Perception of Breast Cancer Among Female Students in the College of Nursing Sciences, Adazi Nnukwu, Anambra State
Chapter One
Objectives of the Study
The general objective of this study is to examine the perception of breast cancer among female students of the College of Nursing Sciences, Adazi Nnukwu, Anambra State. The specific objectives are to:
- Determine the level of awareness and knowledge of breast cancer among female students.
- Examine the beliefs and attitudes of female students toward breast cancer and its risk factors.
- Assess the influence of educational exposure on students’ perception and practice of breast cancer prevention.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
Concept of Breast Cancer
Breast cancer is a type of malignancy that arises from uncontrolled growth of cells in the breast tissue, typically affecting the milk-producing glands (lobules) or the ducts that transport milk (Isah et al., 2023). Clinically, breast cancer is recognised as a condition where abnormal cells begin to proliferate uncontrollably and can eventually spread to other parts of the body via the lymphatic system or bloodstream (Peng et al., 2023). In everyday terms, breast cancer is often associated with women, though it can also occur in men, albeit at a much lower frequency (George et al., 2019).
Various scholars have offered more specific definitions of breast cancer. Nwaneri et al. (2023) describe breast cancer as a multifactorial disease, influenced by genetic, environmental, and lifestyle factors. They also emphasise that early detection through methods such as mammography and breast self-examination significantly reduces the mortality rate. Neji et al. (2023) define the condition in terms of its pathophysiology, noting that it can vary from a localised tumour within the breast to a more aggressive form that metastasises to other organs.
A critique of these definitions is that they often focus on the medical and clinical perspectives, which may overlook the social and cultural factors that influence the recognition and response to breast cancer, particularly in low-resource settings. For instance, while the disease is clinically understood as a biological process, cultural beliefs and stigma around cancer in certain communities may delay early detection and treatment (Lokossou et al., 2024). In some African cultures, the perception of breast cancer as a death sentence or taboo subject may result in individuals avoiding diagnosis, which can contribute to higher mortality rates (Isah et al., 2023). Therefore, a more holistic definition of breast cancer, incorporating both clinical and sociocultural factors, is necessary to fully understand its impact.
In relation to nursing education and public health, the concept of breast cancer is of immense importance. Nurses, particularly those in training, must have a thorough understanding of not only the clinical aspects of breast cancer but also the social and cultural factors influencing its diagnosis and treatment. Such an understanding is crucial for health promotion and education, as nurses can help bridge gaps in knowledge, encourage early detection, and reduce the stigma surrounding breast cancer. By being well-informed, nursing students can empower patients and their communities, thereby improving early detection rates and ultimately reducing the health burden posed by breast cancer (George et al., 2019).
CHAPTER THREE
METHODOLOGY
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This chapter provides a detailed account of the research design, target population, sampling techniques, data collection instruments, reliability and validity of the instruments, data collection methods, data analysis methods, and ethical considerations for the study on the “Perception of Breast Cancer Among Female Students in College of Nursing Sciences Adazi Nnukwu, Anambra State.
Study Settings
The study is conducted in the College of Nursing Sciences Adazi Nnukwu, Anambra State, a well-established institution providing nursing education to female students. The study setting is significant because nursing students, as future healthcare professionals, play a pivotal role in shaping health perceptions in society. By conducting the study in a learning environment, it is expected that the respondents may possess some basic knowledge of healthcare issues, including breast cancer, which may influence their perceptions and attitudes.
The College of Nursing Sciences is located in Adazi Nnukwu, a town in Anambra State, southeastern Nigeria. The geographical location offers a unique perspective, as it is situated within a region with varied access to healthcare information and education, which might impact students’ awareness and understanding of breast cancer.
Target Population
The target population for this study consists of female students of the College of Nursing Sciences Adazi Nnukwu, with a focus on those enrolled in undergraduate programs. The study will specifically target 2000 female students who are currently studying nursing within the institution.
The justification for selecting this population lies in the fact that nursing students, particularly female students, are likely to have more exposure to health-related issues and may possess knowledge or misconceptions about breast cancer. Additionally, as future healthcare providers, their perceptions and knowledge are critical in determining how they will educate others about breast cancer awareness and prevention.
The size of the target population (2000 respondents) is large enough to provide a comprehensive view of the general perception of breast cancer among nursing students. Furthermore, this size allows for statistically meaningful results, which will enhance the reliability and generalizability of the findings.
