RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

MS. J.VIJAYAKALA

FIRST YEAR M.Sc (NURSING)

MEDICAL SURGICAL NURSING

YEAR 2008-2010.

THE KARNATAKA COLLEGE OF NURSING

NO. 12, KOGILU MAIN ROAD,

YELAHANKA, BANGALORE - 560064

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1.NAME OF THE CANDIDATE

AND ADDRESS

VIJAYAKALA. J

Ist YEAR M.Sc., NURSING STUDENT,

THE KARNATAKA COLLEGE OF

NURSING , NO.12, KOGILU MAIN

ROAD, YELAHANKA,BANGALORE,

KARNATAKA

2. NAME OF THE INSTITUTION

THE KARNATAKA COLLEGE OF

NURSING ,NO.12, KOGILU MAIN

ROAD, YELAHANKA,BANGALORE,

KARNATAKA

3. COURSES OF STUDY

FIRST YEAR M.SC

NURSING(MEDICAL SURGICAL

NSG)

4. DATE OF ADMISSION 01-07-2008

5. TITLE OF THE STUDY

A STUDY TO EVALUATE THE

EFFECTIVENESS OF A

STRUCTURED TEACHING

PROGRAMME ON BREAST SELF

EXAMINATION AMONG WOMEN

ADMITTED IN FEMALE MEDICAL

WARD HINDUJA SINDHI HOSPITAL

- BANGALORE

6. BRIEF RESUME OF THE INTENDED WORK:-

6.1. INTRODUCTION

Every year we celebrate the women’s International Day, inspiring the women of

today to stride a head in life. While women have made progress in most off the field but

still her tends to in inexplicably neglect her own health.

BLACK(1997) defines breast cancer as a group of malignant disease that

commonly occurs in the female breast and infrequently in the male breast.

The cause of breast cancer is unknown. The risk factors are obesity, null parity,

high intake of fatty diet, and hormonal drugs, genetics, early menarche below the age of

11 years and late menopause. The mean age of occurrence of cancer in India women in

42 years as cared to 53 years in white women and it is leading cause of death among

middle aged when (Drakshyani devi, 1994).

World wide, 1.05 million new cases have been reported in the year 2001. (ICMR

Bulletin 2003). The incidence rate of breast cancer for Urban Indian Women is 18 to

25/1,00,000 where as for India Rural Women it is 8.6 per lakh. Due to lack of awareness

and poverty, even after knowledge of the presence of breast lump, the patient comes very

late for treatment (Dr.B.C Bakance, 2002). In India 80,000 new cases are detected every

year (K.K. Singh, 2003).

The primary health care which is a key to achieve the goal of health for all 2000

A.D included indigenous system of medicine as an important element. The national

health plan have consistently emphasized on the importance of maternal and child health.

There is a need for developing new or improved method through systematic

investigations of traditional system of medicine I order to optimize the use of available

resources.

More over Indian is developing county, 60% are women are considering to the

low and middle class family. Now a days cost of care is high. So “Prevention is better

than cure”. One ounce prevention is better than tones of cure.

At present simple, inexpensive, and early implant for the detection of breast

cancer is breast self examination. It is one of simplest and important health programmers

to promote early detection. Regular breast self examination can identify any abnormal

changes in breast to establish good prognosis.

6.2. NEED FOR THE STUDY

Breast cancer is the second commonest cancer in women in India, next to cancer

of cervix early diagnosis affords a better chance of survival and better prognosis several

methods are available for early diagnosis. Which give good results in early cancer stages?

This makes breast cancer a major problem requiring intensive health awareness

campaign and screening and detection prognosis. The most cost effective and long lasting

programme would be to teach women themselves and to motivate them to participate in

detection

In 2003, current guidelines accepted by the American College of Radiology,

American cancer society, National Cancer institute regarding breast surveillance practices

includes the following:-

Monthly breast self examination from the age of 20 years.

Physical examination of the breast by a trained health professional clinical breast

examination every 3 years between age 20 and 40 and every year these after.

