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Introduktion: Bröstcancer är den vanligaste cancerform som drabbar kvinnor, tidig upptäckt är en viktig del för en ökad överlevnad i sjukdomen. Variationer i kunskap och utbildning gällande bröstcancer samt attityder kring undersökningsmetoder tenderar att påverka kvinnors tolkning av symptom och deras beslut att söka eller delta i screening/vård. Syfte: Att beskriva kunskaper om bröstcancer och attityder kring mammografiundersökning och självundersökning av bröst hos kvinnor med olika kulturell bakgrund som är bosatta i Sverige. Design: En kvalitativ studie med intervjumetodik. Metod: Studien utfördes med hjälp av semistrukturerade intervjuer med öppna intervjufrågor. Ett strategiskt urval med snöbollsurval användes. Tolv kvinnor i åldersspannet 35-65 år som härstammade från olika asiatiska- och afrikanska länder deltog i studien. Kvalitativ innehållsanalys användes för dataanalys. Resultat: Majoriteten av kvinnorna beskrev att de hade goda allmänna kunskaper om bröstcancer, vilket var mer än den kunskap de hade med sig från sina hemländer. Resultatet gällande attityder till mammografiundersökning och självundersökning visade på att kvinnorna ansåg det viktigt att delta i screeningprogram och att utföra självundersökning men att det inte varit så när de först kommit till Sverige. Kulturella uppfattningar som framkom i studien var att det skulle innebära rädsla för kvinnan att dra skam över sin familj, att sjukdomen i vissa kulturer upplevdes som smittsam samt det kunde upplevas lite som tabu att prata om den egna kroppen.  Slutsats: Det finns fortfarande ett kunskapsbehov kring bröstcancer bland kvinnor med icke europeisk härkomst. Ökad medvetenhet kring bröstcancer hos kvinnor, deras kunskapsnivåer om bland annat självundersökning av bröst kan användas för att uppnå målet med tidig upptäckt av sjukdomen. / Introduction: Breastcancer is the most common type of cancer among women, early detection is important for an increased survival of the desease. Variations in knowledge and education about breastcancer and attitudes towards screeningmethods seem to influate womens perceptions about symthoms and decisions to contact healthcare providers or participate in screening-programmes. Objective: To describe the knowledge about breast cancer and attitudes about mammography and self-breast-examination in women with different cultural backgrounds living in Sweden. Design: A qualitative study using interview methods. Method: The study was conducted by using semi-structured interviews with open-ended questions. A strategic selection of snowball sampling was used. Twelve women in the age range 35-65 years descended from different Asian- and African countries participated in the study. Qualitative content analysis was used for data analysis. Results: The majority of women described that they had good general knowledge about breastcancer, which was more than the knowledge they had brought from their homelands. The results regarding attitudes toward mammography screening and self-examination showed that the women considered it important to participate in screening programs and to perform self-examination but that it might not have been like that when they first came to Sweden. Cultural beliefs that emerged from the study was such that it would mean the fear of an affected woman to shame her family, that the disease in some cultures was seen as contagious, and it could seem somewhat taboo to talk about their own body. Conclusion: There is still a need for knowledge about breast cancer among women with non-European descent. Increased awareness of breast cancer in women, their levels of knowledge about including self-breast-examination can be used to achieve the goal of early detection of the disease.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2015. / The most common cancer in women worldwide is breast cancer. It is also the leading cancer affecting women in South Africa. When breast cancer is detected early, it improves the outcome of the disease and reduces mortality. The aim of this study was to determine the knowledge, beliefs, attitude and practice of breast self-examination among female university students. The objectives were, to explore the levels of knowledge of female university students on breast cancer and breast self-examination; to ascertain the beliefs of female university students on breast cancer and breast self-examination; to examine the attitudes of female university students toward breast cancer and breast self-examination and to determine if female university students regularly practice breast self-examination. A Mixed method descriptive design was used for this study. The selected site for this study was a higher education institution in the Western Cape. The population included all female university students in the Western Cape. The sample was female university students studying in the selected higher education institution who reside on the institution’s campus. Convenience sampling was used to select the sample. Two methods were used to collect data; these were questionnaires and face-to-face interviews. Questionnaires were analysed by the use of Microsoft Excel and Statistical Package for Social Sciences. Frequency Distribution was used to analyse descriptive statistics. Interviews were transcribed and analysed by using coding and thematic analysis. Participants lacked knowledge on breast cancer risk factors, as majority of them only knew about family history being a risk factor. Majority of the participants had never been educated by their healthcare provider on breast cancer and its screening. Most of the participants had never examined their breast before. Most of the participants who did not examine their breast did not have any knowledge on how to do BSE. Education on breast cancer and cancer as a whole should be initiated in high schools and higher institutions of learning as part of their curriculum. Posters on breast cancer screening and breast self-examination should be put up at public places and campuses. Breast awareness campaigns must be done every month not only in October which is the breast cancer awareness month. Health care professionals should give information on breast cancer to women when they visit the hospital or health centre

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Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.

