EFFECTIVENESS OF VIDEO ASSISTED TEACHING PROGRAM ON KNOWLEDGE REGARDING BREAST SELF EXAMINATION MR. SUJITH KURIAKOSE* *Lecturer, Nitte Usha Institute of Nursing Sciences, Dept. of Community Health Nursing, Mangalore, Karnataka, India ABSTRACT Breast cancer is the most common disease causing death in women now days. Performing Breast Self Examination regularly helps the women to detect early changes in their breast and seek medical advice. The main aim of the study was to evaluate the effectiveness of Video Assisted Teaching Program on Knowledge Regarding Breast Self Examination among the selected women. The research approach adopted for the study one group pre-test post-test method which was used to assess the knowledge among the women regarding BSE. Convenience sampling technique was used to select the samples. The data collection for the study was done by using demographic Performa and structured knowledge questionnaire. Both descriptive and inferential statistics were used for the data analysis. The study revealed that 15% of the women had poor knowledge and 85% had average knowledge before video assisted teaching. In post educational test 85% of women had average knowledge and 15% had good knowledge. There is significant relation between women's knowledge regarding BSE and demographic variables like women's age, education status, occupation, duration of married life and income. KEYWORDS: Effectiveness; Knowledge; Breast Self Examination; Video assisted teaching 1. INTRODUCTION 1.1. Objectives of the study: 1. To assess the existing knowledge regarding breast self examination among the women. 2. To assess the post educational knowledge regarding breast self examination among the women. 3. To compare pre test and post test knowledge regarding breast self examination among the women. 4. To find the association between the pre educational knowledge regarding breast self examination among the women with selected demographic variables. 219
1.2. Hypothesis H 1 : The mean post test knowledge of the women regarding breast self examination will be significantly higher than their mean pretest knowledge. H 2 : There will be a significant association between level of knowledge of breast self examination of the women and selected demographic characteristics. 1.3. Background Breast cancer is one of the most common malignancies and has become second leading cause of death from cancer in women. Even though there is slight decline in deaths related to breast cancer, the incidence rate is increasing. 1 Breast self examination is a technique, which helps women to look for any changes that may develop in the breast like lump, changes in size or shape, rash, pain or discharge of the nipple etc. Knowledge about self breast examination can reduce the mortality rate from breast cancer and other breast related disorders. 2 While searching for literature regarding breast self examination it is clearly understood that the knowledge level of Indian women regarding breast self examination is lower, according to a study knowledge and attitude of breast self examination in a group of women in Shiraz, Southern Iran '' 52.9 % of women known how to do the breast self examination and are likely to detect cancer at a later or advanced stage. 3 Pham and Mcphee using structured questionnaire assessing cancer knowledge and screening in 400 randomly selected Vietnamese women found that 13% had not heard of BSE. 4 Review of the literature s regarding breast self examination training indicated that any training in breast self examination improves confidence of women in this aspect. 5 2. MATERIALS AND METHODS 2.1. Research Approach A quantitative quasi-experimental research approach was used for the study. 2.2. Research Design One group pre-test post-test design was chosen for the present study to find out the effectiveness of video assisted teaching program on knowledge regarding breast self examination. 2.3. Setting Of The Study The investigator selected Deralakatte area in the outskirts of Mangalore for the study. It is a rural area; data collection was done through home visiting where as the video teaching was done in an Anganwadi, where all the participants came together. 220
2.4. Population The populations for the study were all the women between the age group of 20-50yrs at Deralakatte area in Mangalore. 2.5. Sample In this study, sample comprises of 40 women in the age group 20-50 yrs from Deralakatte area, who met the criteria. 2.6. Data Collection Instruments Since the purpose of the study was to assess the effectiveness of video assisted teaching program on knowledge regarding breast self examination, a video on breast self examination and structured knowledge questionnaire were found to be appropriate and data was collected through Questionnaire administration before and after the video assisted teaching. 2.7. Reliability of The Tool In order to establish reliability, the tool was administered to 6 women who met the inclusion criteria from Mangalore. The reliability of the tool was found by using test - re-test method. The reliability of the knowledge questionnaire was found to be 0.998 which indicated that the tool was reliable. 2.8. Methods One group pre-test post-test design was used for this study. The study was carried out in selected rural area in Mangalore. The sample comprised of 60 women. Sample was selected by convenient sampling technique. The data collection was done 19 th to 30 th, May 2011. Formal written permission was obtained from the authorities to conduct the study and informal consent was obtained from the women prior to the data collection process. A structured questionnaire was used for data collection. The data was analysed using descriptive and inferential statistics. 3. THEORY/CALCULATION The conceptual framework for the present study was developed on the basis of 'Pender' Murdaugh and Parson's 'Health Promotion Model. According to them Health Promotion Model is a competence or approach oriented model that depicts the multi dimensional nature of persons interacting with their interpersonal and physical environment 221
