INTRODUCTION
Breast cancer is one of the most common cancers in women worldwide,
accounting for approximately 570,000 deaths in 2015. Over 1.5 million women
(25% of all women with cancer) are diagnosed with breast cancer every year
throughout the world [1,2]. In America, it is estimated that 30% of all new cancer
cases (252,710) among women are breast cancer in 2017 [3]. Breast cancer is a
metastatic cancer and can commonly transfer to distant organs such as the bone,
liver, lung and brain, which mainly accounts for its incurability. Early diagnosis
of the disease can lead to a good prognosis and a high survival rate. In North
American, the 5-year relative survival rate of breast cancer patients is above 80%
due to the timely detection of this disease [4]. Mammography is a widely used
screening approach in the detecting of breast cancer and proved to help reduce
the mortality effectively. Other screening methods, such as Magnetic Resonance
Imaging (MRI), which is more sensitive than mammography, have also been
implemented and studied during the last decade [5]. There’re numerous risk
factors such as sex, aging, oestrogen, family history, gene mutations and
unhealthy lifestyle, which can increase the possibility of developing breast cancer
[6]. Most breast cancer occur in women and the number of cases is 100 times
higher in women than that in men [3]. Although the incidence rate of breast cancer
in America increases year after year, the mortality rate decreases due to the
widespread early screenings and advanced medical therapies. Biological
therapies have been developed in recent years and proved to be beneficial for
breast cancer.
BACKGROUND OF THE STUDY
Cancer is one of the frequently talked about and most teared diseases. 'The
incidence of breast cancer is rising in every country of the world especially in
developing countries in the past two decades. The disease, which was earlier in
its initial years of discovery dubbed as the death sentence for the person
diagnosed with it, has now become more manageable, thanks to the frequent
efforts of researchers and oncologists. Though science has made rapid strides to
evolve many preventive and curative strategies to fight cancer, it has not been
able to break the fear and confusion that surrounds a person when diagnosed with
the disease.
Worldwide, breast cancer is the most common cancer in women, after skin
cancer, representing 16% of all female cancers. Mortality worldwide is 25%
greater than that of lung cancer in women. Even with all the advances in medicine,
cancer continues to be a dreaded disease. And, of all the cancers affecting women,
breast cancer is one of the most common. The incidence of breast cancer in India
is on the rise and is rapidly becoming the number one cancer in females pushing
the cervical cancer to the second spot. The seriousness of the situation is apparent
after going through recent data from Indian Council of Medical Research in the
year 2010, (ICMR). breast cancer to come into play. These include late age at
first childbirth, fewer children and shorter duration of breast-feeding and obesity
etc.
United States has the highest annual incidence rates of breast cancer in the world
128.6 per 100,000 in whites and 112.6 per 100,000 among African Americans. It
is the second most common cancer (after skin cancer) and the second-most
common cause of cancer death (after lung cancer). In 2007, breast cancer was
expected to cause 40,910 deaths in the US (7% of cancer deaths; almost 2% of all
deaths) this figure includes 450500 annual deaths among men out of 2000 cancer
cases.
World Cancer Report provides clear evidence that Lung cancer is the most
common cancer worldwide, accounting for I .2 million new cases annually
followed by cancer of the breast. just over one million cases. Of the breast cancer
cases, some 580,000 cases occur in developed countries and the remaining in
developing countries. In 2000, the year for which global data exist, some 400,000
women died from breast cancer, representing I .6 per cent of all female deaths.
'WHO and World Cancer Report', a global report by the International Agency for
Research on Cancer, which is the part of World Health Organization.
NEED FOR THE STUDY
Increased public awareness and improved screening have led to earlier diagnosis,
at stages amenable to complete surgical resection and curative therapies.
Consequently, survival rates for breast cancer have improved significantly,
particularly in younger women whether aggressiveness of this disease has any
relation to evolution of the disease, the disease being a late arrival in the
subcontinent.
Breast self-examination has been universally accepted by the experts as a very
simple, significant and effective method of early detection of breast cancer. As
with all other types of cancer early detection and a high index of suspicion are the
keys to combating the menace of cancer. Cancer is to a large extent avoidable,
much cancer can be prevented, and breast cancer when integrated with the
preventive measures offers the greatest potential of cure. Early diagnosis often
involves the patient's awareness of early signs and symptoms .Despite cancer
being a global public health problem many of us are not aware of the importance
of early diagnosis. Brest self-examination is a key factor for early diagnosis of
breast cancer.
Early detection and prompt treatment offer the greatest chance of long-term
survival. Mammography, clinical breast examination and breast self-examination
(BSE) are the preventive methods used for screening in the early detection of
breast cancer. Screening tests play a pivotal role in reducing breast cancer related
mortalities.
It is good to be in the habit of breast self-examination (BSE) on a regular basis
since early detection leads to early investigation and treatment. Women of all
ages should perform self-examination since breast problems can occur at any age.
A woman who regularly examines her breasts will have a very clear idea of her
normal breast texture and consistency, and help her to notice if something is
different.
