A Pre-Experimental Study to Assess the Effectiveness of Structured Teaching Programme regarding Breast Self-Examination among Nursing students of Saraswati Nursing Institute, Dhianpura, Kurali (2025)
Sonali, Ritu Choudhary
Assistant Professor, Saraswati Nursing Institute, Dhianpura, Roopnagar, Punjab, India.
*Corresponding Author E-mail: jerinjosephjr@gmail.com
ABSTRACT:
A breast self-exam is an early detection tool that uses a combination of physical and visual examinations of the breasts to check for signs and symptoms of breast cancer. The purpose of a breast self-exam is to become familiar with the way your breasts normally look and feel. Knowing how your breasts normally look and feel, also called breast self-awareness, will help you identify any changes or abnormalities in your breasts, such as a new lump or skin changes. Any changes in your breasts discovered during a breast self-exam should be reported to your healthcare provider right away. “A pre-experimental study to assess the effectiveness of structured teaching programme regarding breast self-examination among nursing students of Saraswati Nursing Institute, Dhianpura, Kurali”. To assess the pre- test level of knowledge regarding breast self examination among nursing students. To develop and implement structured teaching programme regarding Breast self-examination. To assess post -test level of knowledge regarding Breast self-examination among nursing students. To compare pre- test and post-test level of knowledge regarding breast self-examination. To find out association between post -test knowledge score with their selected socio demographic variables. Raising the level of knowledge regarding Breast self-examination among nursing students. Promotion of STP include various determinants regarding Breast self-examination. A preexperimental design and pre-test and post-test design was used to find out the effectiveness of Structured Teaching Programme. Total 100 subjects were selected by convenient sampling technique. Structured Teaching Programme developed by the investigator was implemented after 7 days post-test was conducted. Descriptive and inferential statistics was used for data analysis. The results revealed that more than half of the subjects 60(60%) were in the age group of 19-20years. Pre-test knowledge score of the subjects (18.76±3.585) and post-test knowledge scores of the subjects (21.47±2.732) was observed. Hence, the knowledge score significantly increased following the implementation of the "Structured Teaching Programme". The findings also revealed that there was no significant association between socio-demographic variables and pre and post-test.
KEYWORDS: Effectiveness, Knowledge, Structured Teaching Programme, Breast self-examination, Students.
INTRODUCTION:
“The silence around breast cancer isn’t just in the body; it’s in the mind, in the culture, in the conversations that never happen.” – Unknown One of the biggest threats to the community nowadays seems to be cancer. Cancer is the second leading cause of mortality globally and India ranks highest in number of estimated breast cancer deaths (98,337) for the year 2022 among females.1
An estimated 310,720 new cases of invasive breast cancer would be identified in India in 2024. One non-communicable disease that has a major impact on overall mortality is cancer. Medical professionals are now compelled to concentrate on cancer prevention and therapy due to the increasing frequency of cancer. Invasive breast cancer is predicted to affect 310,720 Indian women by 2024. This is roughly one out of every 28 women. In India, the 5-year breast cancer survival rate was 66.4% in 2023. Nonetheless, survival rates differ around the nation. The World Cancer Research Fund estimates that in 2022, India had the highest number of women’s breast cancer deaths (98,337 deaths) and the highest number of new cases (192,020 new diagnoses), making it one of the nations with the highest incidence of breast cancer worldwide.2
The primary function of the “breast,” a mammary gland on the chest that is primarily made up of fatty tissue, glandular tissue (lobules), and connective tissue, is to produce and secrete milk for lactation in females. It includes visible structures such as the nipple and areola, as well as internal milk ducts that transport milk from the lobules to the nipple, while the underlying tissue extends into the axilla as the “tail of Spence.”3
PROBLEM STATEMENT:
A Pre-Experimental Study to Assess the Effectiveness of Structured Teaching ProgrammeRegarding Breast Self-Examination Among Nursing Students of Saraswati Nursing Institute, Dhianpura, Kurali (2025).
OBJECTIVES:
· To assess the pre-test level of knowledge regarding breast self-examination among nursing students.
· To develop and implement structured teaching programme regarding Breast self examination.
· To assess post-test level of knowledge regarding Breast self-examination among nursing students.
· To compare pre-test and post-test level of knowledge regarding breast self examination.
· To find out association between post-test knowledge score with their selected socio demographic variables.
METHODOLOGY:
Research Apprroach:
Quantitative approach.