Screening mammography for symptomatic women between the ages of 40 and 49

every year and mammography once or twice annually for women 50 years of age

and older.

So that health Institutions are publishing and announcing a but breast cancer,

causes, risk factors, early diagnosis, prevention and procedure of breast self examination,

due to some reasons like lack of confidence, lack of time, inability to examine, alleged

complexity of the procedure forgetfulness fear of the possible discovery of a lump and

embarrassment, associated with manipulation of breast. The women should be told what

to look for while performing a breast self examination such as lump, nipple discharges

nipple retraction, redness, pain or tenderness dimpling of the skin or oedema. Finally the

women should be reminded that most breast problems are not related to malignancy and

they should be advises to reduce anxiety. As stated “ All guilty is not gold, and all the

breast problems are not related to breast cancer”

In the year 2000, the largest every gathering of heads of state in the United

Nations in New York, USA adopted the UN millennium Declaration two of 8 millennium

developmental goals are related to improving maternal health respectively, pointing to the

importance of these health factor in global development and poverty reduction.

The WHO, the International confederation of midwives and the FIGO are pleased

to see the inclusion in the MDGs of the target to reduce by 3/4 th between 1990 and 2015,

the maternal mortality ration. This inclusion is the result of many years of advocacy for

the need to recognize the link between maternal health and development.

Dr. NIMMAGAD says, is that dreaded through the cancer may be, it is important

for patients to understand that various treatment options are available. In fact, scores of

women have overcome breast cancer to lead successful lives. Doctor recommended that

regular self breast examination after the age of 30 in necessary.

SHARON Mc DONALD evidence suggests that, for some women, DBE can be

an important complement to mammography in the earlier detection of breast cancer.

Mamma care method explained in greater proficiency in carrying out BSE, as

measure by execution of BSE components, and in higher sensitivity, as measured by

lump detection. It will helpful to avoid biopsies, medical visits, and it will assist to reduce

the stress for mothers.

SASLOW, 2005 suggest the performing breast self examination correctly is

important women’s who want to perform self examinations should ask their health care

provider to demonstrate how to do it and how to tell the difference between normal tissue

and suspicious lumps.

Now a day, women’s education is more emphasized and people are more aware

about the health problems and health facilities. It is necessary, to develop a feeling of self

confidence and self satisfaction in the individual in the handling of minor health

problems and how to do breast self examination.

Women are key group to target with health information and training programme

for the following reasons:

Firstly they themselves are risk and in need of information

Secondly. They are the source of information. So that assessment of breast cancer

becomes a part of health announcement in reproductive health lessons.

The investigator took this study to draw some implications. The findings of the

study will be useful for future students in dealing and understanding the importance of

breast self examination.

No study has been done so for on the impact of an admission of mothers in the

female medical ward, area hospital, Madanapalle. In this context in order to improve

holistic care it is essential to gain insights into factor influencing to do BSE.

Therefore the investigator feels that nurses have an educational role concerning

breast lesions. By allowing clients to take about breast cancer, correcting these

misconceptions and supplying accurate fact, nurses can reduce associated fear, anxiety

and create awareness. Women may then seek earlier assessment diagnosis and effective

treatment.

6.3 STATEMENT OF THE PROBLEM:-

“A study to evaluate the effectiveness of a structured teaching progrmme on

breast self examination among women admitted in female medical word, Hinduja Sindhi

Hospital - Bangalore

6.4 OBJECTIVES

To assess the knowledge of Breast self examination among women.

To educate women regarding Breast self examination.

To evaluate women after giving planned health teaching regarding Breast self

examination.

To find out the relation between selected variables and pre-test and post-test

knowledge.

6.5. OPERATIONAL DEFINITIONS

EVALUATE.

Expected outcome of planned health teaching Breast self examination among

women.

STRUCTURED TEACHING PROGRAMME

Referred to systematically planned teaching strategy designed to provide

information regarding Brest Self Examination.

BREST SELF EXAMINATION

A technique that all women can use to assess their own breast.