The investigator have seen and care of various female patients with breast cancer
While working in clinical field, the patients were of different age groups with
breast cancer and researcher felt that unfortunately, women in low-resource
countries generally present at a later stage of disease than women elsewhere .0ne
factor that contributes to later detection is women's delay in having breast lumps
evaluated , Some may not realize how serious their condition is or that cancer are
available, while others may believe their symptoms are best treated with local
remedies.
To improve quality of care and survival rates for breast cancer patients, health
care systems with limited resources need to formulate evidence-based diagnostic
and treatment plans and protocols that reflect the technical and financial resources
available.
Nurses play a unique role in alerting the community to the early detection of
breast cancer as they usually have the closest contacts with female patients.
Nurses can use their knowledge of the health services to educate women about
breast cancer risk factors and available breast cancer screening and practices.
Mass media campaigns and health education activities are other simple ways to
raise awareness and encourage to seek medical care promptly.
So, the researcher feels need that awareness on breast self-examination is
important and will effective through computer assisted instructions.
PROBLEM STATEMENT
“Effect of awareness programme on knowledge regarding Breast cancer and
Breast self- Examination (BSE) among the girls in selected higher secondary
school, West Bengal.”
OBJECTIVES OF THE STUDY
1. To assess the knowledge regarding breast cancer and breast selfexamination among the higher secondary school girls.
2. To determine the effect of awareness programme on the knowledge
regarding breast cancer and breast self-examination among the higher
secondary school girls.
3. To find out the association between knowledge regarding breast cancer
and breast self-examination with selected demographic variables.
PURPOSE OF THE STUDY
To increase the knowledge regarding breast cancer and breast self-examination
among girls in higher secondary school.
ASSUMPTION
The study assumes that
• Higher secondary school girls have minimum knowledge regarding breast
cancer and breast self-examination.
• Awareness programme may increase the knowledge regarding breast
cancer and breast self-examination among girls.
HYPOTHESIS
H0- There is no significant difference between mean pre-test and post-test
knowledge score regarding breast cancer and breast self -examination among
girls at 0.05 level of significance.
H1- The mean post-test knowledge score regarding breast cancer and breast selfexamination is significantly higher than mean pre-test knowledge score at 0.05
level of significance.
OPERATIONAL DEFINITIONS
Effect - In this study, effect refers to the acquisition of knowledge about breast
cancer and breast self-examination after the administration of awareness
programme measured by structured knowledge questionnaire.
Awareness programme – refers to a specific programming activities or
strategies that increase the knowledge of breast cancer and Breast selfexamination of higher secondary school girls.
Knowledge – Refers to the familiarity about breast cancer, importance of breast
self-examination, and steps of breast self-examination and is measured by
structured knowledge questionnaire.
School girls – In this study, school girls refer to the girl student of class IX and
class XI.
VARIABLES UNDER STUDY
Independent variables - Awareness on breast cancer and breast selfexamination.
Dependent variables – Knowledge of girls on breast cancer and breast selfexamination.
Demographic variables – Age, educational status, menarche, family history of
breast cancer.
CONCEPTUAL FRAMEWORK
In this study the conceptual framework is based on System Model.
LITERATURE REVIEW
Literature review is done on the basis of
i)
ii)
Breast cancer
Breast self-examination
DELIMITATION OF THE STUDY
• The study will be conducted in a selected government higher secondary
school.
• The study is delimited to only girl student.
RESEARCH METHODOLOGY
Research Approach – Quantitative approach
Research Design – Pre experimental One group pre-test post-test design
SETTING OF THE STUDY
Pilot study – will be conducted in Harisabha Girls’ school, Purba Bardhaman.
Final study – will be conducted in Achra Girls’ school and Mohila Samiti school,
Paschim Bardhaman.
Rational for selecting this setting –
•
•
•
•
Familiarity with the schools.
Easy accessibility of the area.
Availability of adequate subject for the study.
Feasibility of conducting the study.
POPULATION
All girls studying in class IX and XI in higher secondary schools, West Bengal.
SAMPLE
In this study samples will be selected among the girls studying in class IX and XI
in Achra Girls’ School and Mohila Samiti School, West Bengal.
SAMPLE SIZE
Sample size for this study will be 384 on the basis of 50% awareness of girls
regarding breast cancer, 95% confidence interval and 5% margin of error.
Formula: n = Z2 × p(1-p)/m2
n = Required sample size Z = Confidence level (95%), Standard value = 1.96
P = Estimated Awareness 50% m = margin of error at 5% (0.05)
n = Z2 × p(1-p)/m2
n = (1.96)2 x 0.5(1-0.5)/ (0.05)2
n = (3.84 x 0.25) / 0.0025
n = 384
SAMPLING TECHNIQUE
In this study sample size is 384. Samples will be chosen from class IX and XI
from Achra Girls’ School and Mahila Samiti School, Paschim Bardhaman, who
are willing to participate in the study and fulfilled predetermined criteria. Total
number of eligible subjects in each class will be included by complete
enumeration.