CHAPTER FOUR
RESULTS
Demographic Distribution of Respondents
CHAPTER FIVE
DISCUSSION OF FINDINGS
Findings
This study explored the awareness, attitudes, and educational exposure of students toward breast cancer prevention, with a focus on the College of Nursing Sciences. The findings align with several previous studies conducted in various regions, reinforcing the critical importance of awareness and educational campaigns in improving breast cancer prevention practices. Key aspects of the results from this research are compared with the findings of relevant studies from Nigeria and other African contexts.
The study found that a majority of the respondents (77.4%) either strongly agreed or agreed that breast cancer is a preventable disease, which is in line with George et al. (2019), who found that most women in Nigeria believed breast cancer could be prevented if detected early. This belief in the preventability of breast cancer is pivotal in changing health behaviours, as it fosters the intention to engage in preventive practices like breast self-examination (BSE) and seeking early screening. Similarly, the perception of breast cancer being a concern for older women was expressed by 45.3% of the respondents, suggesting a misconception that breast cancer predominantly affects older women, rather than women across all age groups. This finding mirrors those of Nwaneri et al. (2023) who observed similar beliefs among rural women in Imo State, highlighting the need for broader education on the risk of breast cancer among younger women.
In contrast, the study participants showed a strong awareness that regular breast self-examination (BSE) is effective for early detection, with 80.2% agreeing with this statement. This finding resonates with studies conducted by Irurhe et al. (2024) and Neji et al. (2023), both of which reported high awareness of BSE among female students, but also noted that despite this knowledge, actual practice was low. The gap between awareness and practice is a critical area for intervention.
The respondents demonstrated a proactive attitude toward early detection, with significant proportions believing in the importance of regular screenings. However, there was also a notable percentage (29.4%) uncertain about the risk of breast cancer or unconvinced about the effectiveness of early screening. This aligns with findings from Usman et al. (2020) and Obaji et al. (2023), where women, despite being aware of the benefits of BSE, often expressed hesitation or lack of confidence in their ability to detect abnormalities. Attitude plays a significant role in the practice of breast cancer prevention measures, with a positive attitude generally linked to better health outcomes.
Interestingly, the respondents’ belief that educational exposure increases breast cancer awareness is supported by the results from Lokossou et al. (2024), who noted that enhanced knowledge from health campaigns led to better attitudes and practices regarding breast cancer prevention. In the present study, 80.5% of the respondents agreed that educational exposure had positively impacted their understanding of breast cancer, reinforcing the importance of incorporating health education into the curriculum, as emphasized by Nwaneri et al. (2023).
The study revealed that educational exposure significantly influenced the respondents’ attitudes and practices concerning breast cancer prevention. This was evident as 52.6% of the participants strongly agreed that breast cancer prevention should be part of the curriculum in the College of Nursing Sciences. These findings are consistent with Azubuike and Okwokei (2023), who highlighted the crucial role of education in improving knowledge and practices regarding breast cancer prevention among women. In particular, George et al. (2019) underscored that educational campaigns contribute significantly to early detection and prevention practices, which aligns with the present study’s findings where educational interventions positively impacted students’ attitudes toward breast cancer prevention.
The study also found that a majority of the participants felt that if more information were provided, more students would engage in breast cancer prevention practices. This is consistent with the findings of Aissami and AIssimouha (2020), who found that in Niger, increased awareness and knowledge about breast cancer led to improved attitudes and practices among women. Furthermore, the study participants echoed the sentiment expressed by Peng et al. (2023), which emphasized that awareness of risk factors and early detection methods can significantly alter attitudes toward preventive measures, fostering healthier behaviours.
While the findings from this study are promising, they are not without limitations. The study’s cross-sectional design limits the ability to draw causal conclusions. Future research could explore longitudinal studies to assess changes in attitudes and practices over time. Moreover, although a significant number of respondents reported positive attitudes toward breast cancer prevention, actual practice data, such as the frequency of BSE or mammography, was not measured. Further studies should aim to explore barriers to the practice of early detection, including cultural, socioeconomic, and psychological factors.
Implications of the Findings to Nursing
The findings from this study have significant implications for nursing practice, education, and healthcare delivery, particularly in relation to breast cancer awareness, prevention, and early detection. As healthcare providers, nurses are in a unique position to influence patient education, promote health awareness, and advocate for preventive healthcare measures. This study highlights the importance of enhancing knowledge and attitudes toward breast cancer prevention, which can inform nursing interventions, curricula, and outreach efforts.