Research Design:
Pre experimental; one group pre-test post-test design.
Setting of The Study:
The study was conducted in the Saraswati Nursing Institute, Dhianpura, Kurali, Punjab.
Population:
Undergraduate nursing students of Saraswati Nursing Institute, Dhianpura, Kurali.
Target Population:
The target population was BSc nursing 1st sem and BSC nursing 2nd sem students of Saraswati Nursing Institute, Dhianpura, Kurali, Punjab.
Sample and Sampling Technique:
Convenient sampling technique was used to select the sample from BSc 1st Sem and B.SC nursing 2nd Sem students.
Sample Size:
The sample size of 100 students of BSc nursing 1st sem and BSC nursing 2nd sem of Saraswati Nursing Institute, Dhianpura, Distt Kurali, Punjab.
Sampling Criteria:
Inclusion Criteria:
· Students of BSc nursing 1st semester and B. Sc nursing 2nd semester.
· Students who are willing to participate in the study.
· Students who are the present at the time data collection.
Exclusion Criteria:
· Students who were absent during either the pre-test or post-test.
· Students who had already participated in a similar study earlier.
Variables:
Independent Variables: Structured Teaching Programme
Dependent Variables: Knowledge of selected students of Saraswati Nursing Institute regarding Breast Self- Examination
Development and Descriptive Tools:
The tool was developed by referring books, articles, journals, websites and guidance of guide, co-guide and experts.
Tool 1: Socio- Demographic Variables:
Socio- demographic variables, this data includes variables which were the attribute an characteristic of study. These were – Age, Gender, Class, Religion, Age of menarche, educational status of mother, Occupational status of mother, Source of information, previously attended any seminar.
Tool 2: Self- Structured questionnaire to assess the knowledge
This tool consists of 30 questions to assess the knowledge of nursing students regarding Breast self- examination. Each correct responds was assign score 1 and incorrect responds was assign score 0. The criterion measures was made for assessing the knowledge regarding breast self examination among nursing students. Total 30 marks questionnaire was prepared by the investigators with 30 items, in which each question is having its 4 sub parts among which only one answer was corrected and each answer is awarded with one marks if right response was given by respondent otherwise for each wrong answer 0 marks was given.
Scoring Key for Level of Knowledge:
Level of Knowledge Scoring Range:
Poor Knowledge 0-15
Average Knowledge 16-22
Good Knowledge 23-30
Content validity:
The Content validity of tools was determined by experts, opinion for the relevancy of the items. These experts were from the field of nursing. The suggestion were incorporated after consultation with the research supervisor. The structured knowledge questionnaire was finalized with 30 items to assess the knowledge of nursing students regarding breast self examination.
Pilot Study:
Pilot study was carried out in order to assess and test the research element. The pilot study was conducted in the month of December 2025 to identify the reliability and feasibility of the main study. Pilot study was conducted on 10 subjects at Saraswati Nursing Institute Dhianpura Kurali. The written permission was taken from principal, Saraswati Nursing Institute Dhianpura, Kurali to conduct pilot study. The time taken by each respondent was 20-30 minutes. The data was collected by using self- structured knowledge questionnaire. The descriptive and inferential statistics were used for analysis of the data taken for pilot study.
Reliability of Tool:
Reliability is a degree of consistency or dependability with which an instrument measures the attributes. The internal consistency of the tool was observed. The reliability of tool 0.757 was calculated by using Karl Pearson Correlation Coefficient. Hence the tool was highly reliable.
Analysis of Data:
Analysis and interpretations of data was done according to the objectives using descriptive and inferential statistics.
