The effect of a smartphone application on women's performance and health beliefs about breast self-examination: a quasi-experimental study

The effect of a virtual educational intervention based on self-efficacy theory on women's skills of breast self- examination

BACKGROUND

Correctly, performing breast self-examination (BSE) has an important role in the early diagnosis of breast cancer and prevention of women's mortality due to it. The present study aimed to investigate the effect of virtual education programs on breast self-examination, self-efficacy, and skills.

METHODS

This quasi-experimental study was conducted on 146 women who were 18-59 years old (73 in each intervention, and control group) working in Fars Oil Industry. Data collection tools included the researcher-made knowledge questionnaire (10 items), the self-efficacy questionnaire of Champion and Scott (10 item), and Wood's breast self-examination skill questionnaire (23 items). The participants were selected by systematic random sampling and divided into intervention and control groups through Permuted blocks randomization. A four-week virtual educational interventions were conducted for the intervention group through the WhatsApp messenger by sharing educational videos, booklets, and posters. The control group received no education. The questionnaires were completed by both groups, before and two months after the intervention. Data were analyzed in SPSS version 22 using frequency descriptive statistics, independent t-test, and paired t-test.

RESULTS

The knowledge mean scores showed no significant differences in participants in the two groups before and after the intervention. The mean score of self-efficacy increased significantly, in both the intervention (p < 0.001) and control (P = 0.025) groups. After the intervention, the mean scores of BSE skills in the intervention group were significantly (p < 0.001) higher than the control group.

CONCLUSION

Virtual education using social networks alone is not able to increase and improve all aspects of BSE skills sufficiently.

Virtual physical examination in teleconsultation: A scoping review

BACKGROUND

The conduct of virtual physical examination has provided significant information for the diagnosis during a teleconsultation session, especially during the COVID-19 pandemic, where in-person physical examinations have been greatly compromised.

OBJECTIVE

The aim of this scoping review was to provide a comprehensive overview of the available evidence concerning virtual physical examination (VPE) in all healthcare settings during the COVID-19 pandemic. The review focuses on types of VPE, technological and non-technological approaches, patient and clinician experiences, as well as barriers and facilitators of VPE.

METHODS

A literature search was conducted across three databases, namely MEDLINE, Embase, and Scopus. Only studies in the English language with primary research data collected from December 2019 to January 2023 were included. A narrative analysis, highlighting patients' and clinicians' experiences, was conducted on the included studies. This scoping review was reported using The PRISMA extension for scoping reviews (PRISMA-ScR) Checklist.

RESULTS

A total of 25 articles meeting eligibility criteria were identified. Three major types of VPE included were musculoskeletal, head and neck, and chest exams. Sixteen studies involved specific technological aids, while three studies involved non-technological aids. Patients found VPE helped them to better assess their disease conditions, or aided their clinicians' understanding of their conditions. Clinicians also reported that VPE had provided enough clinically relevant information for decision-making in 2 neurological evaluations. Barriers to conducting VPE included technological challenges, efficacy concerns, confidence level of assistants, as well as patient health conditions, health literacy, safety, and privacy.

CONCLUSIONS

Patients found virtual physical examination (VPE) helpful in understanding their own conditions, and clinicians found it useful for better assessing patient's conditions. From the clinicians' point of view, VPE provided sufficient clinically relevant information for decision-making in neurological evaluations. Major barriers identified for VPE included technological issues, patient's health conditions, and their health literacy.

Knowledge, attitude, and practice towards breast self-examination among women: a web based community study

Background

The most common form of cancer among women is breast cancer in the Kingdom of Saudi Arabia. Thus, the purpose of this study was to evaluate women in Saudi Arabia's Asir Region, on their knowledge, attitudes, and practices (KAP) regarding breast self-examination (BSE).

Methods

The research was carried out cross-sectional and conducted from October 2023 to June 2024 in Saudi Arabia's Asir province.

Results

Out of 397 study participants, 89 (22.4%) had good knowledge, and 308 (77.6%) had poor knowledge; 185 (46.6%) had a positive attitude, and 212 (53.4%) had a negative attitude 24 (6%) had good practice 373 (94%) had poor practice about breast BSE. According to study participants, social media, 204 (51.4%), radio, television, and newspapers were the best places to learn about BSE. In this study, 316 (79.6%) had heard of BSE. 230 (57.9%) stated that breast cancer patient's likelihood of survival increases with early detection. Only 231 (58.2%) and 247 (62.2%) agreed that breast cancer is indicated by changes in the color and shape of the breast and retraction/discharge of the breasts, respectively. Out of 147, 24 (16.3%) self-examined just one week after each menstruation. Single (OR = 6.259; 95% CI = 1.790-21.887, p = 0.004) and married (OR = 4.923; 95% CI = 1.509-16.056, p = 0.008), Single (OR = 2.736; 95% CI = 1.248-6.000, p = 0.012) and married (OR = 3.176; 95% CI = 1.734-5.817, p = 0.00) were significantly associated with good knowledge and attitude of BSE, respectively. Illiterates (OR = 0.233; 95% CI = 0.060-0.895, p = 0.034), pre-university (OR = 0.222; 95% CI = 0.092-0.538, p = 0.001), Illiterates (OR = 0.293; 95% CI = 0.114-0.755, p = 0.011), pre-university (OR = 0.462; 95% CI = 0.271-0.788, p = 0.005) are less likely to have good knowledge and attitude compared to college and university educated.

