Document Type : Original Article
Authors
- . Zahra Khazir 1
- . Mohammad Ali Morrowati Sharifabad1 1
- . Ali Akbar Vaezi 2
- . Behnaz Enjezab 3
- . Hossein Fallahzadeh 4
- . Fatemeh Yari 5
1 Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences
2 Department of Nursing, School of Nursing and Midwifery, Research Center for Nursing and Midwifery Care in Family Health, Shahid Sadoughi University of Medical Sciences,
3 Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences
4 Department of Biostatistics and Epidemiology, Research Center of Prevention and Epidemiology of Noncommunicable Disease, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5 Department of Midwifery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Lorestan, Iran
Abstract
BACKGROUND: Health beliefs play an important role in people’s willingness to participate in
health‑promoting behaviors. Given the role of beliefs in women’s function and the importance of
the benefits of mammogram, and because the predictors of a behavior are a major prerequisite to
codification of an effective prevention program, the present study was conducted with the aim of
predicting mammography based on Health Belief Model (HBM) in women in Khorramabad.
Materials and Methods: In this cross‑sectional study, 262 women referring to health centers in
Khorramabad, Lorestan province, in 2018, were selected by randomly sampling. The data collection
tool was a four‑part questionnaire including demographic information, knowledge on breast cancer
and mammography, Champion’s Health Belief Model, and Champion’s Self‑Efficacy Questionnaire
for Mammography. Validity and reliability of the tool were investigated and confirmed. Data were
analyzed by version 16 of SPSS software using descriptive statistics, Chi‑squared test, and multiple
logistic regression.
RESULTS: The mean (standard deviation) age of the participants was 49.26 (±7.79) years.
Seventy‑nine (30.85%) of the 262 participants reported mammography. Constructs’ sensitivity,
benefits, barriers, and perceived self‑efficacy were significantly different in terms of performing
mammography (P < 0.05). Participants with a history of breast cancer (odds ratio [OR] = 11.18, 95%
confidence interval [CI] = [3.73–33.46]) had lower perceived barriers (OR = 3.54, 95% CI= [1.77–7.09]),
were more likely to undergo mammography than women with no family history of breast cancer, and
had moderate‑to‑high perceived barriers (P < 0.001).
CONCLUSION: The results of this study indicate that health managers are required to pay more
attention to training and promoting screening methods. Understanding the barriers to mammography in
women by managers can help design and implement effective programs that enhance mammography
in women.
Keywords
Dicker D, Pain A, Hamavid H, Moradi‑Lakeh M. The global
burden of cancer 2013. JAMA Oncol 2015;1:505‑27.
2. Behjati F, AtriM, Najmabadi H, Nouri K, ZamaniM, Mehdipour P.
Prognostic value of chromosome 1 and 8 copy number in invasive
ductal breast carcinoma among Iranian women: An interphase
FISH analysis. Pathol Oncol Res 2005;11:157‑63.
3. Harirchi I, Azary S, Montazeri A, Mousavi SM, Sedighi Z,
Keshtmand G, et al. Literacy and breast cancer prevention:
A population‑based study from Iran. Asian Pac J Cancer Prev
2012;13:3927‑30.
4. Coleman MP, Forman D, Bryant H, ButlerJ, Rachet B, Maringe C.
Cancer survival in Australia, Canada, Denmark, Norway, Sweden,
and the UK, 1995‑2007 (the international cancer benchmarking
partnership): An analysis of population‑based cancer registry
data. Lancet 2011;377:127‑38.
5. Ebrahimi M, Vahdaninia M, Montazeri A. Risk factors for breast
cancer in Iran: A case‑control study. Breast Cancer Res 2002;4:R10.
6. Franke F, Kirsten M. Health Belief Model of Breast Cancer
Screening for Female College Students [Master’s Thesis].
Ypsilanti (US): Eastern Michigan University; 2009.
7. Fentiman IS. Fixed and modifiable risk factors for breast cancer.
Int J Clin Pract 2001;55:527‑30.
8. Glanz K, Rimer B, Lewis FM. Health Behavior and Health
Education. 3rd ed.. San Francisco: Jossey‑Bass; 2002.
9. Becker MH, Rosenstock IM. Compliance with medical advice: In:
Steptoe A, Matthews A, editors. Heath care and Human Behavior.
London: Academic Press; 1984. p. 135‑52.
10. ShojaeezadehD. Health Education Models. 1st ed.: Communication
and health Education Center Publisher – Ministry of Health and
Medical Education; Tehran: 2000.
11. Tavafian SS, Hasani L, Aghamolaei T, Zare S, Gregory D.
Prediction of breast self‑examination in a sample of Iranian
women: An application of the health belief model. BMC Womens
Health 2009;9:37.
12. Taymoori P, Habibi S. Application of a health belief model for
explaining mammography behavior by using structural equation
model in women in Sanandaj. Sci J Kurdistan Univ Med Sci
2014;19:103‑15.
13. Noroozi A, Jomand T, Tahmasebi R. Determinants of breast
self‑examination performance among Iranian women: An
application of the health belief model. J Cancer Educ 2011;26:365‑74.
14. Darvishpour A, Vajari SM, Noroozi S. Can health belief model
predict breast cancer screening behaviors? Open Access Maced
J Med Sci 2018;6:949‑53.
15. Kung Hur H, Kim GY, Park SM. Predictors of mammography
participation among rural Korean women age 40 and over.
J Korean Acad Nurs 2005;35:1443‑50.
16. Janbulat N, Uzun O. Health beliefs and breast cancer screening
behaviors among female health workers in Turkey. Eur J Oncol
Nurs 2008;12(2):148‑56.