Text in English / Monthly breast self-examination (BSE) is an extremely important part of health care for all women in every stage of life as a primary tool in the prevention of breast cancer. The purpose of this study was to determine the knowledge and practice of BSE among women at a private clinic in Zimbabwe. A non-experimental cross-sectional descriptive research design was used. The accessible population was one hundred women admitted to the selected private clinic. Data collection was done using a questionnaire which consisted of three parts: socio-demographic characteristics, knowledge about BSE and practices of BSE. Data obtained was analysed using EPI INFO version 3.3.2. Results showed that respondents were knowledgeable about breast cancer early warning signs and symptoms and BSE. About 28% of the respondents were aware of when to initiate BSE and 74% performed BSE, but their practice was poor. Educational materials should be freely available at hospitals and schools to enhance BSE awareness. / Health Studies / M.A. (Health Studies)

Orientador: Marilisa Berti de Azevedo Barros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T03:54:48Z (GMT). No. of bitstreams: 1 Amorim_VivianMaeSchmidtLima_M.pdf: 4488126 bytes, checksum: 21881a106ebbf7f21647cafe00bfac77 (MD5) Previous issue date: 2005 / Resumo:Justificativa: O câncer de mama e do colo de útero são neoplasias com altas taxas de incidência e mortalidade no Brasil e que dispõem de métodos eficazes de rastreamento para detecção precoce, oferecidos pelo Sistema Único de Saúde. Existe a necessidade de se identificar os subgrupos de mulheres que não realizam as práticas preventivas para esses agravos, como forma de se desenvolver estratégias, nas três esferas de governo, que venham minimizar as desigualdades ainda existentes em relação ao acesso aos serviços de saúde, a oferta de cuidados básicos, ao diagnóstico, tratamento e reabilitação nas questões relativas à saúde da mulher. Objetivos: Analisar as práticas de detecção precoce para o câncer de mama e do colo uterino, segundo características sociodemográficas, morbidade e comportamentos relacionados à saúde. Material e Métodos: Estudo do tipo transversal, de base populacional, tendo como população de estudo todos os indivíduos do sexo feminino com idade igual ou superior a 40 anos, não institucionalizados, residentes na área urbana de Campinas. Para a obtenção da amostra, os setores censitários do município de Campinas, foram agrupados em três estratos, segundo o percentual de chefes de família com nível universitário. Foram sorteados 10 setores censitários de cada estrato, e de cada setor censitário foram sorteados os domicílios e selecionados os indivíduos que seriam entrevistados, segundo os domínios de sexo e idade. As informações foram obtidas por meio de questionário estruturado em 19 blocos temáticos, com a maioria das questões fechadas, aplicado diretamente à pessoa sorteada.. O presente estudo incluiu 290 indivíduos pertencentes a dois domínios: mulheres de 20 a 59 anos e mulheres de 60 anos ou mais. Foram incluídos na análise dois grupos de variáveis: as independentes, compostas por variáveis sociodemográficas, comportamentos relacionados à saúde e estado da saúde e as dependentes, referentes à realização das práticas preventivas para a detecção do câncer de mama e do colo de útero. Para as análises estatísticas foi utilizado o programa STATA 7.0, que possibilitou levar em consideração as variáveis do plano de amostragem e o efeito de delineamento. As análises incluíram estimativas de prevalência, de razões de odds brutas e modelos de regressão logística múltipla. Resultados: O presente estudo possibilitou verificar que 83,3% das mulheres com 40 anos ou mais de idade, residentes em Campinas, encontram-se com a prática adequada em relação ao exame de Papanicolaou; 8,5% das mulheres entre 40 e 59 anos de idade e 11,1% das mulheres com 60 anos ou mais nunca haviam realizado o exame de Papanicolaou. Entre os principais motivos alegados pelas mulheres que nunca realizaram o exame citológico, destacam-se: achar que a realização deste exame não é necessária (43,5%), sentir vergonha (28,1%) e dificuldades relacionadas ao serviço prestador do exame (13,7%). Foram detectados, na análise univariada, os seguintes fatores associados à não-realização do exame citológico: idade, raça/cor, escolaridade, número de pessoas no domicílio, posse de bens, a não realização de exames preventivos para o câncer de mama. Os resultados da análise de regressão logística múltipla hierarquizada apontaram que não estar com a prática adequada quanto ao exame de Papanicolaou é mais freqüente nas mulheres entre 40 a 59 anos de idade, com escolaridade de até 4 anos, não brancas, e que não tiveram consulta odontológica no último ano. Verificou-se que 43,2% das mulheres que haviam feito o Papanicolaou tinham-no realizado em serviços do SUS. Em relação às práticas relativas à detecção precoce do câncer de mama, 50,8% das mulheres não fizeram mamografia nos últimos dois anos e dessas, 42,5% nunca haviam feito a mamografia e 8,3% realizaram-na há mais de 2 anos; 38,2 % não foram submetidas ao exame físico das mamas no ano que antecedeu a entrevista. Entre as mulheres