PATTERNS AND PREDICTORS OF MAMMOGRAPHY USE AS A BREAST CANCER SCREENING SERVICE AMONG FEMALE NURSES IN UNIVERSITY COLLEGE HOSPITAL IBADAN

Abstract

Screening mammogram is a medical procedure used for the early diagnosis and treatment of breast cancer, the commonest malignant neoplasm among women. Nurses are involved in creating a supportive environment, interacting, with patients and their relations and providing patient education about mammogram. However, to perform these roles efficiently, nurses should have experiential knowledge and positive dispositions towards its utilisation; hence this study assessed pattern and predictors of mammography use for breast cancer screening by female nurses in University College Hospital (UCH), Ibadan. This was a cross-sectional study. A three-stage random sampling technique was used to select a total of 319 consenting female nurses from 14 units of the hospital. A validated, interviewer-administered questionnaire was used to elicit information on socio-demographic characteristics, knowledge of breast cancer and its risk factors measured on the scale of 19 points, personal risk to breast cancer, knowledge of mammography measured on the scale of 11 points and level of utilisation of mammography services. Knowledge of breast cancer and its risk factors was categorised as good (≥ 14 points), fair (9 to 13 points) and poor (≤8 points while knowledge of mammography was categorised as good (≥ 8 points) fair (5-7 points) and poor (≤14 points). Data were analysed using descriptive statistics, Chi-square and logistic regression model at p=0.05. Age of respondents was 31.9± 7.8 years, 68.0% were registered nurses/midwives, 89.7% were Yoruba. 88.4% were married and 72.1% had more than 5 years work experience. Most (99.4%) had heard about breast cancer, 45.8% defined it as abnormal growth of the breast cell and 85.6% had managed a patient with the condition. Knowledge score of breast cancer and its risk factors was 10. 2±12.9 and only 12.9% had good knowledge. Only 1.9% claimed to have a family member that had been diagnosed with breast cancer and 5.0% had any breast changes in the last three months. Majority (98.7%) heard about breast cancer screening and 43.3% defined mammography as radiological examination of the breast. Mammography knowledge score was 4.8±3.0 and only 20.4% had good knowledge of mammography. Respondents that had poor knowledge of breast cancer and its risk factors were four times more likely to also have poor knowledge of mammography (OR:4.3; CI:1.5-12.4). Only 4.7% had ever had a screening mammogram. Among mammography utilsers, 77.8% were Christians and 47.1% had work experience of 21-25 years while 25.1% believed they can never come down with cancer. Having no breast complain (11.7%) was the main reason for never having a mammogram; 60.8% would want to utilise mammography in the future and 4.9% for screening purpose. The nurses had poor knowledge of breast cancer and mammography utilisation. Work experience of at least twenty-one years played a positive role in predicting utilisation, though utilisers were quite few. Pre and in-service training of nurses on breast cancer can enhance utilisation of mammography.