One of the most prominent findings of this study is the critical role of educational exposure in improving awareness and attitudes toward breast cancer prevention. Nurses, especially those in educational settings, can use these findings to advocate for the inclusion of comprehensive breast cancer education in nursing curricula. By integrating information about the risk factors, symptoms, early detection methods like breast self-examination (BSE), and the importance of screening, nursing students can be better prepared to educate patients in their future roles.
Moreover, nursing programs should consider expanding training on effective communication strategies for discussing sensitive topics like breast cancer with patients. The study found that a substantial proportion of students expressed strong attitudes toward early detection, but there was still uncertainty regarding the effectiveness of screening. This presents an opportunity for nursing educators to emphasize the value of early screening and demonstrate its impact on improving survival rates, thus encouraging students to pass on this knowledge to the communities they serve.
Nurses play a pivotal role in advocating for preventive health behaviours, such as regular breast cancer screening and BSE, which are crucial in detecting breast cancer at an early stage. The study findings showed that, despite a high level of awareness regarding the importance of early detection, a significant number of respondents still held misconceptions or were unsure about their role in screening. This suggests that knowledge alone is not sufficient to promote preventive practices—there is also a need for ongoing support and guidance.
Nurses, as patient educators, can take the lead in providing tailored information about breast cancer and screening, ensuring that individuals understand the procedures, benefits, and potential outcomes of early detection. They can also offer emotional and psychological support to patients who may be apprehensive about undergoing screenings, as well as address any fears or misconceptions that could prevent individuals from seeking early detection.
Nurses are often involved in community-based health promotion activities, where they have the opportunity to directly impact public awareness about health issues like breast cancer. The study’s findings highlight the need for targeted educational campaigns to address specific gaps in understanding, such as the misconception that breast cancer primarily affects older women. Nurses can leverage these findings to tailor their outreach programs to address common myths, increase knowledge about the risk factors across all age groups, and empower women to adopt preventive behaviours.
Furthermore, community nursing services can collaborate with healthcare organizations to organize breast cancer screening programs, ensuring that underserved and high-risk populations have access to preventive services. Nurses can serve as advocates for equitable access to healthcare, encouraging individuals from rural or lower socioeconomic backgrounds to seek regular screening and engage in BSE. In doing so, they can contribute to reducing health disparities and improving early detection rates in underserved communities.
Nurses should base their clinical practices on evidence-based guidelines, which include promoting breast cancer prevention through education and screening. The findings of this study reinforce the importance of understanding how educational exposure influences attitudes and practices. Nurses can apply these insights by developing evidence-based educational materials, such as brochures or workshops, that are culturally sensitive and tailored to the needs of diverse patient populations.
Additionally, the findings support the integration of preventive practices into routine nursing assessments. Nurses can incorporate questions about breast cancer awareness and screening into their patient assessments, providing an opportunity for early education and intervention. Through these strategies, nurses can foster an environment where breast cancer prevention is prioritized, leading to better health outcomes and improved quality of life for their patients.
The study identified that while awareness of breast cancer is high, there are still barriers to the adoption of preventive practices, such as fear, uncertainty, and misconceptions about the disease. Nurses can play a crucial role in identifying these barriers during patient interactions and addressing them through education, counseling, and support. By building trust with patients and creating a safe space for them to express concerns, nurses can help alleviate fears about breast cancer and its screening processes.
Moreover, nursing interventions could include offering resources for mental health support, as fear of a cancer diagnosis can be overwhelming for many individuals. Nurses can also work with interdisciplinary teams to provide holistic care that addresses both the physical and emotional aspects of breast cancer prevention.
Limitations of the Study
One limitation of this study is its reliance on self-reported data, which may lead to biases such as social desirability or recall bias, where participants might overstate their awareness or adherence to breast cancer prevention practices. Additionally, the study was conducted within a specific population, which may limit the generalizability of the findings to other demographic groups or geographical locations. The sample was also drawn primarily from a university setting, meaning the results may not reflect the attitudes and practices of broader community members, particularly those in rural or less educated populations. Furthermore, the study did not explore the depth of participants’ knowledge or the effectiveness of specific educational interventions, which would have provided more insight into how different factors contribute to breast cancer awareness and prevention. Lastly, the cross-sectional design of the study restricts the ability to assess causal relationships, making it difficult to determine the direct impact of awareness on behaviour change.
