KNOWLEDGE, PRACTICE AND ATTITUDE OF BREAST SELF-EXAMINATION AMONG NURSES AND MIDWIVES IN SAINT GERARD COLLEGE OF NURSING SCIENCE, KAKURI, KADUNA
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ABSTRACT
This study assessed the knowledge, practices and attitudes of nurses and midwives regarding Breast Self-Examination (BSE), using a quantitative survey research design. A structured questionnaire was developed and administered to 120 respondents comprising nursing and midwifery students at Saint Gerard College of Nursing Science, Kakuri, Kaduna. The collected data were analysed using the Statistical Package for the Social Sciences (SPSS), version 27. Statistical techniques, including t-tests, were employed to examine the formulated research hypotheses. The findings revealed significant relationships among respondents' knowledge of BSE, their frequency of practice and their attitudes towards the procedure. In particular, respondents with better knowledge of breast self-examination demonstrated a greater tendency to practise it regularly and accurately. Similarly, positive attitudes towards BSE were associated with increased compliance with recommended self-examination practices. The study concludes that addressing deficiencies in knowledge, encouraging positive attitudes and promoting appropriate breast health practices among nurses and midwives are important for strengthening breast health education and awareness. The findings further highlight the need for comprehensive training programmes, continuous professional and academic education, and institutional support to encourage appropriate breast health practices among healthcare trainees. Recommendations include introducing targeted educational interventions, incorporating breast health education into relevant clinical and academic programmes, and establishing peer-support systems to encourage sustained engagement in breast health activities. Future studies should consider larger and more diverse populations and adopt longitudinal or experimental research designs to provide a deeper understanding of the factors influencing BSE-related behaviours and their implications for breast health outcomes. Implementing these recommendations may strengthen breast health awareness and contribute to the broader efforts towards breast cancer awareness and early detection, thereby promoting improved health and well-being among women.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Breast cancer remains one of the most common forms of cancer affecting women across the world, including Nigeria (Latif, 2014). Early identification of breast abnormalities and timely access to appropriate medical assessment are important aspects of breast cancer control and management (Abera et al., 2017). Breast Self-Examination (BSE) is a method through which women become familiar with the normal appearance and feel of their breasts and may notice unusual changes that require medical attention (Levin-Zamir & Bertschi, 2018). Despite the simplicity of the procedure, studies have reported that many women, including healthcare professionals, do not engage in regular breast self-examination (Solomon et al., 2018). Nurses and midwives have important responsibilities in health education, disease prevention and the promotion of healthy behaviours. Consequently, their knowledge, practices and attitudes concerning breast self-examination are relevant to their ability to provide appropriate breast health education to women.
Saint Gerard College of Nursing Science, located in Kakuri, Kaduna, is an institution involved in the training of nurses and midwives (Mansour et al., 2021). Assessing the knowledge, practices and attitudes of these healthcare trainees towards BSE is important for understanding their preparedness to promote breast health awareness (Abu Sharour et al., 2017). This study therefore seeks to examine the extent to which nursing and midwifery students at the institution understand and practise breast self-examination, as well as identify areas where improvements may be necessary to strengthen their contribution to breast cancer awareness and prevention (Latif, 2014). Evaluating their knowledge and existing practices is particularly important because they are being prepared for future responsibilities in healthcare delivery and patient education (Abera et al., 2017).
Nurses and midwives frequently serve as important sources of health information and may be among the first healthcare professionals women approach when seeking guidance about their health (Brum et al., 2018). Through appropriate health education and counselling, they can encourage women to become familiar with their breasts, recognise unusual changes and seek timely medical attention. Their contributions can therefore support breast cancer awareness and facilitate earlier presentation for clinical assessment (Abo Al-Shiekh et al., 2021). However, to perform these responsibilities effectively, nurses and midwives need adequate knowledge, appropriate practical skills and positive attitudes towards breast health education and self-examination (Levin-Zamir & Bertschi, 2018).
Previous studies have indicated that healthcare providers' knowledge and attitudes concerning breast self-examination can influence their ability to educate patients and encourage appropriate breast health behaviours (Abu Sharour et al., 2017). It is therefore necessary to identify and address any deficiencies in knowledge or unfavourable perceptions of BSE among nursing and midwifery students (Mansour et al., 2021). Educational programmes designed to improve understanding and encourage positive attitudes towards breast health have demonstrated potential for improving engagement in BSE-related activities among healthcare providers (Brum et al., 2018). Introducing appropriate educational interventions at Saint Gerard College of Nursing Science may consequently strengthen students' understanding and preparedness to educate women about breast health.