Conclusion

The study revealed that few women have good knowledge, attitudes, and practices among BSE. In this study, attitude level is high in comparison to knowledge and practice. However, 94% never practiced at all. It is strongly advised that a focus be placed on improving women's KAP regarding BSE, as well as BSE educational programs in universities and more community service activities such as health campaigns in public places.

Effect of monthly reminders by telephone message on women's beliefs and practice behaviours regarding breast self-examination: A randomized controlled study

AIMS

This study was conducted to examine the effect of monthly telephone message reminders after training on women's beliefs and practice behaviours regarding breast self-examination.

METHODS

This randomized controlled study was conducted with 83 women aged 20-69 years living in Turkey between September 2021 and July 2022. Women were randomly assigned (1:1) to the intervention (n = 41) or control group (n = 42), both groups received online breast self-examination training, and the intervention group received monthly reminders on their mobile phones for 3 months. Participants completed the Champion's Health Belief Model Scale and breast self-examination practice evaluation form at baseline and 3 months after intervention.

RESULTS

After the intervention, the mean scores of the benefits and self-efficacy subscales of Champion's Health Belief Model Scales were significantly higher in the intervention group compared to the control group, and the mean score of barriers was lower. The rate of performing breast self-exam regularly and at the appropriate time was higher in the intervention group. The rate of forgetting to perform breast self-examination was higher in control group.

CONCLUSION

A monthly reminder message may be recommended to increase women's belief in breast self-examination and increase regular practice.

Designing a virtual breast cancer prevention program for Iranian women: A study protocol

BACKGROUND

The growing number of breast cancer patients in Iran, following the lower referrals of women to screening centers after the outbreak of the COVID-19, suggests the need for designing virtual educational interventions to teach self-care methods to women. The aim of this study is to design a virtual training program for the prevention of breast cancer in women based on the steps of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) educational design model.

MATERIALS AND METHODS

This developmental study will be conducted based on the steps of the ADDIE model. In the first step (analysis), a qualitative study, literature review, and a panel of experts will be conducted to analyze the situation (learners, content, platforms, and media for the electronic presentation of the program). In the design step, the learning objectives, educational strategies, and the way of program's implementation and evaluation will be specified. In the third step, not only are the content, storyboard, and educational program developed, but the pilot study is also conducted and formative assessment is performed. In the fourth step, the program will be provided to the audience and will be implemented as a preliminary program. In the final step, the final virtual education program for the prevention of breast cancer in women will be presented based on the results of the evaluation.

CONCLUSIONS

Using a comprehensive and systematic educational design model can be a step toward making changes and encouraging innovations in breast cancer prevention education programs in women based on virtual education. Given the existing needs and conditions, this program can promote cancer preventive behaviors as much as possible, reduce the costs imposed on the family and healthcare systems, and lower the complications and mortality rate caused by the delayed diagnosis of the disease.

Mobile-Based Application Interventions to Enhance Cancer Control and Care in Low- and Middle-Income Countries: A Systematic Review

Objective: To identify and appraise mobile-based application (mAPP) interventions that have been used to support cancer control and care in low- and middle-income countries (LMICs). Methods: Four electronic databases were systematically searched for studies that reported primary research findings related to mAPP interventions applied in oncology settings in LMICs. A narrative synthesis was performed using the Mhealth Index and Navigation Database as an analytical framework. Results: Twenty studies reporting 18 cancer control and care mAPPs were included in this review. Among these mAPPs, ten focused on prevention, screening and early detection of cancer, five provided information to optimise supportive and palliative care, two provided support to assist treatment-shared decision-making and one covered information for follow-up and survivorship care. Conclusion: Cancer mAPP interventions are gradually gaining attention in LMICs as they provide unique resources for empowering and strengthening the role of people with cancer in their own care. To enhance cancer control, a focus on prevention and early detection is important; however, more mAPP interventions related to cancer treatment, follow-up and survivorship are also needed to enable more cost-effective cancer care.

