Five hundred and sixty-seven women with a family history of breast cancer completed health belief and breast self-examination questionnaires at 'Time 1' and nine months later. Based on their answers, the women were categorised as either infrequent checkers (3-4 times a year or less), appropriate checkers (monthly or fortnightly) or excessive checkers (weekly or daily).
The strongest predictor of infrequent checking at nine months was past behaviour - infrequent checkers at Time 1 were also likely to be infrequent checkers nine months later. However, women lacking confidence in their ability to perform breast self-examination, and those who perceived there to be few benefits, were also more likely to be infrequent checkers nine months later, regardless of their past behaviour. This suggests "health professionals should highlight the positive benefits of performing a monthly self-examination and should seek to enhance women's confidence in their ability to self-check", the authors said.
Excessive checkers tended to be women who were confident in their ability to self-check, and who were more worried about breast cancer. Excessive breast self-examination can be counter-productive, being more frequent but less thorough, and diagnosis of benign lumps may be increased, impeding the detection of malignant lumps. The authors recommended practical demonstrations of self-checking, and said there was a need to address the high levels of cancer-related anxiety experienced by some women with a family history of breast cancer.
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Norman, P. & Brain, K. (2005). An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer. British Journal of Health Psychology, 10, 1-17.
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