ABSTRACT

The objective of the study was to assess female secondary school teachers’ knowledge and attitude of breast self examination (BSE) and to describe the extent of practice of breast self examination among them. This study employed a descriptive design and data was collected with the aid of validated semi structured questionnaire from 100 female teachers in all the five secondary schools in Oko, Oyo State, and analysis was done using Statistical Package for Social Sciences. The result showed that 82% of the respondents were aware of breast self examination practices and their source of this information was from mass media (55%) and friends (25%). Fifty-four respondents had poor knowledge of BSE and 48% had negative attitude towards practice of BSE and majority (62%) had a low practice. The study however, revealed that majority of the respondents who practice BSE do not know what to look for. The results further showed that, there is no significant relationship between age of the respondents and their awareness (X² = 8.322; p = 0.0800; df = 4) and knowledge (X² = 14.501; p = 0.264 and df = 8) of breast self examination. This study concluded that there is poor knowledge and attitude towards BSE practice among the secondary school teachers in Oko community and with unsatisfactory practice. It therefore, suggests that breast awareness campaign and self efficacy development is important for teachers in secondary schools to aid early detection and better prognosis of breast cancer in this community, and this will have a multiplier effect on female secondary school girls.

1. INTRODUCTION

Globally, breast cancer is the most common malignant neoplasm among women [1]. Cancer in all forms is responsible for about 12 percent of deaths throughout the world [2]. Breast cancer causes 376,000 deaths a year worldwide; about 900,000 women are diagnosed every year with the disease [1]. This could rates could further increase by 50% to 15 million [3]. Although the incidence of breast cancer in developing countries is relatively low [4], about 50% of all cases of breast cancer are diagnosed in these countries [4,5]. Asia and Africa have experienced a more rapid rise in the annual incidence rate of breast cancer than that of North America and Europe [6]. The disease has been reported to have an early onset among Nigerian women [7].

Cancer is a group of diseases that cause any affected part of the body to change and grow out of control. Most types of cancer cells form a lump or mass called tumour, when the tumour metastasize they are transported to another part of the body where they continue to grow [2]. Not all tumours are malignant, some are benign while some are malignant. Benign tumours do not grow and spread the way malignant (cancerous) tumours do, and they are usually not a threat to life [8]. Most types of cancer are named after the part of the body where the cancer first starts. Breast cancer begins in the breast tissues [8]. In breast cancer the cells of the breast grow in a chaotic way. Instead of growing and dividing in a regular and expected order, they grow out of control. If the cancer is not treated, the cells can spread within the breast or even break off and (metastasize) to other parts of the body.

The high incidence of breast cancer necessitates the need for early detection since it aids early initiation of treatment thereby reducing mortality. Dolinsky [9] stated that the important thing any woman can do to decrease her risk of dying from breast cancer is to learn how to perform breast self examination, have a regular physical examination by their physician and have regular mammogram screening. Among these various diagnostic measures put up for detection of breast lumps, breast self examination is the one that can be performed by individuals on their own and most lumps are detected by women themselves, and besides, it is cheap [2]. Even though mammography is a better and more efficient way of diagnosing breast cancer, in developing country like Nigeria, clinicians and women still rely on breast examination. This may be due to its availability and very low technicalities.

A breast self examination can help women detect cysts or other benign (noncancerous) breast problems between checkups. It can also help some women detect breast cancer. It is easy to perform breast self-examination, and it only takes a few minutes. Although it might seem strange or inconvenient at first, it is a skill that all women can use throughout life to help ensure good breast health. There is also evidence that most of the early breast tumours are self-discovered and that the majority of early self-discoveries are by breast self examination (BSE) performers [8].

Kayode, Akande and Osagbemi [10] also asserted that despite the advent of modern screening methods, more than 90% of cases of cancers of the breast are detected by women themselves, stressing the importance of breast self-examination. Okobia et al., [8] also stressed that there is evidence that most of the early breast tumours are self-discovered and that the majority of early selfdiscoveries are by breast self-examination (BSE) performers. Previous studies on cancer detection practices have focused on women in urban and semi urban setting and little or no research have been conducted among women in rural and remote area. In most Nigerian villages, access to health care services, especially comprehensive diagnostic services is very low, if not completely unavailable hence, individual self health empowerment is very important. Female secondary school teachers are not only educators, but serve as role models and change agents who often offer useful counsel on health promotion especially in a very low literate society. Therefore, this study aimed at assessing breast self examination practice among female secondary school teachers in Oko, Oyo State. The objectives of the study are to: assess female secondary school teachers’ knowledge of breast self examination, to establish their awareness and sources of information, determine their attitude, and to describe the extent of practice of breast self examination among them.

2. RESEARCH METHODOLOGY

The study employed a descriptive quantitative design to assess the knowledge and practice of breast self examination among female teachers in five secondary schools in Oko, Oyo State. Oko is a remote village in Iresa Adu Local Government Area of Oyo State. It has five secondary schools owned by government and private individuals. The target population comprises all female teachers in the village at the time of data collection. And it includes Baptist Grammar School (42), Muslim Comprehensive High School (27), First Baptist Church Academy (12), Juli Standard Secondary School (19) and Frontier Model College (13). This gives a total of one hundred and three (103) teachers. However, three of them could not be reached as a result of official assignment that made them not to be around.

Data was collected using a self-administered questionnaire developed through extensive literature search. The instrument was tested for validity and reliability before final usage. It consisted of closed-ended questions that were used to collect data that would meet the objectives of the study.

Permission to collect data was obtained from the Local Inspector of Education, Surulere Local Government Area, Iresa Adu. Further permission and approval was requested and obtained from principal of each school before the commencement of the study. Besides, informed consent was obtained from each respondent and they were assured of their confidentiality and anonymity of the information provided.

Data generated for the study was analyzed using Statistical Package for Social Sciences (SPSS version 16). Statistical techniques employed include descriptive statistics (frequency and percentage) and inferential statistics (chi square). Initial analysis was done by generation of frequency tables while further analysis involved crosstabulations to explore statistical relationships between variables.

3. RESULTS

One hundred questionnaires were administered to female secondary school teachers and all were returned completed. As presented in table 1, the age of the respondents ranged from 21 to 45 years with a mean 28 years (±6.2). Thirty-one respondents were between 26 - 30 years of age, majority (80%) of the respondents were Yoruba. Similarly, the educational profile revealed that a large proportion (43%) had National Certificate in Education (NCE) qualification, 46% were married and 65% were Christian.

Table 2 revealed that 82% of the respondent were aware of breast self examination, and their major source of information is from radio and television (55%) and friends (25%). Table 3 presents the responses to various questions on BSE. Only 22% had understanding of what BSE assessment is all about. Although 82% claimed to have examined their breast before but only 12% have the correct knowledge that it should be examined monthly and only 16% knew that it should start from 20 years of age. Furthermore, when asked about the benefits of per-