Abstract
Background: Breast cancer is the most commonly diagnosed malignancy and the leading cause of death among women throughout the world. The incidence of breast cancer has been increasing in Iran and the disease has been the most prevalently registered cancer in the country during the past decade.
Objective: Therefore, this study aimed to investigate the effects of motivational interviewing (MI) on awareness, attitude, and practice of breast self-examination (BSE) in high-risk women.
Methods: This randomized clinical trial recruited 60 rural women at higher risk of breast cancer in Babol, Iran in 2016. Thirty women from two randomly selected villages were assigned to the MI group. Two other villages were also randomly selected and 30 of their female residents were allocated to the control group. Eligible people were first identified by referring to the villages’ health centers. The participants were recruited using a table of random numbers and their informed consent was obtained. In the MI group, five 90-minutes weekly sessions of MI were held. Conventional training was conducted in the control group. All subjects completed a researcher-made questionnaire at baseline (before the intervention), at the end of the study, and three months later. Data were analyzed using repeated measures analysis of variance, and Bonferroni, Friedman, Wilcoxon, and chi-square tests.
Results: In the MI group, there were significant increases in women's mean scores of awareness in the first and second follow-ups compared to the baseline. Moreover, the mean score of attitude toward BSE in the MI group increased at the end of the study (P<0.001). The positive performance of the participants was significantly different between the MI and control groups at the end of the study (86.7% vs. 16.7%; P<0.001) and three months later (83.3% vs. 13.3%; P<0.001).
Conclusion: MI can be used alongside conventional trainings to promote and motivate screening behaviors.
Keywords: Motivational interviewing, breast self-examination, attitude, awareness, performance, conventional training.
Graphical Abstract
[1]
Word Health Organization. Latest global cancer data: Cancer burden
rises to 18.1 million new cases and 9.6 million cancer deaths in
2018. Available from. https://www.iarc.fr/wp-content/up-loads/ 2018/09/pr263_E.pdf Accessed on: September 12, 2018.
[2]
Ferlay J, Shin HR, Bray F, Forman D, Mathers CD, Parkin D. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127(12): 2893-917.
[3]
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2): 69-90.
[4]
Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev 2010; 19(8): 1893-907.
[5]
Gibbs R, Karlan B, Haney A, Nygaard I. Danforths Obestetrics and Gynecology. 10th ed. Lippincott Williams &Wilkins 2008.
[6]
Hulka BS, Moorman PG. Reprint of breast cancer: Hormones and other risk factors. Maturitas 2008; 61(1-2): 203-13.
[7]
Kelsey JL, Gammon MD, John EM. Reproductive factors and breast cancer. Epidemiol Rev 1993; 15(1): 36-47.
[11]
Ardahan M, Dinc H, Yaman A, Aykir E, Aslan B. Health beliefs of nursing faculty students about breast cancer and self breast examination. Asian Pac J Cancer Prev 2015; 16(17): 7731-6.
[12]
Soheili F, Alizade S, Hasani M, Bastami P. The pathologic assessment of breast mass before and after menopause. IJOGI 2013; 68(16): 21-7.
[13]
Almassi NF, Akbari H, Madani SH, Izadi B, Emami AA. Incidence of breast cancer in breast sample pathology reports in Iran (Kermanshah) 2001-2004. IJOGI 2006; 8: 23-8.
[14]
Mousavi SM, Montazeri A, Mohagheghi MA, et al. Breast cancer in Iran: an epidemiological review. Breast J 2007; 13(4): 383-91.
[15]
Han WT, Collie K, Koopman C, et al. Breast cancer and problems with medical interactions: Relationships with traumatic stress, emotional self-efficacy, and social support. Psychooncology 2005; 14(4): 318-30.
[16]
Somerset W, Stout SC, Miller AH, Musselman D. Breast cancer and depression. Oncology 2004; 18(8): 1021-34.
[17]
Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry 2008; 30(2): 112-26.
[18]
Cramer H, Lauche R, Paul A, Dobos G. Mindfulness-based stress reduction for breast cancer-a systematic review and meta-analysis. Curr Oncol 2012; 19(5)e343
[19]
Cuzick J, Powles T, Veronesi U, et al. Overview of the main outcomes in breast-cancer prevention trials. Lancet 2003; 361(9354): 296-300.
[20]
Kösters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev 2003; (2): CD003373
[22]
Siu AL. U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2016; 164(4): 279-96.