In view of these considerations, breast health awareness and familiarity with breast self-examination are important components of women's health education. Nurses and midwives, as essential members of the healthcare workforce, have significant responsibilities in promoting awareness, encouraging appropriate health-seeking behaviours and providing accurate information about breast abnormalities. It is therefore important to assess their knowledge, practices and attitudes towards BSE. This study, conducted at Saint Gerard College of Nursing Science, Kakuri, Kaduna, seeks to evaluate these areas and identify possible gaps that require attention. Addressing the findings may help strengthen the capacity of nursing and midwifery students to contribute effectively to breast health education and awareness.
1.2 Statement of the Problem
The problem addressed by this study concerns possible deficiencies in the knowledge, practices and attitudes of nursing and midwifery students at Saint Gerard College of Nursing Science regarding Breast Self-Examination (BSE) and its relevance to breast cancer awareness and early detection.
Firstly, although breast self-examination has been widely discussed as a means of increasing women's awareness of changes in their breasts, studies have identified gaps in understanding its procedures, appropriate application and significance among healthcare trainees (Solomon et al., 2018). At Saint Gerard College of Nursing Science, inadequate knowledge of BSE techniques, timing and importance may limit the ability of nursing and midwifery students to provide accurate information and appropriate health education to women (Abera et al., 2017).
Secondly, concerns have been raised regarding the regularity and accuracy with which nursing and midwifery students perform breast self-examination (Brum et al., 2018). Although BSE is relatively simple to perform, some healthcare trainees do not practise it consistently (Abu Sharour et al., 2017). This situation may be associated with insufficient practical training, unfavourable attitudes, inadequate awareness or a limited understanding of the importance of becoming familiar with normal breast changes.
Thirdly, students' attitudes towards breast self-examination may influence their willingness to engage in the practice and encourage other women to become conscious of their breast health (Mansour et al., 2021). Negative perceptions, fear, misconceptions or a lack of confidence may discourage individuals from performing BSE or discussing it with others. Such attitudes may also affect their willingness to educate patients about breast health and the importance of seeking medical assessment when unusual changes are noticed (Abo Al-Shiekh et al., 2021). It is therefore important to examine the attitudes of nursing and midwifery students and identify factors that may prevent them from adopting appropriate breast health practices.
In addition, the availability of healthcare resources, cultural perceptions and socioeconomic circumstances may influence the promotion and practice of breast health awareness within the wider community (Levin-Zamir & Bertschi, 2018). These factors may create further challenges for nursing and midwifery students when attempting to encourage women to engage in appropriate breast health practices.
In view of these concerns, there is a need to assess the knowledge, practices and attitudes of nursing and midwifery students at Saint Gerard College of Nursing Science towards breast self-examination. Identifying existing gaps will provide a foundation for appropriate educational interventions and institutional support aimed at improving their knowledge, practical understanding and attitudes. Strengthening these areas may better prepare future healthcare professionals to promote breast health awareness, encourage timely medical assessment of suspicious breast changes and contribute to broader breast cancer control efforts.
1.3 Objectives of the Study
The main objective of this study is to assess the knowledge, practices and attitudes of nurses and midwives towards Breast Self-Examination at Saint Gerard College of Nursing Science, Kakuri, Kaduna.
The specific objectives are to:
1. Determine the level of knowledge of breast self-examination among nurses and midwives.
2. Assess the frequency and accuracy of breast self-examination practices among nurses and midwives.
3. Examine the attitudes of nurses and midwives towards breast self-examination.
1.4 Research Questions
The following research questions were formulated to guide the study:
1. What is the level of knowledge of breast self-examination among nurses and midwives at Saint Gerard College of Nursing Science?
2. How frequently and accurately do nurses and midwives at Saint Gerard College of Nursing Science practise breast self-examination?
3. What are the attitudes of nurses and midwives at Saint Gerard College of Nursing Science towards breast self-examination?
1.5 Research Hypotheses
The following null hypotheses were formulated and tested in the study:
1. There is no statistically significant relationship between the level of knowledge of breast self-examination and the practice of BSE among nurses and midwives.
2. There is no statistically significant relationship between the frequency of breast self-examination and the accuracy of BSE practices among nurses and midwives.
3. There is no statistically significant relationship between attitudes towards breast self-examination and the practice of BSE among nurses and midwives.