SELECTED VARIABLES OF THE WOMEN

Name, age, religion, place, educational status, address, marital status.

6.6 ASSUMPTIONS

It is assumed that the women will have knowledge on Breast Self Examination.

It is assumed that planned health teaching will improve the knowledge of

women’s regarding Brest self examination.

It is assumed that women selected for study will co-opearate and respond

appropriately before and after structured teaching programme regarding Breast

self examination.

It is assumed that the tool prepared by the investigator will gather reliable and

valid data for the study.

6.7 RESEARCH HYPOTHESIS:

H1= The mean post – test knowledge score of mothers on breast self examination

will be significantly higher than the mean pre – test knowledge scores as evident.

6.8 REVIEW OF LITERATURE.

The review of literature of the present study is organized under the following

headings.

According to Indian National Cancer Registry report of 1987, it was estimated

that one in nine Indian women will get breast cancer as comported to one in three women

in U.S.A

M.K. TISH KNOFB, RN,MSN, 2004 is a clinical oncologist, in his study he

stated that the incidence of breast cancer in men is about one percent of that in women

and accounts for 0.2% of male cancers. It is usually diagnosed at a more advanced stage

but the pathology, pattern of metastasis and prognosis are similar to women.

The National Cancer Institute and American cancer society recommended annual

mammograms for asymptomatic women over 50 years or over 40 if here is family history

of breast cancer or if the woman has ha breast cancer before.

MAN OF SHARMA, 2004 in his study stated about cancer detection in that, a

through breast examination is always done with the patient in the erect and supine

position and with full relaxation of the patients shoulder and pectoral muscles.

SUSAN ALBRECHT, RUTH ANN MILLER, 2005 in their pilot study of 138

women with mastectomies that explored the consistent finding of more left breast cancer

in American women.

DILIP ROY, 2005, in his study state that malignancies of breast in highest in

women in U.K and U.S.A and other western countries where as in India carcinoma of

female genital tract has highest incidence.

LUCKMANN & SORENSON, 2005, in his study explained that, breast cancer is

the leading cause of death in women between ages 39 to 44, it is also the leading cause of

cancer deaths in women between ages 35 to 74.

R.K.BHADURI, 2006 written new soviet theory about origin of cancer, in that he

stated that the disease develops under the influence of various physical and chemical

agents known as carcinogens.

PARAMESH KUMARKAR, M.D., d.g.o., Ph.D., 2006 in his study stated that,

the incidence of breast cancer is increasing world over. There is 2-3 fold increase in the

risk of breast cancer amongst the first degree relatives of the patient with the cancer in the

breast.

Breast cancer frequently metastasizes in the auxiliary nodes; metastasis

involvement of the mammary nodes info great importance as a prognostic factor. Many

breast cancer patients who remain disease free after initial treatment, eventually relapse

have recurrence of the disease and die of metastases;

J.E.DUFFY & R.CLYNN OWENS, 2004 the present findings indicate that

attempts to encourage self examination of breast are only moderately successful and even

its use is not necessarily strongly indicative of promptness of presentation. More over, it

is clear that not only are many women ignorant regarding the facts of breast cancer and

its treatment. In addition the findings suggest that wider knowledge of the availably of

breast conversation treatment could not only improve promptness and decrease anxiety in

women in general and particularly ion increasing women’s knowledge of available breast

conversation treatments.

Dr. EMENS in currently (2007) conducting a clinical study that integrates a cell-

based breast cancer vaccine with low, immune-modulating doses of chemotherapy in

patients with metastasis breast cancer. The study is designed to use low dose

chemotherapy to step away suppressive immune cells that help tumors to grow and

spread, and replace them with vaccine – induced immune cells that are activated to seek

out and destroy breast cancer cells. This should ultimately shrink existing breast tumors,

and prevent others from forming. She will soon begin another clinical study that adds

chemotherapy-modulated vaccination to standard Trastuzumb (Herceptin) therapy for

