Iranian Women’s Experience of Self Care in Breast Cancer Prevention: A Qualitative Study
Abstract
Background: The mortality rate of breast cancer has increased in women who are referred late in the advanced stages of their disease, while morbidity and mortality from cancer can be reduced through prevention programs, such as self‑care behaviors and early detection. Therefore, more attention should be paid to primary prevention, self‑care, and the role of women in breast cancer prevention. The aim of this study was to describe women’s experiences of self‑care in breast cancer prevention.
Materials and Methods: In this descriptive‑exploratory qualitative study, 38 participants, including 23 women who were eligible for breast cancer screening, eight service providers, and seven health policymakers, were selected by purposive sampling. Data were collected through semi‑structured interviews and analyzed using conventional qualitative content analysis. To assess data trustworthiness, Lincoln and Guba’s criteria were used.
Results: The results of this study are summarized in one theme, three categories, and eight subcategories. The theme extracted from the data analysis was “the agency of women in self‑care in breast cancer prevention,” which included three main categories: women’s understanding of the concept of self‑care in breast health, subjective challenges in breast cancer prevention, and active management and follow‑up of breast health status.
Conclusions: This study provided a new understanding of the experience regarding women’s self‑care in breast cancer prevention. The experiences were in a wide range demanding comprehensive attention. Healthcare authorities/providers can use the findings of this study to develop strategies to support women regarding preventive self‑care for breast cancer.
Keywords
Full Text:
PDFReferences
International Agency for Research on Cancer Breast. Available from: https://www.uicc.org/news/globocan-2020-global-cancer-data. [Last accessed on 2024 July 10].
International Agency for Research on Cancer. Iran, Islamic Republic of. Available from: https://macsa.ir/fa/wp-content/ uploads/2021/04/364-iran-islamic-republic-of-fact-sheets.pdf. [Last accessed on 2024 July 10].
Jazayeri SB, Saadat S, Ramezani R, Kaviani A. Incidence of primary breast cancer in Iran: Ten-year national cancer registry data report. Cancer Epidemiol 2015;39:519-27.
Asgarian F, Mirzaei M, Asgarian S, Jazayeri M. Epidemiology of breast cancer and the age distribution of patients over a period of ten years. Iranian Quarterly Journal of Breast Disease 2016;9:31-6.
Birnbaum JK, Duggan C, Anderson BO, Etzioni R. Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: A modelling study. Lancet Glob Health 2018;6:e885-93.
Birhane K, Alemayehu M, Anawte B, Gebremariyam G, Daniel R, Addis S, et al. Practices of breast self-examination and associated factors among female Debre Berhan University Students. Int J Breast Cancer 2017;2017:8026297.
Saranrittichai K, Ussavapark W, Thamrongwarangkoon A, Haengsorn T, Daoruang S, Teeranut A. Community- based approaches to cancer prevention in rural Thailand based on experiences of accredited health professionals. Asian Pac J Cancer Prev 2020;21:7-12.
Chrischilles EA, Riley D, Letuchy E, Koehler L, Neuner J, Jernigan C, et al. Upper extremity disability and quality of life after breast cancer treatment in the Greater Plains Collaborative clinical research network. Breast Cancer Res Treat 2019;175:675-89.
Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, Allen C, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: A systematic analysis for the global burden of disease study. JAMA Oncol 2018;4:1553-68.
Shams M, Faya Bakhsh A, Saffari M. A review of studies conducted on efficacy of health educational interventions to correct women’s behavior in performing breast self-examination. Basic Clin Cancer Res 2014;6:2-9.
Capri S, Russo A. Cost of breast cancer based on real-world data: A cancer registry study in Italy. BMC Health Serv Res 2017;17:84.
Asban A, Homsy C, Chen L, Fisher C, Losken A, Chatterjee A. A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with single stage implant reconstruction in the treatment of breast cancer. Breast 2018;41:159-64.
Tosteson ANA, Yang Q, Nelson HD, Longton G, Soneji SS, Pepe M, et al. Second opinion strategies in breast pathology: A decision analysis addressing over-treatment, under-treatment, and care costs. Breast Cancer Res Treat 2018;167:195-203.
