Student Short Project

Advanced Diploma In Midwifery

Supervisor:
Logeswaree a/p Alagapan Puan Haymalatha Rajagam
ADMW 2/2019(P) - 0443

Institut Latihan Kementerian Kesihatan

Malaysia Sultan Azlan Shah ,Ulu Kinta ,Perak

Research Proposal :
The lack of reachability in General Awareness of Breast Self-Examination (BSE) among antenatal
mothers using the Health Belief Model’s Perceived Susceptibility
 1.1 Background Of Study
“A given health condition is based on the knowledge about the
condition”

 The Health Benefit Model (HBM) engaging in health promoting activities

 ‘Reachability’ existent across 5 researched journals

 clear explanation why respondents still lack awareness in all the five
studied journals.

 Study attempts to identify the absence of study

hybridized contexts in the social media platform about
Breast Self Examination (BSE)
 Scholars appear remain rooted in

Perceived Barrier characteristics according to the Health Belief Model.

Refuse to read current studies via

Perceived Susceptibility Characteristics

hinders the reachability to address changes to the study
structure of Breast Self Examination Journals across many scholarly works.

This study suggests

different theoretical construct i.e. Perceived Susceptibility for better reachability of BSE in
antenatal mothers
 Hesitation of healthcare facilitators

to use the right visual designs

use of visual media platforms in the social
media
(appendix 1 & 2)
 To reestablish hybridized social media contexts

 To justify ample reachability modes via Perceived Susceptibility

factor of the Health Belief Model .

 To reveal the importance of Breast Self Examination, enhance

self esteem diagnose breast cancer at an earlier
stage
 Why
is there a lack of awareness
exposed to social media or mass media?

How
such information can be made available study sample of antenatal
mothers?

Which
channel or mode is the most effective to effectively encourage
reachability and disseminate information?
 Hypothesis 1
Scholars refuse to read current studies trough the concept of Perceived Susceptibility
Characteristics .

Hypothesis 2
Scholars appear to remain largely rooted in the thought of Perceived barriers characteristics
according to the Health Belief Model

Hypothesis 3
Different theoretical construct i.e. Perceived Susceptibility is needed to find a solution of
reachability

Hypothesis 4
Make it readily available via the use of visual media platforms in the social media
 To ensure
ample reachability modes among antenatal mothers.

Study will reveal the importance of Breast Self examination

To diagnose breast cancer at early stages irrespective of level of
education or social among antenatal mothers.

Plan effective strategies or channels and hybridized

context materials that enables reachability of pivotal

information with regards to breast self examination among

antenatal mothers.
 BSE- Breast Self-Examination is the regular examination of one’s own breast to detect
lumps or other changes that may need to be further evaluated as part of screening for
Breast Cancer

 Reachability- an act or instance of reaching / the extent or distance of reaching

 HBM- Health Belief Model is a social psychological health behavior change model
developed to explain and predict health-related behaviors, particularly in regard to the
uptake of health services

 Hybridized contexts-is a term used to describe a type of media convergence whereby a

new mode emerges containing elements of combined media. ... by taking basic forms of
communication and putting the content into a certain type of *medium, those mediums
can converge to become a hybrids of its predecessors.

 Perceived Susceptibility-refers to subjective assessment of risk of developing a health

problem

 Perceived Barrier-refer to an individual's assessment of the obstacles to behavior

change
 Knowledge- understanding of or information about a subject that you get by experience
or study, either known by one person or by people generally

 Practice-used to describe what really happens as opposed to what you think will happen
in a particular situation

 Awareness- knowledge that something exists, or understanding of a situation or subject

at the present time based on information or experience

 Hindrance-something that makes it more difficult for you to do something or for

something to develop

 Antenatal attendees-relating to the medical care given to pregnant women before their
babies are born

 Proforma- is a newly developed methodology for a specific type of knowledge based

systems. Proforma is intended for decision support systems and in particular for clinical
procedures in the medical domain
2.1 a) Study by Tazeem and Nisa (2013) indicates :

 “In our study, level of education of attendees and their awareness of breast self-
examination showed a direct association with each other. Women with higher education
were found to have more knowledge about BSE.” ~ Shahbaz,Tazeem & Khair,Un(2013)

 “This low level of knowledge was found to be directly associated with early detection of
signs of breast cancer …age of starting BSE…” ~ Shahbaz,Tazeem & Khair,Un(2013)