[24]
Ancoli-Israel S, Liu L, Marler MR, et al. Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer. Support Care Cancer 2006; 14: 201-9.
[25]
Montazeri A, Vahdaninia M, Harirchi I, et al. Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med 2008; 7(1): 6.
[26]
Baxter N. Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer? CMAJ 2001; 164(13): 1837-46.
[27]
Absavaran M, Niknami S, Zareban I. Effect of training through lecture and mobile phone on breast self-examination among nurses of Zabol Hospitals. J Iran Inst Health Sci Res (ACERC) 2014; 4(3): 363-73.
[28]
Doganer Y, Aydogan U, Kilbas Z, Rohrer J, Sari O, Usterme N. Predictors affecting breast self-examination practice among turkishwomen. Asian Pac J Cancer Prev 2014; 15(20): 9021-5.
[29]
Gwarzo UM, Sabitu K, Idris SH. Knowledge and practice of breast self-examination among female undergraduate students. Ann Afr Med 2009; 8(1): 34-9.
[30]
Hackshaw AK, Paul EA. Breast self-examination and death from breast cancer: A meta-analysis. Br J Cancer 2003; 88(7): 1047-51.
[31]
Yoo B, Choi K, Jung K, Jun J. Awareness and practice of breast self-examination among Korean women: Results from a nationwide survey. Asian Pac J Cancer Prev 2007; 13(1): 123-5.
[32]
Martínez JT, Pabón-Rozo C, Quintero-Contreras N, et al. Barriers associated with breast selfexamination among women 18 to 50 years old: A cross sectional study. Nutr Hosp 2015; 32(4): 1664-9.
[33]
Haji-Mahmoodi M, Montazeri A, Jarvandi S, Ebrahimi M, Haghighat S, Harirchi I. Breast self-examination: Knowledge, attitudes, and practices among female health care workers in Tehran, Iran. Breast J 2002; 8(4): 222-5.
[34]
Tilaki KH, Auladi S. Awareness, attitude, and practice of breast cancer screening women, and the associated socio-demographic characteristics, in Northern Iran. Iran J Cancer Prev 2015; 8(4)e3429
[35]
Parsa P, Kandiah M, Mohd Zulkefli NA, Rahman HA. Knowledge and behavior regarding breast cancer screening among female teachers in Selangor, Malaysia. Asian Pac J Cancer Prev 2008; 9(2): 221-7.
[36]
Rabin C, Pinto B. Cancer-related beliefs and health behavior change among breast cancer survivors and their first-degree relatives. Psychooncology 2006; 15(8): 701-12.
[37]
Hajian S, Vakilian K, Najabadi KM, Hosseini J, Mirzaei HR. Effects of education based on the health belief model on screening behavior in high risk women for breast cancer, Tehran, Iran. Asian Pac J Cancer Prev 2011; 12(1): 49-54.
[38]
Al-Naggar RA, Al-Naggar DH, Bobryshev YV, Chen R, Assabri A. Practice and barriers toward breast self-examination among young Malaysian women. Asian Pac J Cancer Prev 2011; 12(5): 1173-8.
[39]
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(1): 37.
[40]
Korcha RA, Polcin DL, Evans K, Bond JC, Galloway GP. Intensive motivational interviewing for women with alcohol problems. Counselor (Deerfield Beach,Fla) 2015; 16(3): 62-9.
[41]
Navidian A, Rostami Z, Rozbehani N. Effect of motivation group interviewing based safety education on workers safety behaviors in glass manufacturing. BMC Public Health 2015; 15: 929.
[42]
Janis IL, Mann L. Decision making: A psychological analysis of conflict, choice, and commitment. New York, NY, US: Free Press 1977.
[43]
Rosengren DB. Building Motivational Interviewing Skills: A Practitioner Workbook (Applications of Motivational Interviewing). New York: The Guilford Press; 1st Edition, (Lay-Flat Paperback) edition 2009.
[44]
Abadi M, Mahmoudi M, Vakilian K, Safari V. Motivational interview on having Pap test among middle-aged women–a counselling service in primary care. J Family Med Prim Care Rev 2018; 20(2): 101-5.
[45]
Barnes R, Ivezaj V. A systematic review of motivational interviewing for weight loss among adults in primary care. Obes Rev 2015; 16(4): 304-18.