Table No.1: Frequency and Percentage Distribution Among Nursing Students According to Their Socio-Demographic Variables. N=100
|
Variables |
f (%) |
|
Age: 17–18 years |
23(23%) |
|
19–20 years |
60(60%) |
|
21–22 years |
17(17%) |
|
Above 22 years |
0 |
|
Class: B.Sc. Nursing 1st semester |
52(52%) |
|
B.Sc. Nursing 2nd semester |
48(48%) |
|
Religion: Hindu |
27(27%) |
|
Muslim |
6(6%) |
|
Sikh |
66(66%) |
|
Christian |
1(1%) |
|
Family History of Breast Cancer: Yes |
10(10%) |
|
No |
90(90%) |
|
Age at Menarche: 9–10 years |
0 |
|
10–11 years |
7(7%) |
|
12–13 years |
68(68%) |
|
Above 14 years |
25(25%) |
|
Mother's Education Status: No formal education |
5(5%) |
|
Secondary |
65(65%) |
|
Graduate |
20(20%) |
|
Post graduate |
10(10%) |
|
Mother's Occupation: Homemaker |
88(88%) |
|
Health sector |
2(2%) |
|
Business |
5(5%) |
|
Other |
5(5%) |
|
Attended Educational Program on BSE: Yes |
42(42%) |
|
No |
58(58%) |
|
Source of Information: Mass media |
49(49%) |
|
Health personnels |
17(17%) |
|
Peer group / Friends |
24(24%) |
|
Family members / Relatives |
10(10%) |
Table No.2: Frequency and percentage distribution as per pre-test knowledge regarding breast self- examination among nursing students. N=100
|
Criteria Measure of Pretest Knowledge Score |
|
|
Score Level (n= 100) |
f (%) |
|
Poor Knowledge (0-10) |
2(2%) |
|
Average Knowledge (11-20) |
69(69%) |
|
Good Knowledge (21-30) |
29(29%) |
|
Total |
100 |
Mean score±SD = 18.76±3.585
Table no.2 showed that during pretest 29% subject had good knowledge while 69% subjects had average knowledge and 2% subjects had poor knowledge regarding BSE.
Table no.3: Frequency and Percentage distribution of subjects as Per Post-Test Knowledge Regarding Breast Self- Examination Among Nursing Students. N=100
|
Criteria Measure of Posttest Knowledge Score |
|
|
Score Level (N= 100) |
Post Test f (%) |
|
Poor Knowledge (0-10) |
0(0%) |
|
Average Knowledge (11-20) |
39(39%) |
|
Good Knowledge (21-30) |
61(61%) |
|
Total |
100 |
Table no.4: Comparison of descriptive statistics of pre-test and post-test scores knowledge of nursing students regarding breast self- examination. N=100
|
Paired t Test |
Mean ± S.D. |
Mean% |
Range |
Mean Diff. |
Paired "t" Test |
|
Pre-Test Knowledge |
18.76±3.585 |
62.50 |
10-25 |
2.710 |
8.936 * |
|
Post-Test Knowledge |
21.47±2.732 |
71.60 |
15-28 |
||
|
**Significance level 0.05 Minimum=0 Maximum=30 |
|||||
Table no. 3: showed that in post-test the majority of subjects i.e. 61% had good knowledge while 39% subjects knowledge was average whereas 0% had poor knowledge regarding BSE.
Table no. 4 : Shows that there is significant difference in the pre-test and post-test knowledge regarding breast self-examination among nursing students. The mean post-test knowledge score was 21.47 which is higher than the mean of pre-test knowledge score was 18.76. The finding also show that standard deviation of post-test knowledge score was 2.732 whereas the standard deviation of pre-test knowledge score was 3.585. The obtained mean difference between the post-test and pre-test knowledge scores of pre-experimental groups was found to be statistically significant as evident from the 't' value 8.936 at 0.05 level. Therefore the obtained mean difference was true difference and not by chance.