The effect of gamification-based training on the knowledge, attitudes, and academic achievement of male adolescents in preventing substance and internet addiction

BACKGROUND

Preventing addiction through training takes precedence over treatment and plays a crucial role in enhancing the well-being of adolescents. Utilizing inclusive and participatory methods can significantly enhance the effectiveness of education. Numerous studies have demonstrated that gamification, as an interactive and comprehensive approach, has the potential to boost teenagers' motivation to engage in learning and contributes to better comprehension.

AIM

This study aimed to assess the impact of gamification-based training to prevent substance and internet addiction on the knowledge and attitudes of male adolescents. Additionally, the study examined this educational program's effects on male adolescents' academic achievement.

METHODS

This study employed a quasi-experimental design with a control group. One hundred fourteen male adolescents were randomly assigned to the intervention or control groups. They completed a pre-intervention questionnaire assessing addiction-related knowledge, attitudes, and academic achievement. Subsequently, the intervention group received the gamification-based drug and internet addiction prevention training. Post-tests were conducted immediately after the training and again one month later for both groups.

RESULTS

Before the intervention, there were no significant differences in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement between the intervention and control groups (P > 0.05). However, after the intervention, the intervention group demonstrated significantly higher scores in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement compared to the control group (P < 0.001).

CONCLUSION

The current study highlights the positive impact of gamification-based training on enhancing male adolescents' knowledge, attitudes, and academic achievement.

Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria

Background

Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to assess breast cancer awareness and practice of BSE among female staff at Babcock University, Ogun State, Nigeria.

Methods

The cross-sectional descriptive design was adopted for this study. Data were collected using a structured questionnaire administered to 160 respondents. Data analysis was done using Statistical Package for Social Sciences version 23.

Results

Although the majority of the respondents were highly aware of breast cancer (78.12%) and had good knowledge about BSE (96.9%), their practice of BSE was low. Only 11.3% always examine their breasts in the mirror by raising their hands over their head, looking at their breasts and examining it in a circular motion; 56% rarely looked for puckering, colour changes and dimpling of the skin when examining their breasts in the mirror, although 53.8% sometimes squeezed their nipples and looked for discharge when they examined their breasts.

Conclusion

Knowledge and positive opinions toward preventive strategies for breast cancer should not be interpreted as readiness for practice. Educational intervention programs emphasising the importance of early detection in managing breast cancer should be reinforced to birth the desirable change.

What is the uptake rate of breast self-examination in Iranian women? Estimation based on systematic review and meta-analysis

BACKGROUND

Breast self-examination is a simple, painless, confidential and inexpensive screening method for early diagnosis that does not require specialized tools and equipment. In this study, we have estimated the pooled percentage of breast self-examination (BSE) in Iranian women.

METHODS

All the published literatures between 2012 and 2022 have been reviewed. Searches were performed in PubMed, Web of Science, ProQuest, Science Direct, Google Scholar, Scientific Information and Magiran databases. The effect size was the pooled percentage of breast self-examination (BSE). In order to check the heterogeneity, the estimation of the I2 index and extraction of the Galbraith plot were used, and the drivers of heterogeneity have been identified through meta-regression and estimates were made based on subgroups. All the analysis was done in STATA 15.

RESULTS

From the initial 294 records, 38 were included in the final analysis in which 9960 women have been studied. The heterogeneity of the studies was high based on the variation in OR (I2 = 98.4%, heterogeneity X2 = 2278.21 (d.f. = 37), p < 0.01). The pooled rate of BSE based on fixed and random methods was obtained as 15.46 (95% CI: 14.83 to 16.09) and 24.74 (95% CI: 19.62 to 29.86) percent, respectively. The highest pooled percentage BSE (39.41%, 95% CI: 30.98 to 47.83) was obtained from studies that investigated the action phase in the Trans theoretical model. The pooled percentage obtained from the studies conducted in the central regions of Iran was higher than other cities (27.47%, 95% CI: 17.38 to 37.55).

CONCLUSION

The result from our analysis determined that performing breast self-examination in Iranian women is low. Health policy makers can increase the rate of breast self-examination in Iran by implementing basic educational programs in schools and encouraging and justifying women in social health centers.

Breast Cancer Prevention: The Key Role of Population Screening, Breast Self-Examination (BSE) and Technological Tools. Survey of Italian Women

Breast cancer is the most common tumor among women worldwide and still remains the leading cause of death in women in Italy. Although survival from this pathology has increased, this disease and its treatment can have lasting or delayed effects that can greatly affect a woman's quality of life. Primary and secondary prevention are currently the best strategies to combat this cancer: improved lifestyle, early adherence to screening, Breast Self-Examination (BSE), and even now the use of technology, have become among the most important tools to ensure increasingly early diagnosis of this disease, which is a major cause of suffering and premature mortality in women. Indeed, early diagnosis of the disease can lead to a good prognosis and a high survival rate. This study investigates the attitude of Italian women to perform clinical checkups aimed at cancer prevention, particularly adherence to free screening programs offered by the National Health Service (NHS) for women in the 50-69 age group. The knowledge, use and emotional approach toward BSE as a screening tool and the use of dedicated apps for this purpose are also investigated. Low adherence to screening programs, lack of BSE practice, and nonuse of dedicated apps are just some of the results observed in this study. Therefore, it becomes essential to spread the culture of prevention, cancer awareness and the importance of screening throughout life.

