Breast self-examination practice in older women

The problem of this study was to determine what variables are predictive of breast self-examination in a population of older women. This study tested the health protecting behavior of breast self-examination using the scales of the Champion (1985) instrument and the researcher-developed Williams Breast Inventory. These instruments were based on the Health Belief Model. Selected variables of the Health Belief Model and the dependent variable of frequency of breast self-examination formed the conceptual framework of this investigation.

The sample consisted of 253 women between the ages of 62 and 93. Subjects completed the instruments used to test the seven research hypotheses, and to describe the sample. Five research hypotheses reflected the five constructs of the Champion questionnaire. Two research hypotheses reflected knowledge and health history derived from the Williams Breast Inventory.

Reliability indices were computed for the Champion scales using Cronbach's alpha. All scales reached the reliability coefficient of .60. Factor analysis yielded strong evidence for construct validity of the scales.

Multiple regression analysis tested each of the research hypothesis. Analysis of the data supported the Health Belief Model, as four of the five variables were significant in accounting for variances in the frequency of BSE. Health motivation accounted for 18% of the variance, with perceived barriers accounting for 8%. Susceptibility and benefits were also significant predictors of BSE practice. No significant relationship was found on frequency of BSE and Perceived Seriousness. Knowledge and Health History were related to BSE. Higher knowledge scores were related to more frequent practice. The health history variables predictive of BSE practice were: (a) examination by physician, (b) instruction by nurse, and (c) no history of skin cancer.

Implications of the investigation suggested a prescriptive framework from which nurses can organize and integrate cancer prevention strategies specific to the needs of older women. Nurse teaching BSE made a significant difference in practice rates; therefore, nurses need to be prepared to promote this health protecting behavior throughout the life span.