Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Abstract

BACKGROUND: Breast cancer is the most common cancer in Iranian women. The number of people
with this disease is increasing across the world. Positive family history is one of the risk factors for
developing breast cancer. However, early detection is the main method to fight this disease. This
study was conducted to examine the effect of education based on the health belief model (HBM) on
self‑care behaviors among first‑degree relatives of patients with breast cancer.
METHODS: This clinical trial was conducted in 2016 on 80 women in Tehran city, Iran. Data were
collected using a three‑part questionnaire regarding demographic data, the HBM, and self‑care
behaviors. The educational program based on the HBM was held in 4 ninety‑minute training sessions
through lectures, group discussions, question and answer, image presentations, and PowerPoint
presentations. The questionnaires were completed before and 2 months following the intervention
by intervention and control groups. Data were analyzed using descriptive and inferential statistics
through the SPSS16 software.
RESULTS: The mean score of the HBM constructs before the intervention in the groups had no
statistically significant differences (P > 0.05). Eight weeks after the intervention, the mean score of the
constructs of the HBM in the intervention group significantly increased and a statistically significant
increase in the mean score of self‑care in the intervention group compared to the preintervention
was found, so that the self‑care behavior score in the intervention group was 0.69 ± 0.09 before the
intervention and was changed to 0.74 ± 0.09 after the intervention (P < 0.0001).
CONCLUSION: Our results suggest that education based on the HBM was effective in promoting
self‑care behaviors among first‑degree relatives of breast cancer patients. Therefore, education
based on HBM may have an important implication for breast cancer prevention in Iran.