patients with metastatic brest cancer that expresses high levels of the HER-2/nue also

takes advantage of the ability of Trastuzumab to further increase the numbers of activated

immune cells that fight breast cancer. Dr.Emern is also investigating immune based

therapies that target not only the malignant breast cancer cells, but also the tumor-

associated blood vessels that support breast cancer growth and progression. These studies

are all designed to strategically integrate breast cancer vaccines with standard and novel

breast cancer drugs to achieve the greatest therapeutic impact, and to reveal not only that

they work, but also how they work. This research should pave the way for breast cancer

vaccines to become a unique but standard part of breast cancer treatment, and ultimately

breast cancer prevention.

No inherited (somatic) mutations also have been identified in breast tumors. For

example, somatic mutations in the ERBB2 (also called Her -2/neu), DIRAS3, and TP53

genes have been associated with some cases of breast cancer. Susan Orel, M.D. 2006

advised “The biggest misconception about mammography is that is picks up every breast

cancer. In fact, mammography misses at least 10 percent of breast cancer. So if you feel a

lump that doesn’t show up on a mammogram, bring it to your doctor’s attention. Get it

evaluated”.

In 2007 American cancer research centre suggests that inherited variants of the

ATM, BARDI, BRIP1, CHECK2, NBN, PALB2, RAD50, and RAD51 genes, as well as

certain versions of the AR gene, may also be associated with breast cancer risk. Ot all

studies have shown these connections, however. Of these genes, ATM and CHEK2 have

the strongest evidence of being related to the risk of developing breast cancer.

CHICAGO (AFP) 2005 – Researchers have identified a new target for drugs to

help treat the most common form of breast cancer in the developing world, a study

released Thursday said, the target is a molecular “switch” in the protein – making

machinery of the cancer cell that enables a tumor to aggressively develop its won blood

supply. Women with what is called locally advanced breast cancer can develop tumors

that grow anywhere from 2 centimeters to 10 centimeters in diameter.

2006 according to the Deserved Health website, one of the most effective

breast cancer awareness programs is the breast cancer walk which is a Breast Cancer 3

Day benefit. The fund raising program is participated by men and women who want to

make a difference in the lives of these breast cancer victims. The program involves 60

miles of walking and is participated by millions of people nationwide. It is a chance for

the participants to learn about cancer and at the same time help in promoting awareness.

Medicines to reduce Breast cancer Risk center 2006 in US Results suggest

that selective estrogen receptor modulators (SERMs) such as tamoxifen and raloxifence

may lower breast cancer risk in women with certain breast cancer risk factors. But so far,

most women are reluctant to take these medications because of concern about possible

side effects.

K.K.SINGH et. al., (2003), carried out pre-experimental study on awareness

regarding Breast Self Examination among 30 school teachers at Sawing. The findings

that in Pre-test, 33.33 percent of teacher’s ad knowledge on Brest Self Examination and

66.67% teachers did not have any knowledge regarding Breast Self examination. In post

test 96.67% had gained knowledge regarding Breast Self Examination. It indicated that

information will be effective in improving awareness and practice.

Pratima Chatterjee (2202) conducted pre-experimental study on 30 G.N.M

students in West Bengal regarding breast cancer and BSE to assess the effects of planned

teaching programme. The finding reveals that knowledge mean scores in pre test were

26.23. in post test mean was 73.66. mean gain was 47.43, ability scores in pretest man

was 0, Post test mean was 21.5 and sum of square deviation 31.5 It suggested that there

was a significant on breast cancer and Breast self examination.

Ladwick R.Gaczkowski T. (2001) carried pre-experimental study on

breast self examination to identify the belief knowledge and practice of breast self

examination in adolescent girls. The study results reveals that in pre test 66 percent said

that they never examined their breast, and 3 percent had performed breast self

examination and 32 percent never practiced breast self examination monthly. The result

of this study demonstrates that a one time intervention can be successful in increasing

breast self examination practice and knowledge of breast self examination and cancer in

adolescents.

