- Volume 17 Issue 3
DOI QR Code
Psychosocial Predictors of Breast Self-Examination among Female Students in Malaysia: A Study to Assess the Roles of Body Image, Self-efficacy and Perceived Barriers
Ahmadian, Maryam;Carmack, Suzie;Samah, Asnarulkhadi Abu;Kreps, Gary;Saidu, Mohammed Bashir
- 발행 : 2016.04.11
Background: Early detection is a critical part of reducing the burden of breast cancer and breast self-examination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women. Objective: This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia. Materials and Methods: Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future. Results: Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future. Conclusions: Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.
- Ahmadian, M, Abu Samah A (2013). Application of health behavior theories to breast cancer screening among asian women. Asian Pac J Cancer Prev, 14, 4005-13. https://doi.org/10.7314/APJCP.2013.14.7.4005
- Ahmadian M, Abu Samah A (2014). Relationship between body image and breast self-examination intentions and behaviors among female university students in Malaysia. Asian Pac J Cancer Prev, 15, 5097-05. https://doi.org/10.7314/APJCP.2014.15.12.5097
- Bentler PM (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238. https://doi.org/10.1037/0033-2909.107.2.238
- Bentler PM (1992). On the fit of models to covariances and methodology to the Bulletin. Psychological Bulletin, 112, 400-4. https://doi.org/10.1037/0033-2909.112.3.400
- Bronfenbrenner U (1989). Ecological systems theory. In R. Vasta (Ed.), Annals of child dev, 6, 187-249. Greenwich, CT: JAI Press.
- Brown TA, Cash TF, Mikulka PJ (1990). Attitudinal body-image assessment: Factor analysis of the Body-Self Relations Questionnaire. J Pers Assess, 55, 135-44. https://doi.org/10.1207/s15327752jpa5501&2_13
- Browne MW, Cudeck R (1989). Single sample cross-validation indices for covariance structures. Multivariate Behavioral Res, 24, 445-55. https://doi.org/10.1207/s15327906mbr2404_4
- Byrne BM (2010). Structural equation modeling with AMOS: basic concepts, applications, and programming (2nd Ed.). Taylor and Francis Group, LLC.
- Calnan M, Rutter DR (1988). Do health beliefs predict health behaviour? A follow-up analysis of breast self-examination. Soc Sci Med, 26, 463-465. https://doi.org/10.1016/0277-9536(88)90315-2
- Cash TF, Deagle EA (1997). The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: a meta-analysis. Int J of Eating Dis, 22, 107-26. https://doi.org/10.1002/(SICI)1098-108X(199709)22:2<107::AID-EAT1>3.0.CO;2-J
- Cash TF, Henry PE (1995). Women’s Body Images: The results of a national survey in the USA. Sex roles, 33, 19-28. https://doi.org/10.1007/BF01547933
- Cash T F, Smolak L (2011). Body Image: A handbook of science, practice, and prevention, New York, Guilford Press.
- Cash TF (2000). Manual for the appearance schemas inventory. unpublished manuscript. old dominion university. norfolk, VA.
- Chait SR, Thompson JK, Jacobsen PB (2009). Relationship of body image to breast and skin self-examination intentions and behaviors. Body image, 6, 60-3. https://doi.org/10.1016/j.bodyim.2008.09.003
- Champion V (1995). Development of a benefits and barriers scale for mammography utilization. Cancer Nurs, 18, 53-59.
- Champion VL, Scott CR (1997). Reliability and validity of breast cancer screening belief scales in African American women. Nursing Res, 46, 331-337. https://doi.org/10.1097/00006199-199711000-00006
- Chouliara Z, Papadioti-Athanasiou V, Power K, et al (2004). Practice of and attitudes toward breast self-examination (BSE): a cross-cultural comparison between younger women in Scotland and Greece. Health Care for Women Inter, 25, 311-33. https://doi.org/10.1080/07399330490278385
- Clark C R, Baril N, Kunicki, M, et al (2009). Addressing social determinants of health to improve access to early breast cancer detection: results of the Boston REACH 2010 breast and cervical cancer coalition women's health demonstration project. J of Women's Health, 18, 677-690. https://doi.org/10.1089/jwh.2008.0972
- Corbex M, Burton R, Sancho-Garnier H (2012). Breast cancer early detection methods for low and middle income countries, a review of the evidence. Breast, 21, 428-34. https://doi.org/10.1016/j.breast.2012.01.002
- Dahlui M, Gan DEH, Taib NA, et al (2013). Breast screening and health issues among rural females in Malaysia: How much do they know and practice? Prev Med, 57, 18-20. https://doi.org/10.1016/j.ypmed.2012.12.010
- Fish J, Wilkinson S (2003). Understanding Lesbians’ Healthcare Behaviour: the Case of breast self-examination. Soc Sci Med, 56, 235-45. https://doi.org/10.1016/S0277-9536(02)00022-9
- Forbes G, Frederick D (2008). The UCLA body project II: breast and body dissatisfaction among african, asian, european, and hispanic american college women. Sex Roles, 58, 449-457. https://doi.org/10.1007/s11199-007-9362-6
- Green BB, Taplin SH (2003) Breast cancer screening controversies. J Am Board Fam Pract, 16, 233-241. https://doi.org/10.3122/jabfm.16.3.233
- Hair Jr JF, Black WC, Babin BJ, et al (2009) Multivariate data analysis (7th Ed.). Upper Saddle River: Prentice Hall International Inc.
