Breast self-examination proficiency in older women: measuring the efficacy of video self-instruction kits

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Abstract
Older women represent the highest risk group for breast cancer but do not use screening at recommended frequencies. Age-sensitive screening programs addressing the developmental issues, unique value systems, and problems of access for all older women are critically needed. Television is an ideal medium for reaching isolated older women with health information and educational programs. This research explored the efficacy of using video self-instruction kits to increase breast self-examination (BSE) proficiency and knowledge about breast cancer among a sample of 62 women > 60 years of age. Participants were given breast health kits containing an instructional video, printed educational materials, a miniature lump model, and BSE skill checks. Before using the kits and 30 days later they were tested on measures of BSE proficiency and knowledge about breast cancer. Results indicate that the self-instruction programs had significant and positive impacts on the two BSE proficiency measures: skill demonstrations (t = 7.32, p < 0.0001) and lump detection using a simulation model (t = 4.23, p < 0.0001). Knowledge about breast cancer scores also improved from pretest to posttest. Implications for cancer nurses and direct outcomes from the research including newly designed instructional media materials are discussed.