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BMC Public Health

, 15:1163

First Online: 23 November 2015Received: 23 June 2015Accepted: 17 November 2015DOI: 10.1186-s12889-015-2510-y

Cite this article as: Abolfotouh, M.A., BaniMustafa, A.A., Mahfouz, A.A. et al. BMC Public Health 2015 15: 1163. doi:10.1186-s12889-015-2510-y


BackgroundIn the Kingdom of Saudi Arabia, breast cancer BC usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination BSE for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model HBM.

MethodsA convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia n = 225, and their non-working adult female family members n = 208, were subjected to the Arabic version of revised Champion’s Health Belief Model Scale CHBMS and the Arabic version of Breast Cancer Awareness Measure CAM, to assess their knowledge and attitude on BC respectively. Percentage mean score PMS for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05.

ResultsThe majority of women heard about BSE 91.2 %, only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast 54.9 %, or untrusting themselves able to do it 24.5 %. Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively. They reported low scores of; perceived susceptibility, seriousness, confidence and barriers PMS: 44.8 %, 55.6 %, 56.5 % and 41.7 % respectively, and high scores of perceived benefits and motivation PMS: 73 % and 73.2 % respectively to perform BSE. Significant predictors of  BSE performance were: levels of perceived barriers p = 0.046 and perceived confidence p = 0.001 to BSE, overall knowledge on BC p < 0.001, work status p = 0.032 and family history of BC p = 0.011.

ConclusionsSaudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.

KeywordsBreast cancer HBM Saudi women Breast self examination Screening Breast awareness AbbreviationsBCBreast cancer

BSEBreast self examination

HBMHealth Belief Model

CHBMSChampion’s Health Belief Model Scale

CAMCancer Awareness Measure

PMSPercentage mean score

CBEClinical breast examination

BABreast awareness

KAMCKing Abdulaziz Medical City

HRTHormone replacement therapy

OCPOral contraceptive pills

KAIMRCKing Abdullah International Medical Research Center

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Author: Mostafa A. Abolfotouh - Ala’a A. BaniMustafa - Aisha A. Mahfouz - Mohammed H. Al-Assiri - Amal F. Al-Juhani - Ahmed S


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