- Hisham AN, Yip CH (2003). Spectrum of breast cancer in Malaysian women: overview. World J Surg, 27, 921-923. https://doi.org/10.1007/s00268-003-6976-x
- Hu LT, Bentler PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. https://doi.org/10.1080/10705519909540118
- Janda M, Youl PH, Lowe JB, et al (2004). Attitudes and intentions in relation to skin checks for early signs of skin cancer. Prev Med, 39, 11-18. https://doi.org/10.1016/j.ypmed.2004.02.019
- Jensen JD, Moriarty CM (2008). Psychosocial factors associated with skin self-exam performance. J Ame College Health, 56, 701-5. https://doi.org/10.3200/JACH.56.6.701-705
- Kreps GL, Sivaram R (2008). The central role of strategic health communication in enhancing breast cancer outcomes across the continuum of care in limited-resource countries. Cancer, 113, 2331-7. https://doi.org/10.1002/cncr.23832
- Luszczynska A, Schwarzer R (2003). Planning and self-efficacy in the adoption and maintenance of breast self-examination: A longitudinal study on self-regulatory cognitions. Psych Health, 18, 93-108. https://doi.org/10.1080/0887044021000019358
- Ma J, Jemal A (2013). Breast cancer statistics. breast cancer metastasis and drug resistance, Springer New York.1-18.
- MacCallum RC, Browne MW, Sugawara HM (1996). Power analysis and determination of sample size for covariance structure modeling. Psych Methods, 1, 130. https://doi.org/10.1037/1082-989X.1.2.130
- McCaul KD, Sandgren AK, O'Neill HK, et al (1993). The value of the theory of planned behavior, perceived control, and self-efficacy expectations for predicting health-protective behaviors. Basic Applied Soc Psycho, 14, 231-252. https://doi.org/10.1207/s15324834basp1402_7
- Millsted R, Frith H (2003). Being large-breasted: Women negotiating embodiment. Women’s Studies Inter Forum, 26, 455. https://doi.org/10.1016/j.wsif.2003.08.003
- Misovich SJ, Martinez T, Fisher JD, et al (2003). Predicting breast self-examination: a test of the information-motivation-behavioral skills model1. J Applied Soc Psycho, 33, 775-90. https://doi.org/10.1111/j.1559-1816.2003.tb01924.x
- Moore SM, Barling NR, Hood B (1998). Predicting testicular and breast self-examination behaviour: A test of the theory of reasoned action. Behaviour Change, 15, 41-49. https://doi.org/10.1017/S0813483900005891
- Oscarsson MG, Wijma BE, Benzein, EG (2008). 'I do not need to... I do not want to... I do not give it priority...'-why women choose not to attend cervical cancer screening. Health Expectations, 11, 26-34. https://doi.org/10.1111/j.1369-7625.2007.00478.x
- Parsa P, Kandiah M, Mohd Nasir MT, et al (2008). Reliability and validity of champion's health belief model scale for breast cancer screening among Malaysian women. Singapore Med J, 49, 897.
- Ridolfi DR, Crowther JH (2013). The link between women’s body image disturbances and body-focused cancer screening behaviors: a critical review of the literature and a new integrated model for women. Body Image, 10, 149-62. https://doi.org/10.1016/j.bodyim.2012.11.003
- Risica PM, Weinstock MA, Rakowski W, et al (2008). Body satisfaction: Effect on thorough skin self-examination. Am J Prev Med, 35, 68-72. https://doi.org/10.1016/j.amepre.2008.03.017
- Rodin J, Silberstein L, Striegel-Moore R (1984). Women and weight: a normative discontent. In Nebraska symposium on motivation. University of Nebraska Press.
- Rosmawati NHN (2011). Knowledge, attitude, and practice of breast self-examination among women in a suburban area in Terengganu, Malaysia. Asian Pac J Cancer Prev, 11, 1503-8.
- Samah AA, Ahmadian M, Latiffah LA (2015). Insufficient knowledge of breast cancer risk factors among malaysian female university students. Global J Health Sci, 8, 277-285. https://doi.org/10.5539/gjhs.v8n1p277
- Sharma K, Costas A, Shulman LN, et al (2012). A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol, 2012.
- Thomas E, Usher L (2009). One more hurdle to increasing mammography screening: Pubescent, adolescent, and prior mammography screening experiences. Women’s Health Issues, 19, 425-33. https://doi.org/10.1016/j.whi.2009.07.002
- Tavafian SS, Hasani L, Aghamolaei T, et al (2009). Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model. Women's Health, 9, 37.
- Wang WL, Hsu SD, Wang JH, et al (2014). Survey of breast cancer mammography screening behaviors in Eastern Taiwan based on a health belief model. Kaohsiung J Med Sci, 30, 422-427. https://doi.org/10.1016/j.kjms.2014.04.007
- Yip CH, Smith RA, Anderson BO, et al (2008). Guideline implementation for breast health care in low and middle income countries: Early detection and resource allocation. Cancer, 113, 2244-56. https://doi.org/10.1002/cncr.23842
- Yip CH, Taib NA, Mohamed I (2006). Epidemiology of breast cancer in Malaysia. Asian Pac J Cancer Prev, 7, 369.
- Yokoyama K (2007). The double binds of our bodies: multiculturally-informed feminist therapy considerations for body image and eating disorders among asian american women. Women Therapy, 30, 177-192
- Development and psychometric evaluation of the breast size satisfaction scale vol.30, pp.8, 2017, https://doi.org/10.7314/APJCP.2016.17.3.1277
연구 과제 주관 기관 : University Putra Malaysia