Breast Self-Examination: Attitudes and Knowledge Among Polish Nurses

Background: Breast cancer (BC) is 1 of the most challenging types of malignant cancer, both in Poland and in the world. Accordingly to the latest epidemiologic data, in Poland in 2015 BC was the most frequent cancer among women and was second leading cause of cancer deaths. World Health Organization highlights that BSE has significant role in empowering women to take responsibility for their own health and is recommended as an educational tool in raising women's awareness about BC risk. Appropriate knowledge level about BSE is especially crucial among nurses - in many cases nurses are the first and only source of knowledge about BSE and BC for women. Aim: To investigate level of knowledge about BSE among Polish nurses. Methods: To assess BSE correctness performed by nurses, authors used the scale based on 4 items. Each item referred to 1 following principle of appropriate BSE: regularity (once a month); BSE performed 2-3 days after menstruation among women in premenopausal age and within the set day among postmenopausal women; using both visual and palpation technique; examination in standing and lying position. For each principle respondent received 1 point. Total maximum number of points was 4. Among the variables characterizing the examined group of nurses potential qualitative and quantitative factors were identified, the impact of which on the correctness of BSE performance has been assessed. To evaluate the impact of specific factors on the probability of correct BSE performance the logistic regression method has been used. Results: In our study all nurses declared that they had performed BSE at least once in their life. However, less than half (41.1%) did this for the first time at the age of 20 or earlier. 56.7% of nurses regularly examined their breasts once a month. Among menstruating women (N = 1058) at the recommended time (2-3 days after the end of menstruation), BSE was performed by 67.3% of nurses, the others during different periods of the menstrual cycle. Among postmenopausal women (N = 184) 30.4% have been performing BSE on a specific day of the month. Almost all subjects (about 98%) used both - viewing and palpation method. 58.9% did it in 2 positions - standing and lying. The average number of points on the BSE correctness scale, including 4 items, was 2.8 points. BSE was fully correctly performed by 27.5% of women (4 p.) and almost fully correctly by 33.9% of nurses (3 p.). Less than 1% of nurses carried out BSE contrary to the 4 recommendations assessed during the study. Conclusion: Despite medical education only about 1/3 of nurses has performed BSE in a completely correct way. It shows the need of constant education in this matter which has significant meaning for same nurses but also for women educated by them. Moreover, in the face of alarming epidemiologic data on BC and unsatisfactory quality of performed BSE, devoting more attention in the nurses´ education process for BC issues should be considered.