Health perceptions and attitudes on mobile health apps in China

Since the COVID-19 pandemic, the use of mobile health apps has been increasing significantly. Many have started using mobile health apps to manage their health and well-being. People need to develop healthy habits that will increase their job productivity, life expectancy and improve their social relationships. This study tests the Health Belief Model with adults in China in influencing health motivation and in turn improving their health behavior. A mobile and online survey was developed, and 120 usable responses were collected. A structural equation modeling was used to test the relationships between perceived benefits, perceived susceptibility, perceived barriers, health motivation, and health behavior. We found perceived self-efficacy, perceived benefits, and perceived susceptibility predicts health motivation, and health motivation predicts health behavior. We did not find that perceived barrier is a predictor for health motivation. We conclude that to encourage behavioral change, it is important to enhance self-efficacy and address the benefits; in the meantime, educating people on susceptibility is also important.

Iskandar YH, Ab Hadi IS, Nasution A, Lean Keng S. Breast awareness mobile apps for health education and promotion for breast cancer

Background

Lack of knowledge, poor awareness, and attitude are barriers to breast cancer (BC) screening participation. The ubiquitous usage of mobile phones makes it a perfect platform for delivering interventions to increase knowledge and awareness in screening, a strategy for early identification of BC. However, although numerous applications for BC prevention are available on major mobile phone platforms, relatively few have been tested in scientific studies to determine their efficacy.

Objective

This study aimed to assess the efficacy of BrAware Apps in increasing the knowledge of BC risk factors, awareness of warning signs and confidence in breast self-examination (BSE) among women in northeast peninsular Malaysia.

Methods

A quasi-experimental pre and post-test research design were conducted with 41 women participants in Kelantan, Malaysia, before and after using the BrAware apps. Participants were given an online, adapted Breast Cancer Awareness Measure questionnaire. Post-test was 2 months after using the BrAware apps. Comparison using paired T-tests were conducted to evaluate the change in knowledge of risk factors, warning signs awareness and confidence level for BSE.

Results

The mean age of women was 39.71(SD = 8.80). The participants' mean knowledge score of BC warning signs differs before using BrAware (mean 70.62, SD 11.74) and after using the BrAware app (mean 79.83, SD 10.15) at the <0.001 level of significance.

Conclusions

The BrAware mobile app had a positive effect in increasing the women's knowledge of risk factors of BC, warning signs awareness and confidence level for BSE. It can be concluded that the mobile app may be an adjunct in educating women on BC.

Psychosocial Experiences of Older Women in the Management of Urinary Incontinence: A Qualitative Study

Introduction

Urinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence.

Methods

This qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman.

Results

The results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: “problem incompatibility with the disease,” “mental impasse,” “facing social restrictions,” and “concealment and social escapism.”

Conclusion

The findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life.

The effects of continuous care model using a smartphone application on adherence to treatment and self-efficacy among patients with multiple sclerosis

Background

Adherence to disease-modifying therapy is important in patients with Multiple Sclerosis (MS) to increase the positive outcomes and improve the quality of life. This study aimed to determine the effects of Continuous Care Model (CCM) using a smartphone application on adherence to treatment and self-efficacy among MS patients.

Methods

This quasi-experimental study with pre/posttest design was conducted on 72 MS patients in Shiraz, Iran from June 2020 to August 2021. The samples were randomly assigned to intervention (n = 36) and control (n = 36) groups. In the intervention group, the CCM using a smartphone application was implemented during two months. However, no intervention was performed for the control group. The data were collected using the self-report Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) and MS Self-Efficacy Scale (MSSS) at baseline and two and four months after the intervention.

Results

The results showed an improvement in adherence to treatment and self-efficacy in the intervention group compared to the control group after implementing the virtual CCM and at the two-month follow-up (p < 0.001).

Conclusions

Implementing the CCM using a smartphone application resulted in improvements in the MS patients’ adherence to treatment and self-efficacy. It can be concluded that providing care using an interactive multimedia application can improve the outcomes as well as patients’ satisfaction, especially during the COVID-19 pandemic. Therefore, this approach is recommended to be used for nurses, healthcare providers, and clinicians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01785-x.