17. Hatefnia E, Niknami SH. Predictors of mammography use in
employed women 35 years and older from the health belief model.
J Zabol Univ Med Sci Health Serv 2013;5:47‑56.
18. Hatefnia E, Niknami SH, Mahmoudi M, Ghofrani F, Lamyian M.
The effects of health belief model education on knowledge attitude and behavior of Tehran pharmaceutical industry
employees regarding breast cancer and mammography.
J Kermanshah Univ Med Sci 2010;14:42‑53.
19. Champion VL. Instrument development for health belief model
constructs. ANS Adv Nurs Sci 1984;6:73‑85.
20. Taymoori P, BerryT, Farhadifar F. Predicting mammography stage
of adoption among Iranian women. JEduc Health Promot 2012;1:13.
21. Champion V, Skinner CS, Menon U. Development of a self‑efficacy
scale for mammography. Res Nurs Health 2005;28:329‑36.
22. Hashemian M, Amin Shokravi F, Lamyian M, Hassanpour K,
Akaberi A. Reliability and validity of the champion’s health
belief model scale for mammography among Iranian women
with family history of breast cancer. Health Educ Health Promot
2013;1:19‑31.
23. Farshbaf‑Khalili A, Shanazi M, Ghavech A, Torabi S. Breast cancer
screening methods and factor influencing on women visiting clinic
in Tabriz. Nurs Res 2010;4:27‑38.
24. Aflakseir A, Abbasi P. Health beliefs as predictors of breast cancer
screening behaviour in a group of female employees in Shiraz.
Iran J Cancer Prev 2012;5:124‑9.
25. Avci IA. Factors associated with breast self‑examination practices
and beliefs in female workers at a Muslim community. Eur J Oncol
Nurs 2008;12:127‑33.
26. National Center for Health Statistics. Health, United, State, With
Special Feature on Medical Technology. Hyattsville: National
Center for Health Statistics; 2010.
27. Canbulat N, Uzun O. Health beliefs and breast cancer screening
behaviors among female health workers in Turkey. Eur J Oncol
Nurs 2008;12:148‑56.
28. Elsie KM, Gonzaga MA, Francis B, Michael KG, Rebecca N,
Rosemary BK, et al. Current knowledge, attitudes and practices of
women on breast cancer and mammography at Mulago hospital.
Pan Afr Med J 2010;5:9.
29. Okolie UV. Breast self‑examination among female undergraduates
in Enugu, southeast, Nigeria, Okolie, Uchenna Virginia. Int J Nurs
Midwifery 2012;4:1‑7.
30. Alam AA. Knowledge of breast cancer and its risk and protective
factors among women in Riyadh. Ann Saudi Med 2006;26:272‑7.
31. Moodi M, Mood MB, Sharifirad GR, Shahnazi H, Sharifzadeh G.
Evaluation of breast self‑examination program using health belief
model in female students. J Res Med Sci 2011;16:316‑22.
32. Redman S, Reid AL, Campbell E, Sanson‑Fisher RW. Breast
self‑examination and breast examination by a health care
provider: Prevalence and predictors of screening in a
randomly selected sample of Australian women. Med J Aust
1990;152:640‑5.
33. Taymoori P, Berry T, Roshani D. Differences in health beliefs
across stage of adoption of mammography in Iranian women.
Cancer Nurs 2014;37:208‑17.
34. Lagerlund M, Hedin A, Sparén P, Thurfjell E, Lambe M. Attitudes,
beliefs, and knowledge as predictors of nonattendance in a
Swedish population‑based mammography screening program.
Prev Med 2000;31:417‑28.
35. Shiryazdi SM, Kholasehzadeh G, Neamatzadeh H, Kargar S.
Health beliefs and breast cancer screening behaviors among
Iranian female health workers. Asian Pac J Cancer Prev
2014;15:9817‑22.
36. Secginli S, Nahcivan NO. Factors associated with breast
cancer screening behaviours in a sample of Turkish women:
A questionnaire survey. Int J Nurs Stud 2006;43:161‑71.
37. Kadaoui N, Guay M, Baron G, St‑Cerny J, Lemaire J. Breast cancer
screening practices for women aged 35 to 49 and 70 and older.
Can Fam Physician 2012;58:e47‑53.
38. Kessler TA. Increasing mammography and cervical cancer
knowledge and screening behaviors with an educational program.
Oncol Nurs Forum 2012;39:61‑8.
39. Navabi Rigi SH, Kerman Saravi F. The effect of teaching breast
self‑examination based on health belief model in teachers in
Zahedan. Med Surg Nurs J 2012;1:24‑30.
40. Avci IA, Gozum S. Comparison of two different educational
methods on teachers’ knowledge, beliefs and behaviors regarding
breast cancer screening. Eur J Oncol Nurs 2009;13:94‑101.
41. Finney Rutten LJ, Iannotti RJ. Health beliefs, salience of breast
cancer family history, and involvement with breast cancer issues:
Adherence to annual mammography screening recommendations.
Cancer Detect Prev 2003;27:353‑9.
42. Meiser B, Cowan R, Costello A, Giles GG, Lindeman GJ, Gaff CL,
et al. Prostate cancer screening in men with a family history
of prostate cancer: The role of partners in influencing men’s
screening uptake. Urology 2007;70:738‑42.
43. Yarcheski A, Mahon NE, Yarcheski TJ, Cannella BL.
A meta‑analysis of predictors of positive health practices. J Nurs
Scholarsh 2004;36:102‑8.
44. Kerlikowske K, Smith‑BindmanR, Ljung BM, GradyD. Evaluation
of abnormal mammography results and palpable breast
abnormalities. Ann Intern Med 2003;139:274‑84.
)