as they pursue health. Pender, Murdaugh and Parsons (2002) defined Health Promotion as Behaviour motivated by the desire to increase wellbeing and actualise human health potential. They define Health protection or illness prevention as Behaviour motivated by a desire to actively avoid illness, detect at early, or maintain functioning within the constraints of illness. Health promotion model focussed on health promoting behaviours rather than health protection or illness prevention behaviours. Individual characteristics and Experiences:- Individual s personal factors or characteristics or experiences have great influence on health promoting behaviours. It includes personal factors and prior related behaviour. The personal factors are categorized as biological, psychological and socio-cultural. In this study the biological factor is the age, menarche, heredity and menopause. Psychological factors refer to self confidence and motivation to do Breast self examination. Socio-cultural factors refer to educational status viz. Income, occupation, marital status etc. Behaviour specific cognition and Affect:- These are considered as major motivational significant for maintaining Health promoting behaviour. This constitutes critical care for intervention because they can be motivated through nursing interventions. Health promoting behaviour:- The outcome of health promotion model is directed towards at any positive health outcomes. In this study the health promoting behaviour results in increased knowledge about Breast self examination, practicing of Breast self examination, early detection and treatment of Breast cancers, improving quality of health and improved quality of life. 6 4. RESULT 4.1. TABLE 1 : Knowledge of women regarding breast self examination RANGE OF SCORE PRE-TEST POST-TEST LEVEL OF KNOWLEDGE 0-7 6 15% - - POOR 8-14 34 85% 34 85% AVERAGE 15-20 - - 6 15% GOOD 222
Data in table 1 shows that 15% of the women had poor knowledge and 85% had average knowledge regarding breast self examination. None of the study participants had good knowledge about BSE. But the post test scores shows that there was a remarkable improvement in the knowledge as 15 % developed good knowledge and 85% of them fell into the category of average knowledge level. 4.2. TABLE - 2: Comparison of pre-test and post-test knowledge scores regarding breast self-examination among the women. Mean Mean Difference S.D T d.f LOS Pre-test 8.85 4.17 1.71 20.6 39 0.00 Post-test 13.0250 1.38 P 0.05 Significant Table (t) value (39) =2.2118 The table 2 shows that the mean difference between pre test and post test is 4.17.S.D of pretest (1.71) and post test (1.38).The calculated t value is 20.6 which is more than the table value 2.21(p<0.05). Hence the research hypothesis is accepted indicating that there is a significant difference between pre test and the post test. 4.3. Association The data analysis revealed that there is a significant association between women's knowledge of breast self examination and demographic variables like age, educational status, occupation, duration of married life and income. 5. DISCUSSION The study showed that 15% of the women had poor knowledge and 85% had average knowledge before video assisted teaching. In post educational test 85% of women had average knowledge and 15% had good knowledge. There is significant association between women's knowledge regarding BSE and demographic variables like women's age, education status, occupation, duration of married life and income. The present study results are consistent with majority of the reviewed literatures. 223
6. CONCLUSION The findings of this study suggest the need for educating the women regarding Breast Self Examination, the most simple, effective and inexpensive method of preventing and detecting breast cancer. Breast cancer is the most common cancers found in women. Many times the signs and symptoms are neglected until the disease reaches advanced stage. Teaching women, the Breast Self Examination, through video/ demonstration is an effective measure to improve their knowledge and thus can effectively detect the disease at an early stage. The health care professionals have the responsibility of educating the women regarding Breast Self Examination. Clearly the task before us is enormous but with it could be simplified with the use of videos or self instructional modules. 7. REFERENCES 1. Black.J.M, Hawks.J.H, Keene A.M. 2009. Medical Surgical Nursing. Elsevier publication. 2. Lewis.S.M,Cower.I.C,HeitkemperM.M. 2009. Medical Surgical Nursing. Elsevier publication. 3. Smeltzer.S.C,Bare.B.G. Brunner & Siddarth. 2004. Text book of Medical Surgical Nursing. Lippincott publication. 4. Rashidi Anahita, S. Rajaram. 1999. Middle eastern Asian Islamic women and BSE. University of Nebraska. 5. Ludwick Ruth, Gaczkowski Tanya. 2001. Breast Self Examination by Teenagers. 6. Potter. Perry. 2007. Basic Nursing essentials for practice, fifth ed. Elsevier publication, New Delhi. 7. Robins Georgia, Bhatia Neeta. 2001. Asian Indian women: knowledge, attitudes and behaviours towards breast cancer early detection. UCSD cancer center. 8. Smith. A. Robert. 2006. Breast Cancer in limited- Resource Countries: Early detection and Access to care. American Cancer Society. 9. Lu Jane Zxy Yann. 1995. Variables associated with Breast Self Examination among Chinese women. Urban regional programme. 224