Table No.5: Item wise analysis representing comparison of pre-test and post-test level of knowledge
|
Item wise Analysis |
Pre-Correct f (%) |
Post-Correct f (%) |
|
Qno.1 |
74(74.0%) |
79(79.0%) |
|
Qno.2 |
63(63.0%) |
74(74.0%) |
|
Qno.3 |
58(58.0%) |
78(78.0%) |
|
Qno.4 |
61(61.0%) |
78(78.0%) |
|
Qno.5 |
61(61.0%) |
72(72.0%) |
|
Qno.6 |
56(56.0%) |
72(72.0%) |
|
Qno.7 |
61(61.0%) |
71(71.0%) |
|
Qno.8 |
60(60.0%) |
71(71.0%) |
|
Qno.9 |
60(60.0%) |
70(70.0%) |
|
Qno.10 |
61(61.0%) |
74(74.0%) |
|
Qno.11 |
64(64.0%) |
74(74.0%) |
|
Qno.12 |
66(66.0%) |
67(67.0%) |
|
Qno.13 |
63(63.0%) |
68(68.0%) |
|
Qno.14 |
60(60.0%) |
63(63.0%) |
|
Qno.15 |
64(64.0%) |
68(68.0%) |
|
Qno.16 |
61(61.0%) |
68(68.0%) |
|
Qno.17 |
62(62.0%) |
68(68.0%) |
|
Qno.18 |
68(68.0%) |
71(71.0%) |
|
Qno.19 |
64(64.0%) |
73(73.0%) |
|
Qno.20 |
61(61.0%) |
66(66.0%) |
|
Qno.21 |
66(66.0%) |
67(67.0%) |
|
Qno.22 |
67(67.0%) |
70(70.0%) |
|
Qno.23 |
63(63.0%) |
71(71.0%) |
|
Qno.24 |
62(62.0%) |
74(74.0%) |
|
Qno.25 |
60(60.0%) |
72(72.0%) |
|
Qno.26 |
63(63.0%) |
75(75.0%) |
|
Qno.27 |
65(65.0%) |
74(74.0%) |
|
Qno.28 |
60(60.0%) |
74(74.0%) |
|
Qno.29 |
60(60.0%) |
68(68.0%) |
|
Qno.30 |
62(62.0%) |
77(77.0%) |
Table No.6: Table showing association of scores and demographic variables:
|
Variables |
Good Knowledge |
Average Knowledge |
Poor Knowledge |
P Value |
df |
Chi Test (𝝌𝟐) |
|
|
Age |
17–18 years |
7 |
16 |
0 |
0.586 |
4 |
2.832NS |
|
19–20 years |
19 |
39 |
2 |
||||
|
21–22 years |
3 |
14 |
0 |
||||
|
Above 22 |
0 |
0 |
0 |
||||
|
Class |
BSc (N) 1st semester |
6 |
46 |
0 |
0.000 |
2 |
19.503* |
|
BSc (N)2nd semester |
23 |
23 |
2 |
||||
|
Religion |
Hindu |
8 |
18 |
1 |
0.694 |
6 |
3.872NS |
|
Muslim |
0 |
6 |
0 |
||||
|
Sikh |
21 |
44 |
1 |
||||
|
Christian |
0 |
1 |
0 |
||||
|
Family history of breast cancer |
Yes |
2 |
8 |
0 |
0.695 |
2 |
0.727NS |
|
No |
27 |
61 |
2 |
||||
|
Age at menarche |
9–10 years |
0 |
0 |
0 |
0.440 |
4 |
3.757NS |
|
10–11 years |
1 |
6 |
0 |
||||
|
12–13 years |
23 |
43 |
2 |
||||
|
Above 14 |
5 |
20 |
0 |
||||
|
Mother’s education status |
No formal education |
1 |
3 |
1 |
0.121 |
6 |
10.081NS |
|
Secondary |
17 |
47 |
1 |
||||
|
Graduate |
7 |
13 |
0 |
||||
|
Post graduate |
4 |
6 |
0 |
||||
|
Mother’s occupation |
Homemaker |
28 |
58 |
2 |
0.695 |
6 |
3.868NS |
|
Health sector |
0 |
2 |
0 |
||||
|
Business |
0 |
5 |
0 |
||||
|
Other |
1 |
4 |
0 |
||||
|
Attended educational program on BSE |
Yes |
13 |
27 |
2 |
0.213 |
2 |
3.090 NS |
|
No |
16 |
42 |
0 |
||||
|
Source of information |
Mass media |
18 |
29 |
2 |
0.398 |
6 |
6.231 NS |
|
Health personnels |
4 |
13 |
0 |
||||
|
Peer group / Friends |
6 |
18 |
0 |
||||
|
Family members/Relatives |
1 |
9 |
0 |
||||
NS= Not significant, *-=Significant
Table no.6: Depicts the association between findings pre-test knowledge score with selected demographic variables. The findings revealed that there was no significant relationship between the socio-demographic variables and the pre-test knowledge score related to breast self- examination as all the variables were found to be not significant [<0.05] such as age [𝑋2=2.832], religion [ 2=3.872] and occupation of mother [ 𝑋2=3.868] .According to class, the value is higher [ 𝑋2=19.503] than the p value. The relationship between class and breast self- examination is statistically significant.