Daroudi R, Akbari Sari A, Nahvijou A, Kalaghchi B, Najafi M, Zendehdel K. The economic burden of breast cancer in Iran. Iran J Public Health 2015;44:1225-33.
Riegel B, Barbaranelli C, Sethares KA, Daus M, Moser DK, Miller JL, et al. Development and initial testing of the self-care of chronic illness inventory. J Adv Nurs 2018;74:2465-76.
Khazaee-Pool M, Montazeri A, Majlessi F, Rahimi Foroushani A, Nedjat S, Shojaeizadeh D. Breast cancer-preventive behaviors: Exploring Iranian women’s experiences. BMC Womens Health 2014;14:41.
Ghahremani L, Mousavi Z, Kaveh MH, Ghaem H. Self-care education programs based on a trans-theoretical model in women referring to health Centers: Breast self-examination behavior in Iran. Asian Pac J Cancer Prev 2016;17:5133-8.
Morowati Sharifabad MA, Seifi M, Dehghani A, Kargar S, Mortazavizadeh SMR. The relationship between breast self-examination and the disease stage in detection time among patients with breast cancer in Yazd. Journal of Tolooebehdasht 2019;18:37-45.
Ghodsi Z, Hojjatoleslami S. Breast self-examination and mammography in cancer screening: Women health protective behavior. J Prev Med Hyg 2014;55:46-9.
Moodi M, Miri MR, Sharifzadeh G, Miri M, Norozi E, Es-haghi S. Predictors of breast self-examination behavior in housewives based on trans-theoretical Model. J Birjand Univ Med Sci 2019;26:64-73.
Berrino F, Villarini A, Gargano G, Krogh V, Grioni S, Bellegotti M, et al. The effect of diet on breast cancer recurrence: The DIANA-5 randomized trial. Clin Cancer Res 2024;30:965-74.
Harvie M, Howell A, Evans DG. Can diet and lifestyle prevent breast cancer: What is the evidence? Am Soc Clin Oncol Educ Book 2015:e66-73.
Ahmadian M, Carmack S, Samah AA, Kreps G, Saidu MB. Psychosocial predictors of breast self-examination among female students in Malaysia: A study to assess the roles of body image, self-efficacy and perceived barriers. Asian Pac J Cancer Prev 2016;17:1277–84.
McBride KA, Fleming CAK, George ES, Steiner GZ, MacMillan F. Double discourse: Qualitative perspectives on breast screening participation among obese women and their health care providers. Int J Environ Res Public Health 2019;16:534.
March S, Villalonga B, Sanchez-Contador C, Vidal C, Mascaro A, de Lluc Bennasar M. et al. Barriers to and discourses about breast cancer prevention among immigrant women in Spain: A qualitative study. BMJ Open 2018;8:021425.
Simon MA, Tom LS, Dong X. Breast Cancer Screening Beliefs among Older Chinese Women in Chicago’s Chinatown. J Gerontol A Biol Sci Med Sci 2017;72(Suppl 1):S32-40.
Alatrash M. Prevalence, Perceived Benefits, and Perceived Barriers Regarding Breast Cancer Screening Among Three Arab American Women Subgroups. J Transcult Nurs 2020;31:242-9.
Charaka H, Khalis M, Elfakir S, Huybrechts I, Khazraji YC, Lyoussi B, et al. Knowledge, perceptions, and satisfaction of Moroccan women towards a new breast cancer screening program in Morocco. J Cancer Educ 2021;36:657-63.
Dahiya N, Basu S, Singh MC, Garg S, Kumar R, Kohli C. Knowledge and practices related to screening for breast cancer among women in Delhi, India. Asian Pac J Cancer Prev 2018;19:155-9.
Wang L, Mackenzie L, Hossain, Z. Breast cancer screening practices and associated factors among Chinese-Australian women living in Sydney: A cross-sectional survey study. Nurs Health Sci 2022;24:293–303.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105-12.
Polit DF, Beck CT. Nursing Research: Principles and Methods. Lippincott Williams and Wilkins; 2014.
Karaca Bıçakçı N, Karakaş D, Aydın Avcı İ. Fear of breast cancer and assessment of the efficiency of mammography scanning in working women. Eur J Breast Health 2023;19:70-5.
