Breast Cancer (BC) is one of the concerns of societies especially for women and is the most prevalent female malignancy. It is at the top of all the malignancies among Saudi females with the proportion of young age-onset BC much higher than in western countries. Breast Self Examination (BSE) is the lowest cost screening modality for BC. Female health workers play an important role in creating an environment supportive of screening behaviors by offering positive role models. Knowledge and proper attitude of healthcare workers are important determinants of BSE practice among clients and in the implementation of breast screening programs. This study aimed to explore female health workers' of Ministry of Health (MOH), knowledge, attitudes and performance of BSE.
Methodology
The present study was conducted in Riyadh, among female health care workers at MOH Primary health care centers (PHCCS). There are 87 PHCCs in Riyadh, a proportionate sample was selected from PHCCs of each the 5 areas of the city, and 31 PHCCs were selected. The researcher interviewed all female health workers at each selected PHCC. Any health worker with current or history of BC was excluded from the study. A total of 570 female health care workers were included in this study. The data collection instrument inquired on personal characteristics, risk factors for BC and knowledge, attitude and practice of BSE.
Results
A total of 570 female MOH health care workers were included. Almost all participants knew about BC (96.1%) and only 10.9% were not aware about BSE. Regarding risk factors for BC, 17.4% had exclusively breastfed their infants, 17.2% artificially, while 40.5% provided mixed feeding. About one third of participants were current users of contraceptive methods (31.9%), mainly pills (29.5%). The Ministry of Health's campaigns were the main source of information about BSE; 18.1% did not know when to start performing BSE. The timing of BSE for a non-menopausal woman was not known by 44.2% while that of a menopausal woman was not known by 37.5%. More than one fifth of participants did not know if it is important to stand in front of a mirror while performing BSE. About one fifth of participants (19.1%) did not know if BSE is useful, while 43% had never performed BSE. The main reasons for not performing BSE were not knowing how to correctly perform it (40.4%), absence of symptoms or signs of a breast disease (32.2%) or being afraid to discover breast cancer (12.1%). Awareness, attitude and practice of BSE differed significantly according to participants' qualifications and job.
Conclusion
There are several deficient knowledge items regarding BSE among MOH female health care workers in Riyadh City, and their practice of BSE is relatively low. The main reason for not practicing BSE was not knowing how to do it. Highly qualified female health care workers practiced BSE more than less qualified ones, while non-medical female health care workers rarely practiced BSE. It was recommended to implement health education intervention programs on early detection of breast cancer for health care workers to improve their breast cancer knowledge and practices. Health education programs should tackle the current misconceptions related to BSE among health care workers.