Volume 30, Issue 3 (Summer 2022)                   Avicenna J Nurs Midwifery Care 2022, 30(3): 191-199 | Back to browse issues page

Ethics code: IR.RUMS.REC.1399.255
Clinical trials code: IRCT20181210041911N3


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Ebrahimi M, Lotfipur S M, Ghorashi Z. Effect of Targeted Educational Program Based on Thetranstheoretical Model on the Acceptance and Understanding of Mammography in Women Over 40. Avicenna J Nurs Midwifery Care 2022; 30 (3) :191-199
URL: http://nmj.umsha.ac.ir/article-1-2382-en.html
1- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran , 6889Lotfipur@yahoo.com
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 Background and Objective
Breast cancer is one of the most common and known diseases and the second cause of death in women. Mammography is the most sensitive and specific test that is performed periodically for the early diagnosis of breast cancer. More than 90 percent of women do not have enough information about the benefits of mammography and its role in reducing mortality caused by breast cancer.
One of the widely used models for planning effective educational interventions is the model of stages of change. This model has been developed as a comprehensive model for behavior change that focuses on people’s decision-making. Changing behavior is a stepwise process that requires appropriate interventions from individuals and helps them go through different stages.
Regarding the existence of conflicting studies and racial, cultural, and ethnic factors that affect acceptance or non-acceptance of health behaviors, such as mammography screening, the present study aimed to investigate the impact of education based on the pattern of stages of change on acceptance and perception of mammography in the female population of Amol city, Iran.
Materials and Methods
This pilot study was conducted on 128 women over 40 years of age. Participants were divided into intervention and control groups using a random sampling method.
The inclusion criteria included the age range of 40-60 years, being Iranian, being literate, and having no personal or family history of breast cancer. However, the exclusion criteria were being placed in the operation and maintenance phase upon entering the study, based on Rakoweski stage of change scale; the occurrence of any type of stressful event during the study (e.g., death of a first-degree relative, cancer, and divorce); and unwillingness to continue participation in the study.
Both groups completed the demographic characteristics form, Rakoweski stage of change scale, and Decision Balance Questionnaire. For the intervention group, four online training sessions were held in four weeks. Online meetings were conducted through the WhatsApp application and educational clips and pamphlets were sent to participants along with the audio file.
After four weeks of training, questionnaires were completed again by both groups. The collected data were analyzed in SPSS software (version 20).
Results
The stages of change were investigated between the control and intervention groups before, immediately, and one month after the intervention. The results obtained on evaluation of changes in mammography screening behavior showed that the frequency of the pre-contemplation stage decreased in the intervention group immediately after the training sessions (P=0.022) and one month later (P=0.008), while the frequency of the stages of contemplation and action increased in this group.
However, the changes in the trend of negative perception were not significant in the control group before, immediately, and after training and one month later (P=0.19), but it was significant in the intervention group (P<0.001).
Also, the examination of the interaction between training and the negative perception score based on the same test and the interaction between the effect of time and groups showed that the trend of changes between the two groups was also significant. In other words, the changes in the negative perception score were higher and ascending in the intervention group (P<0.001).
The trend of changes in positive perception score before training, immediately after training, and one month later was significant in both control (P=0.002) and intervention groups (P<0.001). In addition, an examination of the interaction of education and positive perception score based on the same test as well as the interaction between the effect of time and groups showed significant changes between the two groups. In other words, changes in the positive perception score were higher and ascending in the intervention group (P<0.001).
 Conclusion 
Based on the obtained results, using the educational model of the stages of change increases positive understanding, improves people’s performance, and can be used for the improvement of screening programs.
 
Type of Study: Original Research | Subject: Education in Nursing and Midwifery
Received: 2021/09/27 | Accepted: 2022/07/12 | Published: 2022/09/1

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