Milaat W.A (2000), conducted a descriptive survey among 6380 female

secondary students with mean age of 18 years to identify their knowledge of breast

cancer and attitudes towards breast self examination. The findings of the study were that

over 80 percent students failed to answer 50 percent of the questions correctly. Only 39.6

percent reported ever-hearing of breast self examination and only 14.4 percent and 7.1

percent respectively know the correct frequency and timing, 82.4 percent had positive

attitude towards learning breast self examination.

Choudhary U.K et al., 1998) conducted descriptive study on knowledge, attitude,

and beliefs on breast cancer detection practice among 57 South Asian Women. The

findings revealed that 13% practiced Breast Self Examination monthly, 49% had

undergone clinical breast Examination and 46% had never had mammography. The

majority 54% said they did not know very much about breast cancer, 21% opined that

early detection of cancer was important. They reported 5% that cancer could cured early,

had no statically significant relationship with the breast health practice scores.

JEBBIN N.J. ADOTEY J.M. (2004), conducted a study on Attitudes to

knowledge and practice of Breast Self Examination among 200 women in Port Harcourt.

Their responses were then collected and analyses; 98% had formal education, 85.5% of

then had heard of Breast self examination but 39.0% practiced Breast self examination

only occasionally, 24.0% did not practice. Most of women aware of breast self

examination and its usefulness never practice it. It suggests that there is a need for

vigorous health education programme for women. It was hoped this will help to reduce

the morbidity and mortality associated with Carcinoma of breast.

Lecy, Kim H.S, et, at., (2003) conducted a quasi- experimental study on

evaluation of a community based programme for Breast Self examination among 1997

community nurse practitioners in Korea. The results of study reveals 30.5% of women in

the intervention group performed regular Breast Self Examination compared to 10.2% in

control group. The mean knowledge score related to Breast cancer and Breast self

examination was significantly higher for the women in the intervention group than in

control group.

Haji-Mahmoodi, M.Montazeri A.(2002) conducted study on breast self

examination among 410 female health care workers from seven health centers in Tehran,

Iran. Most 58% were married 75% of the women knew about breast cancer and

prevalence 63% percent of the respondents claimed that they know how to examine their

breast, but only 6% performed breast self examination monthly. The practice of breast

self examination monthly. The practice of breast self examination was significantly

associated with are, level of education, personal history of breast problems and

knowledge of how to examine the breast. The study finding suggest that the knowledge

and behavior of female health workers concerning Breast Cancer is relatively poor and it

needs to be information about Breast Self Examination.

Madnat H, Merrill R>M (2002) did survey method study on breast cancer risk

factor and screening of health and human performance among 163 nurses, 178 teachers in

Brighten Young University. The findings of study nurses were more aware than teachers

of the importance of breast cancer screening and its techniques mean screening awareness

score for nurses was 88.3% compared with 73.1% for teachers. These results prove

important information about the level of breast cancer awareness among women nurses

and teachers in Jordan and may be useful for developing future prevention and screening

education programme.

Wood R.Y, Duffy M.E, et, al., (2002) conducted quasi-experimental pre-test and

post-test design study among 328 African American and Caucasian Women on the effect

of an educational intervention aged 60 or older, on effect of an educational intervention

aged 60 or older, on effect of an educational intervention on promoting Breast Self

examination. Pre-test and post test interviews conducted by nurses at two-week intervals;

statistically significant differences in outcome variables between the intervention and

control group. The findings reveal statistically significant differences in outcome

variables between the intervention and control groups.

Sadler G.R., et, al., (2201) conducted descriptive study on 194 Asian Indian

Women; knowledge attitude and behaviors towards breast cancer early detection.

Monthly breast self examination adherence was own only 40.7 percent, 61.3 percent of

women 40 and older, and 70 percent of women 50 and older. The majority of these

women reported that their breast cancer knowledge was inadequate.

Clark JK, Sauter M, et, al., (2000), conducted quasi-experimental study on

knowledge land attitude towards breast self examination among 137 adolescent girls. The

findings suggest that one hour lesson can improve knowledge and attitudes of adolescent

girls with respect to breast self examination and early cancer detection.