 “the knowledge of methods of early detection was also very low….Another study in …
revealed very poor knowledge of participants about BSE.” ~ Shahbaz,Tazeem &
Khair,Un(2013)

 “The main factor responsible for this ignorance of breast cancer is lack of education along
with the attitude of society which still regard it a shameful secret.” ~ Shahbaz,Tazeem &
Khair,Un(2013)
2.1 b) Study by Ehwarieme and Amiegheme,(2019) indicates :

 “…(2013) in rural community of Ondo state, Nigeria, a greater proportion of respondents…

was reported to have poor knowledge of BSE…”~Ehwarieme and Amiegheme (2019)

 “…in Malaysia reported that 70.5 % of the respondents do not practice breast self-
examination. “~Ehwarieme and Amiegheme (2019)

 “Despite the elaborate campaigns ... there is still high prevalence rate of breast cancer in
the country…could ... be attributed to ...poor awareness ...is low among women?“
~Ehwarieme and Amiegheme (2019)
2.1 c) Olaogun et al., (2017) discusses :

 “Breast self-examination is one of the important screening modalities for early detection of
breast tumours especially in resource-poor settings” Olaogun et al., (2017)

 “The level of awareness was far lower …The present study was carried out in the rural
setting unlike the previous studies that were done in urban areas (cities) of Nigeria where
people are better informed…involved people with different levels of education…” Olaogun
et al., (2017)

 “Despite this awareness, it is disturbing …still have poor knowledge of the breast cancer
symptoms and signs.” Olaogun et al., (2017)

 “This study has revealed the low level of BSE practice and the poor knowledge …initiate
more health education programs to improve women’s practice of BSE …frequency and
procedure steps and also improve their knowledge …” Olaogun et al., (2017)
2.1 d) Ezeonu et al., (2015) discusses:

 “Nigeria, like other sub-Saharan African countries, does not have organized …screening
programs… is a preponderance of poor health-seeking behavior especially in ….This is
mainly due to poverty, ignorance, and lack of functional health facilities.” Ezeonu et al.,
(2015)

 “…the antenatal clinic attendees who were aware …in this study is similar to …reported in
Pakistan…The high breast cancer awareness among the study participants may have been
due to the high educational status of the majority of them…majority of the study
participants being urban dwellers.” Ezeonu et al., (2015)
2.1 e) Onwere et al., (2009) believes that :

 “Health programs that teach women to regularly

examine their breasts and to seek early treatment
for any detected lesions should be publicized
through the mass media and through seminars,
conferences, workshops at grassroots level and
health education at health facilities. “Onwere et al.,
(2009)
The health belief model was developed in the 1950s by social
psychologists at the U.S. Public Health Service and remains one of
the best known and most widely used theories in health behavior
research.
3.1 a) Tazeem and Nisa (2013)
 Cross-sectional Study

3.1 b) Ehwarieme and Amiegheme (2019)

 Descriptive survey research design

3.1 c) Olaogun et al., (2017)

 Descriptive cross-sectional study

3.1 d) Ezeonu et al., (2015)

 Cross-sectional comparative study

3.1 e) Onwere et al., (2009)

 Descriptive study
3.2 a) Tazeem and Nisa (2013)
 Outpatient Department of Gynecology and Obstetrics at Jinnah Postgraduate Medical Centre,
Karachi,Pakistan
 Sample size: 150 antenatal attendees

3.2 b) Ehwarieme and Amiegheme (2019)

 Ugbekun and Oredo Primary Healthcare Centre in Oredo and Ikpba Okha local government area of Edo
State
 Sample size: 217 antenatal attendees

3.2 c) Olaogun et al., (2017)

 Antenatal Care and Immunization Clinic at State Specialist Hospital, Ikere-Ekiti
 Sample size: 238 antenatal attendees

3.2 d) Ezeonu et al., (2015)

 Antenatal Clinic of Federal Teaching Hospital, Abakaliki
 Sample size: 322 antenatal attendees

3.2 e) Onwere et al., (2009)

 Antenatal Clinic of Abia State University Teaching Hospital, Aba
 Sample size: 100 antenatal attendees
3.3 a) Tazeem and Nisa (2013)
 Pre-tested structured questionnaire (open and close ended questions)

3.3 b) Ehwarieme and Amiegheme (2019)

 Self structured questionnaire

3.3 c) Olaogun et al., (2017)