Summary of the Study
This study aimed to assess the awareness, attitudes, and practices related to breast cancer prevention among female students in a university setting, with a focus on their knowledge of breast cancer, the influence of education on their preventive practices, and their overall perception of the disease. The study also sought to examine the factors that influence students’ awareness and attitudes toward breast cancer prevention, as well as the relationship between educational exposure and the likelihood of engaging in preventive behaviours such as breast self-examination (BSE).
A total of 333 participants were surveyed using structured questionnaires, which were administered to female students in the College of Nursing Sciences. The questionnaire was designed to gather information on their awareness of breast cancer, knowledge of its risk factors, attitudes toward prevention, and self-reported practices related to early detection methods such as breast self-examination and participation in awareness campaigns. In addition, the study explored the impact of educational exposure on students’ perception and practice of breast cancer prevention, particularly focusing on the role of educational campaigns in raising awareness and influencing behaviour change.
The findings revealed that a significant proportion of the participants were aware of breast cancer and its possible symptoms, with 78% of respondents agreeing that they knew about the disease and its warning signs. The awareness level was found to be higher among those who had been exposed to educational campaigns in their academic environment. However, despite this awareness, the study indicated that a relatively low percentage of students engaged in regular breast self-examination (BSE), with some expressing uncertainty about the importance of early detection. These findings align with previous studies such as those by Nwaneri et al. (2023) and Irurhe et al. (2024), which also reported that while awareness levels about breast cancer were high, the practice of BSE remained suboptimal among women in different settings.
Further analysis revealed that participants who had participated in awareness campaigns and received education on breast cancer had a better understanding of the importance of early detection and were more likely to engage in preventive practices. This supports the findings of George et al. (2019), who emphasized that education plays a crucial role in improving attitudes and practices related to breast cancer prevention. The study also highlighted the need for more comprehensive educational initiatives, as nearly 50% of participants expressed a belief that more information would encourage greater participation in breast cancer prevention measures.
A key insight from the study was that while the majority of participants believed breast cancer to be a preventable disease and recognized the importance of early detection, some students still held misconceptions, such as the belief that breast cancer primarily affects older women and not younger women like themselves. This misconception was reflected in their attitudes toward breast cancer prevention, with a sizable portion of participants indicating that they did not consider themselves at risk. These findings resonate with the work of Lokossou et al. (2024) and Nwaneri et al. (2023), who also noted similar misconceptions among women in different African contexts, where breast cancer is often perceived as a disease that affects older women and is less of a concern for younger women.
The study also investigated the relationship between educational exposure and students’ perception of breast cancer. Results indicated that those who had been exposed to breast cancer awareness campaigns were more likely to express concern about their risk of developing the disease. This finding is consistent with the results of Ramathuba et al. (2023), who found that education increased awareness and the likelihood of engaging in preventive measures among rural populations in South Africa. In particular, the study revealed that educational exposure not only increased awareness but also fostered a sense of responsibility among students, encouraging them to adopt healthier behaviours such as regular BSE and early screening.
In terms of the implications for nursing practice, the study emphasized the critical role that nursing professionals play in educating individuals about breast cancer prevention. Nurses, particularly those working in educational institutions and clinical settings, are in a prime position to influence attitudes and behaviours related to health promotion. By incorporating breast cancer education into their practice, nurses can empower individuals to take proactive steps in preventing the disease, such as engaging in self-examination and seeking regular medical check-ups. The study also highlighted the importance of integrating breast cancer awareness into the academic curriculum, particularly in nursing schools, to ensure that future healthcare professionals are equipped with the knowledge and skills to educate the broader community.
Additionally, the findings underscored the importance of designing targeted interventions that address common misconceptions and promote early detection practices. Given that many students still held misconceptions about breast cancer risk factors and prevention, nursing professionals should focus on delivering clear, evidence-based information that dispels myths and encourages preventive behaviour.
Conclusion
In conclusion, the results from the hypotheses tested indicate that there is a significant relationship between students’ awareness, attitudes, and practices regarding breast cancer prevention. The study found that the level of awareness about breast cancer among the participants was high, with most students recognizing the importance of early detection methods like breast self-examination (BSE). This aligns with previous studies, which also highlighted the critical role of awareness in influencing preventive practices.