7. METHODS AND MATERIAL

7.1 SOURCES OF DATA

Women’s admitted in female medical ward in Hinduja Sindhi Hospital Bangalore

7.2 METHODS OF DATA COLLECTION

I. RESEARCH DESIGN

The research design in the plan for the study providing the overall framework for

collecting data. Polit & hungler stated that a research design incorporates the most

important methodological decisions that a researcher in the selection of subjects for

interviewing and determines the type of analysis to be used. Design depends upon the

purpose of the study and the condition under which the study in conducted. The study

was evaluate the effectiveness of structured teaching programme on breast self

examination of women in female medical ward. The descriptive design was selected

since it aided in attaining first hand information and enhanced obtaining accurate and

meaningful data.

II. RESEARCH VARIABLE

There are independent variable and dependent variables are used.

Independent – Structure teaching program on Breast self examination

Dependent variables demographic data.

III. POPULATION

According to Polit & Hungler a population comprises of entire set of individuals

having some common characteristics. The populations of the study comprised of the

women’s admitted in female medical ward in Hinduja Sindhi Hospital Bangalore.

IV. SETTING

The pre-test study to be conduct in Female medical ward Hinduja Sindhi Hospital

Bangalore. The Hinduja Sindhi Hospital is having the bed strength of 100. the female

medical ward has total sanction bed strength of 20. The average nurse patient ratio is 1:10

V. SAMPLE

The present study comprised of 50 women who are admitted in female medical

ward.

VI. CRITERIA FOR SAMPLE SELECTION

INCLUSION CRITERIA

The women

- who are admitted in female medical ward between 1 to 7 days

- who ere available at the setting to conduct post test.

EXCLUSION CRITERIA :

The women who

- are not willing to participate in the study

- has previous diagnosis of psychiatric disorder

VII. SAMPLE TECHNIQUE

Purposive sampling technique used for this study.

VIII. TOOLS FOR DATA COLLECTION

Structured questionnaire and Planned Health Teaching Programme are developed

with the help of related literature from various text books, journals and discussion with

the experts in the field of Oncology, Obstetrics and Gynecology and Nursing.

Section A: Consisted of demographic data of the women such as name, age,

religion, educational status and marital status.

Section B: dealt with Anatomy and Physiology of breast.

Section C: Contained their knowledge on breast cancer.

Section D: dealt with knowledge on breast self examination.

Section E: consist of prevention of breast cancer

IX. METHODS OF DATA COLLECTION

DURATION OF STUDY

One month used for the study

X. PLAN FOR DATA ANALYSIS

It consist of inferential and descriptive data analysis

XI. PROJECTED OUTCOME

The result of the study will determine the existing knowledge of women on breast

self examination and practice of important it also gives insight to teach women about

preventive measures.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN

BEINGS OR ANIMALS?

The study in conducted on Breast Self Examination Among Women Admitted In

female ward Hinduja Sindhi Hospital Bangalore, are not involved in any invasive

investigation or interventions.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM THE CONCERNED

AUTHORITY OF THE HOSPITALS TO CONDUCT THE STUDY?

Yes, prior permission will be obtained from the concerned authority of the

hospitals to conduct the study. The purpose of the study will be explained to the women

in Hinduja Sindhi Hospital confidentiality, privacy and anonymity will be assured to the

women.

8. LIST OF REFERENCES

1. Basavathappa B.T, “Nursing Research” 1st edition., New Delhi, Jayapee Brothers

Meducal Publishers (p) LTd., 1998, 224-227.

2. Diskson, Silverman, Kalan, “Maternal – Infant Nursing Care”. 3rd edition. New

Delhi; MOsby Printers 1994,64,65 and 75.

3. Francine H.Nichols, Elaine Zwelling, “Maternal Newborn Nursing Theory and

practice” 1st edition, 1997, 100-120

4. Gerard J.Tortora., “Principles of Anatormy and Physiology” 8th edition New

York; Herper Collins Copllege Publishers 1996,935-936.