If the population is more than sample size then subjects will be chosen by simple
random sampling technique and if the population is less than sample size then I
include class X and XII in my study setting to conduct the research with
appropriate sample size.
POPULATION CRITERIA
Inclusion criteria –
➢ The school girls who have attended menarche and who are present on the
day of data collection at particular school.
➢ Students who are willing to participate during the time of data-collection.
Exclusion criteria –
➢ The school girls who are on leave on that day.
➢ Girls who are present but sick at the time of data collection.
SELECTION OF DATA COLLECTION TOOL
DATA COLLECTION
TOOLS
Semi structured
Questionnaire
Structured questionnaire
VARIABLES
TECHNIQUES
Demographic data
Paper pencil
Breast cancer and Breast selfexamination
Paper pencil
DEVELOPMENT OF TOOL
For development of tool the following steps will be taken –
▪
▪
▪
▪
An extensive review of research and related literature.
Guidance of guide and other experts.
Development of first draft tool with the help of guide and co-guide.
Establishment of content validity.
▪ Pretesting of the tool.
▪ Reliability of the tool.
▪ Development of final draft of the tool.
PLAN FOR VALIDITY AND RELIABILITY OF THE TOOLS
Validity - Validation of the tool will be done by opinion from experts.
Reliability – Reliability will be calculated by statistical methods.
PLAN FOR DATA COLLECTION
A formal permission will be obtained from the concerned authority (Principal ).
The data collection procedure will be conducted in Achra girls’ school and
Mahila Samiti School, Paschim Bardhaman, West Bengal within a given time
period of 4 weeks.
The formal administrative permission will be taken from Principal of Govt.
College of Nursing, Burdwan. Also, the permission taken from Principal of Achra
Girls’ School and Mahila Samiti School, Paschim Bardhaman.
To collect data, at first self-introduction will be given to the students. Informed
consent will be taken.
Knowledge regarding breast cancer and BSE will be assessed (pre-test) by
knowledge questionnaire before administration of awareness programme.
Awareness programme on knowledge regarding breast cancer and BSE will be
given in planned teaching method separately to the student of class IX and XI.
After 8 days again the knowledge regarding breast cancer and BSE will be
assessed (post-test) by same scheduled knowledge questionnaire.
To get the findings, pre-test and post test score will be compared. Score will be
analysed by inferential statistics.
ETHICAL CONCIDERATION
• Ethical permission will be taken from institutional ethical committee.
• Informed consent will be taken from the participant.
ADMINISTRATIVE PERMISSION
▪
▪
▪
▪
Principal of Govt. College of Nursing, Purba Bardhaman.
Directorate of Health service, West Bengal.
Joint Directorate of Health Services, Nursing.
DI Office of Burdwan and School authority.
PLAN FOR DATA ANALYSIS
Data analysis will be done by using of descriptive and inferential statistics.
BUDGET FOR TOTAL STUDY
Proposed budget
ITEM
Computer type, photo copy, printing
Developing questionnaire
Travelling expenses
Binding
Miscellaneous & stationary
Total
Total expenditure 19000.
COST
8000
1000
3000
4500
2500
19000
RESEARCH PROPOSAL
ON
“Effect Of Awareness Programme on Knowledge
Regarding Breast Cancer and Breast Self-Examination
(BSE) Among the Girls in Selected Higher Secondary
School, West Bengal”
GUIDE
CO-GUIDE
Madam Dipanwita Sen
Madam Tapati Baishya
Senior Lecturer
Senior Lecturer
Govt. college of nursing
Govt. college of nursing
Purba Bardhaman
Purba Bardhaman
INVESTIGATOR
SUMANA MAJI
M.Sc. Nursing (2021-2023)
Govt. college of nursing
Purba Bardhaman
Email – sumanamaji0709@gmail.com
Mob – 8918001974
REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.
Stewart BW, and Wild CP. World Cancer Report 2014. Geneva, Switzerland: WHO
Press; 2014. 20.06.2022. 07:30pm.
[Internet]
WHO: Geneva,
Switzerland. Breast cancer. 20.06.22.7.45pm
http://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer
20.06.22.8pm.
Siegel RL, Miller KD, and Jemal A. Cancer Statistics, 2017. CA Cancer J Clin.
2017; 67: 22.6.2022. 8pm
DeSantis CE, Fedewa SA, Goding Sauer A, et al. Breast cancer statistics, 2015:
22.06.2022.8pm.
Convergence of incidence rates between black and white women. CA Cancer J Clin.
2016; 66: 31-42.23.06.2022.8pm.
Drukteinis JS, Mooney BP, Flowers CI, et al. Beyond mammography: new frontiers
in breast cancer screening. Am J Med. 2013; 126: 472-479.23.06.2022.6pm.
Majeed W, Aslam B, Javed I, et al. Breast cancer: major risk factors and recent
developments in treatment. APJCP. 2014; 15: 3353-3358. 22.06.2022.8pm.