The hypothesis testing further revealed that educational exposure plays a significant role in shaping students’ perceptions and behaviours towards breast cancer prevention. Students who had been exposed to educational campaigns were more likely to engage in preventive practices and perceive breast cancer as a serious health risk. These findings suggest that education is a powerful tool in altering attitudes and encouraging proactive health behaviours.
Moreover, the rejection of the null hypotheses confirms that attitudes toward breast cancer prevention and the likelihood of seeking early screening are strongly associated. Thus, the study emphasizes the need for continued educational interventions and awareness campaigns to enhance breast cancer prevention practices. Overall, the findings underscore the importance of integrating breast cancer education into academic settings to promote early detection and reduce the burden of the disease.
Recommendations
Based on the findings of this study, the following recommendations are made:
- Strengthen Awareness Campaigns in Educational Institutions: Given the significant role that awareness plays in influencing students’ attitudes and practices towards breast cancer prevention, it is crucial to enhance awareness campaigns in schools and universities. Educational programs should focus on the importance of early detection methods like breast self-examination (BSE) and clinical screenings, particularly targeting younger populations who may not perceive themselves at risk.
- Integrate Breast Cancer Education into Curricula: The study found that educational exposure significantly impacted students’ perceptions and practices regarding breast cancer prevention. Therefore, integrating breast cancer awareness into the regular curriculum, especially in health-related fields, would further equip students with the necessary knowledge and skills to detect the early signs of breast cancer and seek timely medical attention.
- Promote Regular Breast Self-Examination (BSE) Practices: The positive correlation between awareness and the practice of breast self-examination (BSE) suggests that more emphasis should be placed on teaching students the correct technique for performing BSE. Health professionals and educators should conduct practical workshops and provide materials on how to carry out BSE regularly.
- Increase the Availability of Screening Services: While awareness and education are vital, access to proper screening services is equally important. Universities and healthcare institutions should collaborate to offer affordable or free screening services for breast cancer, encouraging students and staff to take advantage of these services for early detection.
- Engage Students in Peer Education and Advocacy: Students who have been educated about breast cancer should be encouraged to share their knowledge with their peers. Peer education is an effective strategy for disseminating health information, as students are more likely to trust and engage with information shared by their fellow students. Peer-led workshops and discussions can help in creating a more health-conscious community.
Suggestions for Further Studies
For further studies, it is recommended to explore the impact of socio-economic factors and cultural beliefs on the awareness and practices related to breast cancer prevention across different regions, particularly in rural areas. Future research could also examine the effectiveness of various educational interventions, such as multimedia campaigns or peer-led programs, in improving breast cancer awareness and early detection behaviours. Additionally, longitudinal studies could be conducted to assess the long-term effects of breast cancer education on students’ health behaviours, including their follow-up actions after being educated on self-examination and screening. Research focusing on the barriers to seeking early screening and diagnosis, particularly among populations with limited healthcare access, would also be valuable. Finally, expanding the scope to include male students, as breast cancer awareness is often viewed as a women’s issue, could provide insights into their knowledge and perceptions, contributing to more inclusive health education programs.
References
- Â Isah, R. T., Mohammed, I., & Avwioro, O. G., et al. (2023). Breast cancer in men: A review of epidemiology, risk factors, diagnosis and prevention in Africa. Nigerian Biomedical Science Journal, 11, 13.
- Â Lokossou, M. S. H. S., Ogunjobi, O. M., & Tognifode, V., et al. (2024). Breast cancer prevention: Knowledge, attitudes and practices of women in hospitals environment in urban area of Southern Benin. Journal of Women’s Health Care, 7, 427.
-  George, T. O., Allo, T. A., & Amoo, E. O., et al. (2019). Knowledge and attitudes about breast cancer among women: A wake-up call in Nigeria. Open Access Macedonian Journal of Medical Sciences, 7(10), 1700–1705. https://doi.org/10.3889/oamjms.2019.221
-  Nwaneri, A., Osuala, E. O., & Okpala, P. U., et al. (2023). Knowledge and awareness of breast cancer among rural women in Umuowa Orlu Local Government Area, Imo State, South East, Nigeria. Nigerian Journal of Clinical Practice, 20, 489–494. https://doi.org/10.4103/1119-3077.204374
-  Neji, O. I., Esienumoh, E. E., & Kalu, U. V., et al. (2023). Breast cancer awareness and practice of breast self-examination among women in Adiabo community in Odukpani local government area of Cross River State, Nigeria. Clinical Nursing Studies, 4, 50–56.