com 70 anos ou mais de idade foram encontradas as maiores proporções de não realização da mamografia (67,7%) e do exame clínico das mamas (56,5%). Para a não realização do exame físico anual das mamas, nas análises univariadas, foram encontradas associações com: idade, raça/cor, situação conjugal, escolaridade, posse de bens, consumo de bebidas alcoólicas, prática de atividade física, do auto exame da mama, da mamografia e da citologia oncótica, e o uso de serviços odontológicos. Para a não realização da mamografia nos dois anos que antecederam a entrevista foram encontrados, nas análises univariadas, os seguintes fatores associados: idade, raça/cor, renda familiar per capita, posse de bens, consumo de bebidas alcoólicas, a prática do exame físico anual das mamas e da citologia oncótica. Os resultados do modelo de regressão logística múltipla mostraram que a não-realização do exame clínico das mamas foi mais freqüente entre as mulheres que vivem sem companheiro, que residem em domicílios com mais de quatro moradores, que não ingerem bebidas alcoólicas, que não realizaram o auto-exame das mamas e que não fizeram consulta odontológica no último ano. A não-realização da mamografia foi mais prevalente nas mulheres idade igual ou superior a 70 anos, não brancas, e que não ingeriam bebida alcoólica. Dos exames relatados, 28,8% das mamografias e 38,1% dos exames clínicos de mamas foram realizados pelo Sistema Único de Saúde (SUS). Conclusão: Esse estudo mostrou importantes características das mulheres que não realizam de forma adequada as práticas preventivas para o câncer de colo de útero e o de mama e que estratégias necessitam serem desenvolvidas pelos gestores da saúde, nos três níveis de governo, com o objetivo de minimizar as desigualdades de acesso, garantindo-se os princípios da equidade e da integralidade das ações pertinentes ao programa da saúde da mulher / Abstract: Background: Brazil has high incidence and mortality rates of breast and cervical cancer even though effective screening methods for early detection are provided by the Unified Health System-SUS. There is a need to identify subgroups of women who do not undergo preventive practices for these conditions, so as to develop strategies at the three levels of government in order to minimize the inequalities that still exist in terms of access to health services, offer of basic care, diagnosis, treatment and rehabilitation in issues related to women¿s health. Objectives: To analyze early detection practices for breast and cervical cancer, according to socio-demographic characteristics, morbidity and health-related behaviors. Methods: Cross-sectional, population-based study of all non-institutionalized women, 40 years old and over, and living in the urban area of Campinas. The sample was constructed by dividing the census sectors of Campinas into three strata groups according to the percentage of heads of households with college education. Ten census sectors were drawn from each stratum, and households were drawn and individuals selected for interviews from each census sector, according to gender and age. Information was derived from a questionnaire structured in 19 theme blocks, mostly with closed questions asked directly to the individual drawn. The present study included 290 individuals as follows: women, 20 to 59 years old and women 60 and over. Two groups of variables were analyzed: independent variables, encompassing socio-demographic variables, health-related behaviors and individual and family members¿ health status in terms of undergoing preventive practices to detect breast and cervical cancer. Statistical analysis was performed by using the STATA 7.0 program, which enabled taking into account the variables of the sample plan and design effect. Analyses included prevalence estimates, overall odds ratio and multiple regression logistic models. Results: The present study made it possible to verify that 83.3% of women 40 years and over, living in Campinas, have an inappropriate practice in relation to Pap smears; 8.5% of women between 40 and 59 years of age and that 11.1% of women 60 and over had never undergone a Pap smear. Among the major reasons pointed out by the women that had never had oncotic cytology, the following stand out: believing the test is not necessary (43.5%), being embarrassed (28.1%), and obstacles related to the service performing the test (13.7%). The univariate analysis detected the following factors associated with not having a cytology smear: age, race/color, schooling, number of individuals in the household, having assets, not doing preventive exams for breast cancer. The result of the hierarchy multiple regression logistic analysis pointed out that not having an appropriate practice in relation to Pap smears is more frequent in non-white women between 40 and 59 years of age, with up to 4 years of schooling and that had not had a dental appointment in the past year. The study verified that 43.2% of women that had been submitted to a Pap smear had done so in a SUS service. Regarding practices related to early detection of breast cancer, 50.8% of women had not had a mammogram in the past two years, and of these, 42.5% had never had a mammogram, and 8.3% had had one