This study was conducted in seven Public hospitals found in west Shoa Zone Oromia regional state, Ethiopia using institutional-based cross-sectional study design. Data were collected from March to April 2019.
The sample size was determined using single population proportion formula with the assumption of marginal error of 5%, 5% of non-response rate, 95% confidence level and the prevalence of the breast self-examination practice to be 37% from the study conducted in East Gojjam, North Ethiopia(14).
Since the sample was drawn from a finite population, the correction formula was applied. Finally, the sample size of 379 was determined. The calculated sample size was proportionally allocated to each Hospital based on the number of female health care workers in the hospital. After proportionally assigning sample size to each hospital, a simple random sampling technique was applied to select study participants.
Inclusion and Exclusion criteria
All-female healthcare workers who were actively on job during data collection at each selected hospitals were included.
Data collection tools and techniques
Data was collected using a self- administered questionnaire. The questionnaire was developed in the English language after reviewing and extracting from different pieces of literature developed for the same purpose. For measuring knowledge towards BSE, there were 10 questions developed. Answering a correct answer will result in scoring a mark and loosing will attract zero scores. Accordingly, the final total mark will be added up out of ten and graded for the decision of knowledge level.
To measure attitude towards BSE, Likert scale based items were prepared (total of ten questions). The scales reached from strongly agree to strongly disagree. To assess the internal consistency of the items, Cronbach alpha was assessed and it was 0.87 indicating good internal consistency of the items.
Operational Definitions
Good practice of breast self-examination:- those who performed breast self-examination practice a week after each menses by their palm and middle three fingers otherwise called poor practice
Good knowledge: participant those who answered greater than 75% of the 10 knowledge questions towards breast self-examination.
Average knowledge: participants who answered 50–75% of knowledge questions toward breast self-examination.
Poor knowledge: participants who answered less than 50% of knowledge questions toward breast self-examination.
Favorable attitudes: participants who scored points equal to or greater than mean score of
breast self-examination related attitude questions as measured by Likert scale.
Unfavorable attitude: participants who scored points less than the mean score of attitude
questions (12)(15).
Data management and analysis
The collected data were checked visually for completeness, then coded and entered into Epi data version 4.5 statistical packages. Descriptive analysis was computed. To assess the association between dependent and independent variables by controlling for confounders, first binary logistic regression was run and variables with p-value <=0.25 and the variables which are known to have an association with dependent variables from reviewed literature were selected for Multiple logistic regression analysis. Statistical significance was declared at P-value <0.05 with 95% confidence interval (CI).
Data Quality Control
To ensure the data quality of our study the following measures were taken:
- The questionnaire was developed by reviewing relevant pieces of literature on the subject
to ensure reliability.
- The questionnaire was pre-tested and modified where necessary.
- One day training was given for data collectors and supervisors
Dependent variable
- Breast self-examination practice(BSE)
Ethical consideration
Ethical clearance was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences, Debra Markos University. During the fieldwork, the objective of the study was clearly explained for the study participants, the confidentiality of the data to be collected and the right not to participate was also assured. Before starting the data collection process, written consent was taken from each respondent after they read and signed the consent form.