[46]
Sanders K, Whited A, Martino S. Motivational interviewing for patients with chronic kidney disease. Semin Dial 2013; 26(2): 175-9.
[47]
Vakilian K, Molavi S, Zamani AR, Goodarzi M. Effect of motivational interviewing on using intrauterine device in women at high risk for pregnancy. Open Access Maced J Med Sci 2018; 6(7): 1306-9.
[48]
Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Health Care: Helping Patients Change Behavior (Applications of Motivational Interviewing). New York, NY: The Guilford Press 1st edition 2007.
[49]
Krampe H, Salz AL, Kerper LF, et al. Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: Results from a randomized controlled trial. BMC Psychiatry 2017; 17(1): 417.
[50]
DiClemente CC, Velasquez MM. Motivational interviewing and the stages of change. In: Miller WR, Rollnick S. Motivational interviewing: Preparing people for change. New York, NY: The Guilford Press; 2nd edition . 2002; pp. 201-16.
[51]
Jensen CD, Cushing CC, Aylward BS, Craig JT, Sorell DM, Steele RG. Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. J Consult Clin Psychol 2011; 79(4): 43340.
[52]
Benzo R, Vickers K, Ernst D, Tucker S, McEvoy C, Lorig K. Development and feasibility of a COPD self-management intervention delivered with motivational interviewing strategies. J Cardiopulm Rehabil Prev 2013; 33(2): 113-23.
[53]
Walpole B, Dettmer E, Morrongiello B, McCrindle B, Hamilton J. Motivational interviewing to enhance self-efficacy and promote weight loss in overweight and obese adolescents: A randomized controlled trial. J Pediatr Psychol 2013; 38(9): 944-53.
[54]
Battaglia C, Peterson J, Whitfield E, et al. Integrating motivational interviewing into a home telehealth program for veterans with posttraumatic stress disorder who smoke: A randomized controlled trial. J Clin Psychol 2016; 72(3): 194-206.
[55]
Rajabipour E, Maddah S, Falahi Khoshknab M, Zarei F, Anaraki F. Effect of group motivational interviewingon quality of life of patients with colorectal cancer andpermanent ostomy. IJPN 2014; 2(7): 58-68.
[56]
Reisi M, Javadzadeh H, Sharifirad G, Yarmohammadi P. Knowledge, attitudes and practice of breast self-examination among female health workers in Isfahan, Iran. J Educ Health Promot 2013; 2: 46.
[57]
Miller WR, Rose GS. Toward a theory of motivational interviewing. Am Psychol 2009; 64(6): 527-37.
[58]
Hardcastlem SJ, Taylor AH, Bailey MP, Harley RP, Hagger M. Effectiveness of a motivational interviewing intervention onweight loss, physical activity and cardiovascular disease risk factors: A randomised controlled trial with a 12-month post-intervention follow-up. Int J Behav Nutr Phys Act 2013; 10: 40.
[59]
Shinitzky HE, Kub J. The art of motivating behavior change: The use of motivational interviewing to promote health. Public Health Nurs 2001; 18(3): 178-85.
[60]
Ghasemi B, Keivani Z. Yousefi fard M. The effect of breast self-examination training on knowledge, attitude and practice of women working in Shahrekord universities in 2010. J Clin Nurs Midwife 2012; 3(2): 30-6.
[61]
Nde FP, Assob JC, Kwenti TE, Njunda AL, Tainenbe TR. Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC Res Notes 2015; 8(1): 43.
[62]
Ahmed BA. Awareness and practice of breast cancer and breast-self examination among university students in Yemen. Asian Pac J Cancer Prev 2010; 11(1): 101-5.
[63]
Ryan RM, Lynch MF, Vansteenkiste M, Deci EL. Motivation and autonomy in counseling, psychotherapy, and behavior change: A look at theory and practice. Couns Psychol 2011; 39(2): 193-260.
[64]
Butler C, Rollnick S, Stott N. The practitioner, the patient and resistance to change: Recent ideas on compliance. CMAJ 1996; 154(9): 1357-62.
[65]
Sevil U, Atan SU, Kiris H, et al. Peer education projecton breast self examination in Izmir, Turkey. Asian Pac J Cancer Prev 2005; 6: 29-32.
[66]
Alsaraireh A, Darawad MW. Breast cancer awareness, attitude and practices among female university students: A descriptive study from Jordan. Health Care Women Int 2018; 39(5): 571-83.
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