Knowledge, attitudes, and practices surrounding breast cancer screening in educated Appalachian women.

PURPOSE/OBJECTIVES To determine how and what women learn about breast cancer and screening practices and which factors influence women's breast cancer screening practices. DESIGN Descriptive analysis of questionnaire data collected at the time of enrollment in a clinical trial. SETTING Breast care center of a mid-Atlantic academic health sciences center. SAMPLE 185 women in a predominantly Appalachian, entirely rural state. METHODS Participants completed the Modified Toronto Breast Self-Examination Inventory and questions related to personal mammography practices at the time of enrollment before randomization in a longitudinal clinical intervention study. MAIN RESEARCH VARIABLES Women's demographics, knowledge of breast cancer screening practices, adherence to breast cancer screening guidelines, and motivation, knowledge, and practice proficiency surrounding breast cancer screening. FINDINGS These educated women had knowledge deficits about breast cancer, breast cancer risk factors, and screening guidelines, particularly the timing and practice behaviors of breast self-examination. Women who had received healthcare and cancer-screening instruction by healthcare providers, including advanced practice nurses, had greater knowledge of breast cancer and detection practices. CONCLUSIONS Women still have knowledge deficits about breast cancer, breast cancer detection, and personal risk factors. In addition, some educated women in this study failed to practice breast cancer screening according to current guidelines. IMPLICATIONS FOR NURSING Practitioners must continue to remind and update women about breast disease, and women's cancer-screening practices must be reinforced. All levels of providers should improve their rates of performing clinical breast examinations with physical examinations. Nurses, who greatly influence women's health care, must remain current in their knowledge of breast disease, screening, and treatment.