Breast self-examination: The effects of autobiographical accounts and a multimedia support program on women's knowledge, beliefs and behaviour

  • Nicola Smith

Student thesis: Doctoral Thesis


Each year more than 44,000 women are diagnosed with breast cancer and more than 12,000 of these die from the disease. These mortality rates are relatively high compared to the rest of Europe (Berrino et al., 2007; Mayor, 2003), which in part is due to the advanced stage of the disease at first presentation (McCready et al., 2005; Sant et al., 2003). Regular breast self-examination (BSE) can facilitate early detection (Cancer Research UK, 2008), yet it is not widespread. Identifying the motivational and contextual factors is likely to lead to the development of effective interventions as part of being ‘breast-aware’. This is particularly important given that mammography screening may not be effective (Crossing & Mansezewicz, 2003) or recommended for younger women (Cancer Research UK, 2008) and that BSE may be beneficial in offering women the opportunity to create a positive relationship with their body. This study considered the utility of a proposed Extended Health Belief Model (E-HBM) as a framework for understanding women’s knowledge, beliefs and behaviour. It sought to develop a new way to provide guidance and to encourage BSE by investigating the effect of autobiographical accounts of breast-cancer patients and a multimedia BSE support programme comparing video-enhanced or static guided instructions. The study adopted a 2x2 mixed methods design and 60 white British women aged between 19 and 67 participated. Analysis of Covariance revealed an interaction effect of autobiographical accounts and BSE support on BSE frequency and proficiency and regression analyses examined the utility of the E-HBM, with confidence being the main predictor. Moreover, thematic analysis elicited five themes; Previous Experience, BSE Irregularity, Perceived Susceptibility, Coping Style and The Usability of the 5 Step Model of BSE. The study concludes that the 5-step technique encourages BSE through creating a more pleasant experience, as women form an improved relationship with their breasts. Both the video-enhanced and static BSE supports are effective in terms of encouraging BSE and the effect of autobiographical accounts appears to be dependent on the type support. The practical implications and direction for future BSE interventions are discussed.
Date of Award1 Sept 2012
Original languageEnglish
Awarding Institution
  • Teesside University
SupervisorAnna Van Wersch (Supervisor) & Paul Van Schaik (Supervisor)

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