 Structured pre-texted self-administered questionnaire

3.3 d) Ezeonu et al., (2015)

 Proforma studies

3.3 e) Onwere et al., (2009)

 Structured questionnaire
 The need to respect the privacy and freedom of information

 To ensure that the credibility and the reliability of the data is protected, the
information regarding the data should be done using an accurate data collection
techniques

 Step that should be taken to collect data is by identifying the issues and
opportunities for data collection

 Is important that all data that is collected should follow the regulatory
requirements, human rights policies practices

 The data collection can be based on the levels of education, strata of society and
economic standing of the particular sample of study

 Are resources can be found from the internet from government agencies and
community organizations
 “Big data analysis is considered a valuable
area of study for both policymakers and
researchers, as it can reflect the magnitude
and impact of data-related problems within
the realms of healthcare and social welfare.”
Song & Ryu (2015)
 Professional Competence
 Integrity/Respect for anonymity and
confidentiality
 Professional and Scientific Responsibility
 Respect for People's Rights, Dignity, and
Diversity
 Social Responsibility
 Sample Size
 Lack of available and/or reliable data
 Lack of prior research studies on the topic
 Access to the respondent
 Cultural and other type of bias
 Language barriers of respondents to
questionnaires
 1. Shahbaz, Tazeem & Khair, Un. (2013). KNOWLEDGE AND PRACTICE OF BREAST SELF
EXAMINATION AMONG ANTENATAL ATTENDEES PRESENTING TO A TERTIARY CARE HOSPITAL IN
KARACHI, PAKISTAN. journal of medical and dental college, university of faisalabad. 4.

 2. A, Ehwarieme & Amiegheme, Felicia & J.K, Unigwe & J.O, Ugwueze. (2019). Awareness of breast
cancer and practice of breast self-examination among pregnant women attending antenatal clinic in
selected health centres, Benin City, Edo State. African Journal of Nursing and Midwifery ISSN 2198-4638
Vol. 7 (8), pp. 001-012, August, 2019. Available online at www.internationalscholarsjournals.org ©
International Scholars Journals. 7. 1-012.

 3. Olaogun, Julius & Emmanuel, Eyitayo & Ayokunle, Dada & Odesanmi, Olakunle & Adesua,
Oladapo. (2017). The prevalence of practicing breast self-examination and knowledge of breast cancer
disease among women attending secondary health facility. International Surgery Journal. 4. 3211.
10.18203/2349-2902.isj20174491.

 4. Ezeonu, Paul & Leonard, Ajah & Onoh, Robinson & Lawani, Osaheni & Enemuo, Vincent & Agwu,
Uzoma. (2015). Evaluation of clinical breast examination and breast ultrasonography among pregnant
women in Abakaliki, Nigeria. OncoTargets and Therapy. 8. 1025-1029. 10.2147/OTT.S83437.

 5. Onwere, Stephen & Okoro, Ogechi & Chigbu, Bright & Aluka, Chris & Kamanu, Chuks & Onwere,
Adaugo. (2009). Breast self-examination as a method of early detection of breast cancer: Knowledge
and practice among antenatal clinic attendees in south eastern nigeria. Pakistan Journal of Medical
Sciences. 25.
 6. Abraham, Charles & Sheeran, Paschal. (2015). The Health Belief Model.

 7. Kabir, Syed Muhammad. (2016). METHODS OF DATA COLLECTION.

 8. Ryu, Seewon & Song, Tae-Min. (2014). Big Data Analysis in Healthcare. Healthcare
informatics research. 20. 247-8. 10.4258/hir.2014.20.4.247.

 9. Stichler, J. F. (2013). Ethical Considerations in Healthcare Design and Construction.

HERD: Health Environments Research & Design Journal, 6(4), 5–9.

 10. Fouka, Georgia & Mantzorou, Marianna. (2011). What are the Major Ethical Issues in
Conducting Research? Is there a Conflict between the Research Ethics and the Nature of
Nursing?. HEALTH SCIENCE JOURNAL ®. 5.

 11. Armiger, S. B. (1977). Ethics of nursing research: profile, principles, perspective.

Nursing Research, 26(5), 330-336.

 12. Song, Tae-Min & Ryu, Seewon. (2015). Big Data Analysis Framework for Healthcare
and Social Sectors in Korea. Healthcare informatics research. 21. 3-9.
10.4258/hir.2015.21.1.3.
 Appendix 1
Source: Google image
THE END