5. Inderbir Singh., “Natomy and physiology for nurses”. 1st edition New Delhi;

jaypee brothers, medical publishers(p) LTd., 2005 285-286.

6. Joyce. M.Black and esther matassarin, Jacobs., “Luchmann and sorensesn’s

Medical surgical nursing” 4th edition. Philadelpohia; W.B. Saunders Company,

1993 2055-2061,491,492.

7. Kasper Braunwadl, l fuci., “harrison’s principles of internal medicine” 16th edition

vol.ii, new year; Me graw-? Ill companies.

8. Lippoincott,1991, ‘The lipopincott manual of nursing practice” 5th edition. New

York; J.B. Lippincott company, Philadelphia, 2005 27-28.MC Quiston web.,

“Forundations of nursing theory” California; sage publication. 1995 41-80/

9. Park K.., “Test book of preventive and social medicine” 16th edition. New Delhi

jaypee brothers. 2000 289-291.

10. Polit F.Densive and Hunger. “a text book of nursing research principles and

methods” 4th edition. Philadelphia; Jaypee Brothers Lilppincott company. 196-

219.

11. Studd. “Progress in obsetrics and gynecology” vol.7., New York; Churchill living

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medical and surgical nursing” 7th edition. New York, Lippincott william’s

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13. Alsaif A.A., “Breast Self Examination among Saudi Female nursing students in

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JOURNALS

1. Dr.K.K.Singh., “Awareness regarding Breast Self Examination in school teacher

effect of Health education Programme”. The Indian Journal of Nursing and

Midwifery Vol.6 September 2003, 52-57.

2. Drakshyani Devi. K., “Teacher’s knowledge and practice of Breast Self

Examination”. Indian Journal of Medical Sciences. Vol. 45. No-12 December

1994,284-287.

3. Dr.Be Bakane., “Rehabilitating breast cancer patients” Health Action March,

2002, 24.

4. Fung SY., “Factors associated with Breast Self Examination behavior among

earliler women in Hong Kong” Patient Education counseling Vol.33 No-3, March

1998,233-243.

5. Goergia Robina Sadler et. Al.., “Chinese women Behaviours and attitudes

towards Breast Caner education and screening”. Women’s Health Issues vol. 10.

No-1, February 2000, 20-23.

6. Jebbin NJ. “Attitudes to knowledge and practice of Breast Self Examination in

port Harcourt”. Niger Journal Medicine. Vol. 13 No-2, April 2004, 166-170.

7. K.S Bairwa., “ A study to develop and evaluate the effectiveness of an

information booklet on cancer risk” Nursing Journals of India. Vol. LXXXIII,

No.1 10 October 2002, 227-228.

WEBSITE

Budden@jcu.edu.au

zylu@um.edu.tw

jclark@gw.bsu.edu

woodr@bc.edu

gasalbde@shu.edu

cylee@yumc.yonsei.ac.kr.

jaz@cast.sdu.dk

bobbie@siu.edu.

9. SIGNATURE OF THE CANDIDATE :

10.REMARKS OF THE GUIDE :THIS TOPIC IS RELAVANT TO

THE STUDY

11.NAME AND DESIGNATION OF :

11.1 GUIDE :MRS.LAKSHMI PRIYA,

PROFESSOR, THE KARNATAKA COLLEGE OF NURSING

11.2 SIGNATURE :

11.3 CO – GUIDE :MRS.THANUJA, THE

KARNATAKA COLLEGE OF NURSING

11.4 SIGNATURE :

11.5 HEAD OF THE DEPARTMENT :MRS.LAKSHMI PRIYA,

PROFESSOR, THE KARNATAKA COLLEGE OF NURSING

11.6 SIGNATURE :

12.1 REMARKS OF THE PRINCIPAL :THE RESEARCH TOPIC

SELECTED IS APPROPRIATE TO THE STUDY

12.2 SIGNATURE :