more than 2 years before; 38.2% had not been submitted to a breast examination in the year preceding the interview. The largest ratios of not having a mammogram (67.7%) and of not having a clinical breast exam (56.5%) were found among women 70 years old and over. The following associations were found in the univariate analyses for not having an annual breast exam: age, race/color, marital status, schooling, having assets, liquor consumption, exercising, breast self-examination, mammogram and cytology, and utilization of dental services. The following associated factors were found in the univariate analyses for not having a mammogram in the two years preceding the interview: age, race/color, per capita family income, having assets, liquor consumption, having had an annual breast exam and cytology. The results of the multiple regression logistic model showed that not having a clinical breast exam was more frequent among women that: live without a companion or in households with more than four residents, do not drink liquor, do not perform self breast examination and did not have a dental appointment in the past year. Not having a mammogram was more prevalent in non-white women 70 years or over, and that did not drink liquor. Of the tests mentioned, 28.8% of mammograms and 38.1% of clinical breast exams were performed by the SUS. Conclusion: The study showed the major features of women that did not have appropriate preventive practices for cervical and breast cancer, and that health managers should develop strategies at the three levels of government in order to minimize access inequalities and to guarantee the principles of equity and integrality of the actions of women¿s health programs / Mestrado / Mestre em Saude Coletiva

Este estudo apresenta uma análise de rejeição, realizada na clínica Diagnóstico Avançado Por Imagem – DAPI, com dados de 647 mamografias rejeitadas realizadas de março a novembro de 2015, antes e após treinamentos realizados com a equipe técnica de mamografia, para análise do desempenho. As informações foram coletadas na base de dados do software de análise de rejeição dos mamógrafos, e incluem: incidência; quantidade de repetições; motivo da repetição; identificação da profissional; compressão do exame rejeitado e do exame aceito. Observou-se que após o treinamento os índices de rejeição por posicionamento (a maior causa das rejeições) foram reduzidos em 2%. Identificou-se que as profissionais desenvolveram critérios mais rigorosos, o que também contribuiu para aumento das repetições após o treinamento. A incidência mais rejeitada foi a Crânio Caudal Direita – CCD, tanto antes (32%) quanto após o treinamento (36%). A análise do desempenho da equipe técnica em relação aos critérios de qualidade em mamografia digital pôde ser realizada, uma vez que houve a análise individual das profissionais para contribuição da qualificação da equipe e aumento da qualidade dos exames. A profissional “A”, que possuía o maior índice de rejeição por posicionamento, após o treinamento houve uma redução de 17% das repetições devido a posicionamento inadequado. Foram identificadas imagens com qualidade aceitável que foram rejeitadas desnecessariamente: 8% antes e 3,6% após o treinamento. Antes do treinamento, a equipe técnica realizava as mamografias com valores de compressão entre 80 a 89 N, e após o treinamento a maioria dos exames foi realizada com 90 N ou mais. Esse aumento resulta em exames com melhor qualidade e menor dose para a paciente. / This study presents a rejection analysis performed at the clinic Diagnóstico Avançado Por Imagem - DAPI, with data from 647 rejected mammograms performed three months before and three months after a training session of the mammography team, to analyze the performance of them after the training. The information was collected in the database of mammography rejection analysis software,these data include: Incidence; Number of repetitions; Reason for the repetition; Identification of the professional; Rejection examination and accepted examination. It was observed that, after the training, the rejection indexes by positioning (the greatest cause of the rejections) were reduced. It was observed that the group developed rigorous criteria, which also contributed to increase the repetitions after the training. The most rejected incidence was Cranio Caudal Right - CCD, both before (32%) and after training (36%).The analysis of the performance of the technical team, in relation to the quality criteria in digital mammography, could be performed by the individual analysis of the professionals to contribute to the qualification of the team and to increase the quality of the exams. The "A" professional, who had the highest index of rejection by positioning, after the training there was a reduction of 17% of the repetitions due to improper positioning. Acceptable quality images have been identified that are rejected unnecessarily 8% before and 3,6% after training. Before the training, the technical team performed the mammograms with values of compression between 80 and 89 N, and after training most of the exams were performed with 90 N or more. This increase which results in better quality tests and lower dose for the patient.