Keywords

  1. Ries LA, Kosary CL, Hankey BF, Miller BA, Edwards BK.
    SEER Cancer Statistics Review. Bethesda, MD: National Cancer
    Institute; 1998. p. 1973‑95.
    2. Abolfotouh MA, Ala’a AB, Mahfouz AA, Al‑Assiri MH,
    Al‑Juhani AF, Alaskar AS. Using the health belief model to predict
    breast self‑examination among Saudi women. BMC Public Health
    2015;15:1163.
    3. De Santis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD,
    Kramer JL, et al. Cancer treatment and survivorship statistics.
    Cancer J Clin 2014;64:252‑71.
    4. Noroozi A, Jomand T, Tahmasebi R. Determinants of breast
    self‑examination performance among Iranian women: An
    application of the health belief model. JCancer Educ 2011;26:365‑74.
    5. Cancer Registration Country Reports 2009. Iran: Ministry of
    Health and Medical Education, Cancer Office; 2012.
    6. Enayatrad M, Amoori N, Salehiniya H. Epidemiology and
    trends in breast cancer mortality in Iran. Iran J Public Health
    2015;44:430‑1
  2. 7. Sadjadi A, Nouraie M, Ghorbani A, Alimohammadian M,
    Malekzadeh R. Epidemiology of breast cancer in the Islamic
    Republic of Iran: First results from a population‑based cancer
    registry. East Mediterr Health J 2009;15:1426‑31.
    8. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer
    in Iran: Results of a multi‑center study. Asian Pac J Cancer Prev
    2004;5:24‑7.
    9. Jazayeri SB, Saadat S, Ramezani R, Kaviani A. Incidence of
    primary breast cancer in Iran: Ten‑year national cancer registry
    data report. Cancer Epidemiol 2015;39:519‑27.
    10. Berek J. Berek and Novak Obstetrics. Translated by Ghotbi R,
    Ghazijahani B. 15th ed. Tehran. Iran. Golban Publication; 2012.
    11. Collaborative Group on Hormonal Factors in Breast Cancer.
    Familial breast cancer: Collaborative reanalysis of individual data
    from 52 epidemiological studies including 58,209 women with
    breast cancer and 101,986 women without the disease. Lancet
    2001;358:1389‑99.
    12. Bradbury AR, Patrick‑Miller L, Schwartz L, Egleston B, Sands CB,
    Chung WK, et al. Psychosocial adjustment in school‑age girls with
    a family history of breast cancer. Pediatrics 2015;136:927‑37.
    13. Kırca N, Tuzcu A, Gözüm S. Breast cancer screening behaviors of
    first degree relatives of women receiving breast cancer treatment
    and the affecting factors. Eur J Breast Health 2018;14:23.
    14. Chu KC, Kramer BS, Smart CR. Analysis of the role of cancer
    prevention and control measures in reducing cancer mortality.
    J Natl Cancer Instit 1991;83:1636‑43.
    15. Terry MB, Forman MR. Empowering pediatricians
    to prevent chronic disease across generations. Pediatrics
    2016;138 Suppl 1:S92‑4.
    16. Koosha M, Raoofi A, Haghighat S, Hatefnia E. A study of lifestyle
    factors associated with breast cancer patients in Iran. Ethiopian
    J Health Dev 2019;33:3.
    17. Champion VL, Miller TK. Variables related to breast
    self‑examination: Model generation. Psychol Women Q
    1992;16:81‑96.
    18. Koh E, Choi GY, Cho JY. Effectiveness of an ongoing,
    community‑based breast cancer prevention program for Korean
    American women. Health Soc Work 2016;41:51‑9.
    19. Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and
    Health Education: Theory, Research, and Practice. San Francisco,
    CA: John Wiley & Sons; 2008.
    20. Skinner CS, Tiro J, Champion VL. Background on the health
    belief model. Health behavior: Theory, research, and practice.
    2015 Jul 1;75.
    21. Hajian‑Tilaki K, Auladi S. Health belief model and practice of
    breast self‑examination and breast cancer screening in Iranian
    women. Breast Cancer 2014;21:429‑34.
    22. Masoudiyekta L, Rezaei‑Bayatiyani H, Dashtbozorgi B,
    Gheibizadeh M, Malehi AS, Moradi M. Effect of education based
    on health belief model on the behavior of breast cancer screening
    in women. Asia Pac J Oncol Nurs 2018;5:114‑20.
    23. Jedgal K, Zareban A. The effect of education based on health
    belief model on promoting self‑care behaviors in patients with
    pulmonary tuberculosis. Q J Health Educ Health Prom Iran
    2014;2:152‑43.
    24. Parsa P, Mirmohammadi A, Khodakarami B, Roshanaiee G,
    Soltani F. Effects of breast self‑examination consultation based
    on the health belief model on knowledge and performance of
    Iranian women aged over 40 years. Asian Pac J Cancer Prev
    2016;17:3849‑54.
    25. Khiyali Z, Aliyan F, Kashfi SH, Mansourian M, Khani Jeihooni A.
    Educational intervention on breast self‑examination behavior in
    women referred to health centers: Application of health belief
    model. Asian Pac J Cancer Prev 2017;18:2833‑8.
    26. Kalanfarma KH, Zareban E, Jalili Z, Shahrakipour M. The
    effectiveness of education based on health belief model in the
    prevention of breast cancer behavior among female teachers in
    Zahedan city. J Educ Community Health 2014;1:11‑8.
    27. Eskandari‑Torbaghan A, Kalan‑Farmanfarma K ,
    Ansari‑Moghaddam A, Zarei Z. Improving breast cancer
    preventive behavior among female medical staff: The use of
    educational intervention based on health belief model. Mala J
    Med Sci 2014;21:44.
    28. Nahidi F, Dolatian M, Roozbeh N, Asadi Z, Shakeri N. Effect of
    health‑belief‑model‑based training on performance of women in
    breast self‑examination. Electron Physician 2017;9:4577‑83.
    29. Tuzcu A, Bahar Z, Gözüm S. Effects of interventions based on
    health behavior models on breast cancer screening behaviors of
    migrant women in Turkey. Cancer Nurs 2016;39:E40‑50.