Kissal A, Vural B, Ersin F, Solmaz T. The effect of women’s breast cancer fear and social support perceptions on the process of participating in screening. Glob Health Promot 2018;25:52-9.
Hackett J, Thorneloe R, Side L, Wolf M, Horne R, Cuzick J, et al. Uptake of breast cancer preventive therapy in the UK: Results from a multi-centre prospective survey and qualitative interviews. Breast Cancer Res Treat 2018;170:633-40.
Peek ME, Sayad JV, Markwardt R. Fear, fatalism and breast cancer screening in low-income African-American women: The role of clinicians and the health care system. J Gen Intern Med 2008;23:1847-53.
Ghanouni A, Renzi C, Waller JA cross-sectional survey assessing factors associated with reading cancer screening information: Previous screening behaviour, demographics and decision-making style. BMC Public Health 2017;17:327.
Bamidele O, Ali N, Papadopoulos C, Randhawa G. Exploring factors contributing to low uptake of the NHS breast cancer screening programe among Black African women in the UK. Diversity and Equality in Health and Care 2017;14:212-9.
Chambers SE, Copson ER, Dutey-Magni PF, Priest C, Anderson AS, Sinclair JMA. Alcohol use and breast cancer risk: A qualitative study of women’s perspectives to inform the development of a preventative intervention in breast clinics. Eur J Cancer Care (Engl) 2019;28:e13075.
Wu TY, Lee J. Promoting. Breast cancer awareness and screening practices for early detection in low-resource settings. Eur J Breast Health 2018;15:18-25.
Brandzel S, Chang E, Tuzzio L, Campbell C, Coronado N, Bowles EJ, et al. Latina and Black/African American women’s perspectives on cancer screening and cancer screening reminders. J Racial Ethn Health Disparities 2016. doi: 10.1007/s40615-016-0304-2.
Norfjord Van Zyl M, Akhavan S, Tillgren P, Asp M. Experiences
and perceptions about undergoing mammographic screening: A qualitative study involving women from a county in Sweden. Int J Qual Stud Health Well-being 2018;13:1521256.
Vrinten C, McGregor LM, Heinrich M, von Wagner C, Waller J, Wardle J, et al. What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psychooncology 2017;26:1070-9.
Miles A, Voorwinden S, Chapman S, Wardle J. Psychologic predictors of cancer information avoidance among older adults: The role of cancer fear and fatalism. Cancer Epidemiol Biomarkers Prev 2008;17:1872-9.
Kangmennaang J, Mkandawire P, Luginaah I. Breast cancer screening among women in Namibia: Explaining the effect of health insurance coverage and access to information on screening behaviours. Glob Health Promot 2019;26:50-61.
Vrinten C, Gallagher A, Waller J, Marlow LAV. Cancer stigma and cancer screening attendance: A population based survey in England. BMC Cancer 2019;19:566.
Irawati D, Herawati T. Association between cancer stigma and breast self-examination among nurses. Enferm Clín 2020;30:60-4.
Jerônimo AF, Freitas ÂG, Weller M. Risk factors of breast cancer and knowledge about the disease: An integrative revision of Latin American studies. Cien Saude Colet 2017;22:135-49.
Godfrey K, Agatha T, Nankumbi J. Breast cancer knowledge and breast self-examination practices among female university students in Kampala, Uganda: A descriptive study. Oman Med J 2016;31:129-34.
Mandrik O, Ekwunife OI, Zielonke N, Meheus F, Severens JL, Lhachimi SK, et al. What determines the effects and costs of breast cancer screening? A protocol of a systematic review of reviews. Syst Rev 2017;6:122.
Trupe LA, Rositch A, Dickerson L, Lucas S, Harvey SC. Knowledge and attitudes about breast cancer in Limpopo, South Africa. J Glob Oncol 2017;3:509-14.
Yang RJ, Huang LH, Hsieh YS, Chung UL, Huang CS, Bih HD. Motivations and reasons for women attending a breast self-examination training program: A qualitative study. BMC Womens Health 2010;10:23.
Dewi TK, Ruiter RAC, Diering M, Ardi R, Massar K. Breast self-examination as a route to early detection in a lower-middle-income country: Assessing psychosocial determinants among women in Surabaya, Indonesia. BMC Women’s Health 2022;22:179.
Refbacks
- There are currently no refbacks.