Table No.7: Association of demographic variables with pre-test knowledge of nursing student.
|
Variables |
Good knowledge |
Average knowledge |
Poor knowledge |
P Value |
Df |
Chi Test (𝝌𝟐) |
|
|
Age |
17–18 years |
13 |
10 |
0 |
0.833 |
2 |
0.365NS |
|
19–20 years |
38 |
22 |
0 |
||||
|
21–22 years |
10 |
7 |
0 |
||||
|
Above 22 |
0 |
0 |
0 |
||||
|
Class |
BSc (N) 1st semester |
25 |
27 |
0 |
0.006 |
1 |
7.605* |
|
BSc (N)2nd semester |
36 |
12 |
0 |
||||
|
Religion |
Hindu |
21 |
6 |
0 |
0.004 |
3 |
13.320* |
|
Muslim |
0 |
6 |
0 |
||||
|
Sikh |
39 |
27 |
0 |
||||
|
Christian |
1 |
0 |
0 |
||||
|
Family history of breast cancer |
Yes |
7 |
3 |
0 |
0.539 |
1 |
0.378 NS |
|
No |
54 |
36 |
0 |
||||
|
Age at menarche |
9–10 years |
0 |
0 |
0 |
0.114 |
2 |
4.344 NS |
|
10–11 years |
4 |
3 |
0 |
||||
|
12–13 years |
46 |
22 |
0 |
||||
|
Above 14 |
11 |
14 |
0 |
||||
|
Mother’s education status |
No formal education |
3 |
2 |
0 |
0.983 |
3 |
0.168 NS |
|
Secondary |
39 |
26 |
0 |
||||
|
Graduate |
13 |
7 |
0 |
||||
|
Post graduate |
6 |
4 |
0 |
||||
|
Mother’s occupation |
Homemaker |
55 |
33 |
0 |
0.774 |
3 |
1.114 NS |
|
Health sector |
1 |
1 |
0 |
||||
|
Business |
3 |
2 |
0 |
||||
|
Other |
2 |
3 |
0 |
||||
|
Attended educational program on BSE |
Yes |
27 |
15 |
0 |
0.566 |
1 |
0.329 NS |
|
No |
34 |
24 |
0 |
||||
|
Source of information |
Mass media |
32 |
17 |
0 |
0.514 |
3 |
2.292 NS |
|
Health personnels |
10 |
7 |
0 |
||||
|
Peer group / Friends |
15 |
9 |
0 |
||||
|
Family members/Relatives |
4 |
6 |
0 |
||||
Table no. 7: Depicts the association between findings pre-test knowledge score with selected demographic variables. The findings revealed that there was no significant relationship between the socio-demographic variables and the pre-test knowledge score related to breast self- examination as all the variables were found to be not significant [<0.05] such as age [𝑋2=0.365], education status of mother [ 2=0.168] and occupation of mother [ 𝑋2=1.114] According to religion, the value is higher [ 𝑋2=13.320] than the p value. The relationship between the religion and breast self- examination is statistically significant. According to class, the value is [ 2=7.605] than the p value. The relationship between the religion and breast self- examination is statistically significant.
IMPLICATIONS:
The study findings have several implications for different area such as Nursing practice, Nursing education and Nursing research which are discussed as below:
This study can help the nursing educators to explain to students about Breast self-examination. The nurse can educate the subjects to develop their skills in the preparing programme on Breast self-examination to promote the knowledge.
The nursing personnel can organize programme on Breast self-examination in hospital helps to increase the knowledge related Breast self-examination.
1. Nursing research should be directed towards describing the Breast self-examination among students.
2. Nursing research should be directed towards exploring the knowledge of the students regarding Breast self-examination.
3. Nursing research should be conducted towards the practice and attitude related to Breast self-examination.
The sample size was 100.The Structured Teaching Program was found to be effective in improving the level of knowledge of selected nursing students of Saraswati Nursing Institute, Dhianpura, Kurali regarding human milk banking
AUTHOR CONTRIBUTION:
1. World Health Organization. Breast cancer Geneva: WHO; 2023 [cited 2024 Jan 10].
2. World Cancer Research Fund. Breast cancer statistics London: WCRF; 2022 [cited 2024Jan 10].
3. International Agency for Research on Cancer. GLOBOCAN 2022: Breast Cancer Fact Sheet Lyon: IARC; 2022 [cited 2024 Jan 10
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Received on 08.05.2026 Revised on 18.06.2026 Accepted on 20.07.2026 Published on 10.08.2026 Available online from August 14, 2026 Int. J. of Advances in Nursing Management. 2026;14(3):153-158. DOI: 10.52711/2454-2652.2026.00032 ©A and V Publications All right reserved
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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License. |
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