from other sources (Rezaee et al.,

2018).
 CHAPTER III
METHODOLOGY
This chapter will discuss the research method employed, the research locale, the
subject respondents, the instrument used, and the data gathering techniques.

Research Design

The researchers used descriptive-survey method of research. This type of research

design will be used to provide an accurate description of observations of a phenomenon. It
provided an accurate portrayal or account of characteristics of particular individuals,
situations, or groups as well as will offer researchers a way to discover new meaning,
describe what exists, determine the frequency with which something occurs, and categorize
information. The purpose of this study is to assess the awareness and practice of breast self-
examination of women in reproductive age in Poblacion 1 and 2, Sagay City.

Respondents

The respondents of the study are the women in reproductive age, specifically (20–24-
year-old) from Poblacion 1 and 2, Sagay City.

Research Locale

The study is conducted on Poblacion 1 and 2 Sagay City, Negros Occidental.

Sampling Technique
 Stratified Random Sampling will be utilized to select the respondents of the study. In
this sampling method, a population is divided into subgroups to obtain a simple random
sample from each group and complete the sampling process. Since the Respondents are
female who are in reproductive age. The small group is created based age group in the
population. After dividing the population into smaller groups, the researcher randomly selects
the sample. Each female individual who are in reproductive age in the population has an
equal and likely possibility of getting selected in the sample. Slovin’s formula will be use
with 5% margin of error.

Slovin’s formula:

N
n= 2
(1+ Ne )

Research Instrument
The researchers will use a self-made questionnaire Research instruments is divided

into three (2) parts; first will be used to gather the profile of the respondents. The second part

will be used to measure the level of breast cancer awareness of women from Poblacion 1 and

2, Sagay City.

RESPONDENT’S PROFILE QUESTIONNAIRE. This questionnaire aims to inquire

on the profile of the respondents. It is divided into 3 categories namely: Age, Educational

Attainment, Financial Income, and How frequent does the respondents perform breast self-

examination?

LEVEL OF BREAST CANCER AWARENESS OF WOMEN IN REPRODUCTIVE

AGE QUESTIONNAIRE. In order to gather the data on the, the researchers will create a 10

items questionnaire. Each statement will be rated according to its weighted mean and scale.

Every scale has its own corresponding interpretation.

Table 1: Level of breast cancer awareness of women in reproductive age

questionnaire
 Mean Scale Interpretation
Weighted
Range
Mean

5 4.21 – 5.00
4 3.41 – 4.20
3 2.61 – 3.40
Strongly Agree (SA) Means that you accept the truth of the
statement fully and absolutely
Agree (A) Means that you accept the truth of the
major part of the statement.
Neither Agree nor Means that you neither accept nor
Disagree (NAD) deny the truth of the statement.

2 1.81 – 2.60 Disagree (D) Means that you deny the major part
of the statement.
1 1.00 – 1.80 Strongly Disagree Means that you deny the statement in
(SD) it’s entirely.

Data Gathering Procedure

To collect the data for this study, researchers allocate a lot of time, effort, and
coordination to develop questionnaires with explicit words to serve the expected respondents.

Data will be collected using a self-administered questionnaire. The survey will use
appropriate questions from relevant research and individual questions formed by researchers.
There will be 10 questions developed. All were on 1–5 Likert scales, which range from
strongly agree to strongly disagree. Participants were asked to check on the option that best
describes their current status about having a practice of breast self-examination. A
questionnaire will be distributed to the identified household of Poblacion 1&2, Sagay City.
Participants will be given enough time to respond and then the researchers will collect the
survey questionnaires.

The data collected from the research tools will be collected and sorted based on the
respondents' answers. After collecting all the data, the researcher will use statistical tools to
interpret the data being collected.

Ethical Consideration

The researchers include the statements that consider the following:

  Informed consent (that the participants agreed to participate in the survey
voluntarily);
 Anonymity of the respondents (for privacy purposes);
 Confidentiality of the data;
 Disposal of survey materials.

Data Analysis

Frequency count and percentile will be used. In analyzing on the data, all the data was

reliability and analyzed.

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Questions Strongly Agree Neither Agree Disagree Strongly
Agree nor Disagree Disagree

Are you afraid of

having Breast Cancer?

Are you aware that

there’s Breast Self-
Examination?
Have you been
thought about Breast-
Self-examination?
Are you Interested in
doing Breast Self-
Examination?
Have participated
Breast care awareness
symposium?

Have you performed

breast self-
examination?
How often do you
practice Breast Self-
Examination?
Breast Self-
Examination is a
useful for early
detection?
Breast Self-
Examination could be
done during
menstruation?
Breast Self-
Examination could be
done by doctor?