1.6 Significance of the Study
This study is significant because it seeks to address possible gaps in the knowledge, practices and attitudes of nursing and midwifery students at Saint Gerard College of Nursing Science concerning Breast Self-Examination (BSE) and its relevance to breast health awareness and breast cancer early detection.
Firstly, the research may contribute to improving healthcare education and training. By assessing students' understanding of BSE procedures, appropriate application and significance, the study can identify areas where additional academic instruction and practical education are required. The findings may assist the institution in reviewing and strengthening relevant aspects of its training programmes to ensure that future healthcare professionals possess adequate knowledge of breast health. Improved training may also enhance their ability to provide accurate information and appropriate guidance to women seeking advice about breast health.
Secondly, the study may encourage the adoption of appropriate personal breast health practices among nursing and midwifery students. By examining how frequently students engage in breast self-examination and their understanding of the correct procedures, the research may identify factors responsible for irregular or inappropriate practices. Addressing these challenges through practical demonstrations, educational workshops and relevant training activities may improve students' familiarity with breast changes and encourage informed health-seeking behaviours. Such improvements may also strengthen their preparedness to educate patients and members of the community.
Thirdly, the research may contribute to the development of positive attitudes towards breast health and breast cancer awareness. Personal beliefs, feelings and perceptions can influence individuals' health-related decisions and behaviours. Negative attitudes, fear and misconceptions about BSE may discourage healthcare trainees from engaging in breast health activities or educating others about them. By examining students' attitudes, the study may identify misconceptions and other barriers that require attention. Appropriate interventions, including awareness campaigns, interactive educational sessions and peer discussions, may help promote more informed and positive attitudes towards breast health.
Furthermore, the study may have positive implications for healthcare delivery and community health. Breast cancer remains an important public health concern, and limited access to advanced diagnostic and screening services in some communities may create challenges for early diagnosis. Equipping nursing and midwifery students with appropriate knowledge and communication skills can strengthen their capacity to provide breast health education, encourage women to recognise unusual breast changes and promote timely referral for professional medical assessment. These efforts may support broader breast cancer awareness and contribute to improved health outcomes.
Overall, the findings of this study may be useful to healthcare education, clinical practice and community health promotion. By identifying and addressing deficiencies in knowledge, practices and attitudes towards breast self-examination among nursing and midwifery students, the research may help prepare future healthcare professionals to make meaningful contributions to breast health education and awareness. Ultimately, these efforts may encourage informed health-seeking behaviours and support broader initiatives aimed at reducing the burden of breast cancer.
1.7 Scope of the Study
This study is restricted to nursing and midwifery students at Saint Gerard College of Nursing Science, Kakuri, Kaduna. It focuses specifically on evaluating their knowledge, practices and attitudes towards Breast Self-Examination. Data for the research were obtained through structured questionnaires administered to students enrolled in the nursing and midwifery programmes. The study does not cover practising nurses and midwives working outside the institution or other categories of healthcare professionals.
1.8 Operational Definition of Terms
Breast Self-Examination (BSE): A personal breast-awareness practice through which an individual observes and feels their breasts to become familiar with their normal appearance and identify unusual changes or abnormalities that may require medical evaluation.
Knowledge: The level of information, awareness and understanding that nurses and midwives possess concerning breast self-examination, including its procedures, significance and appropriate application.
Practice: The extent to which nurses and midwives engage in breast self-examination, including how regularly they perform it and their understanding of the appropriate procedures.
Attitude: The beliefs, feelings, opinions and perceptions held by nurses and midwives concerning breast self-examination and its relevance to breast health awareness and the early identification of unusual breast changes.
Nurses: Individuals enrolled in the nursing programme at Saint Gerard College of Nursing Science who are undergoing training to acquire the knowledge and skills required to provide nursing care.
Midwives: Individuals enrolled in the midwifery programme at Saint Gerard College of Nursing Science who are receiving training to provide healthcare and support to women during pregnancy, childbirth and the postpartum period.
Early Detection: The identification of suspicious breast changes or possible signs of breast cancer at an early stage, followed by appropriate clinical assessment and diagnosis to facilitate timely management.
Screening Practices: Established methods used to identify possible signs of disease among individuals who may not have symptoms. In relation to breast health, these may include mammography and other recommended clinical assessment procedures. Breast self-examination is better described as a breast-awareness practice rather than a substitute for established breast cancer screening methods.
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