Breast Cancer Although it Remains True That

Breast Cancer Although it remains true that many Americans will die of acute illnesses, injuries, and accidents, it is at the same time becoming the case that more and more Americans are dying of chronic diseases such as cancer. In fact, cancer is expected in the future to be the leading cause of death in the United States, and any integrated plan for providing quality medical (including) nursing services in the future must focus on the treatment of such long-term illnesses.

Among the most common forms of cancers, breast cancer cases are increasing the most quickly (Ku 2001), with the overall lifetime risk for American women having grown to one in eight (American Cancer Society, 2001).

The reason for this increase is not understood, although a number of factors are known to come into play, and it may be possible that the increased risk is a combination of these various known factors, which include increased overall environmental exposure to known cancer-causing agents as well as delays in first pregnancies and less time spent breastfeeding infants.

It is also possible that the rise in reported incidents of breast cancer may in fact be to some extent an artifact, that it may in fact reflect simply a rise in reported rather than actual incidents. Women are today more aware of the risks of breast cancer than their grandmothers or mothers - or probably even older sisters - were and are more likely to perform self-exams and to have mammograms and other professionally performed exams (American Cancer Society, 2001).

This combination of self-examination and examination by medical staff may well have combined to increase greatly the reported incidence of breast cancer rather than indicating that a true rise in breast cancer cases exists, or that the true rise in breast cancer cases is in fact as high as it currently appears. The true rate at which breast cancer is occurring, and the relationship between this rate and the rate a generation ago is, thus, not precisely known or understand.

One thing that is well understood, however, is the fact that mortality from breast cancer cases is dropping. Even though the overall number of cases of breast cancer is rising, the overall mortality figures are dropping, indicating that American women are detecting their cancers at an earlier and earlier point. One of the most important tools that can be used to detect breast cancer at an earlier stand is, of course, self breast exam.

However, not all women perform self breast exams and do not, therefore profit from the potential for early detection and early treatment. To help all patients become more actively engaged in controlling their own health, hospital nursing staffs should include training patients in breast self-exams. This training should include structured training on breast self-examination using biomedical instrumentation. According to Leight and Leslie (1998), such training has a significant effect on the capability of patients to perform breast self-exams efficiently.

Individual training with guided practice improved two key measures of thoroughness of the exam: depth of palpitation and duration of exam time. Nurses should be trained in how to provide such training for their patients. However, merely establishing such a program will not be enough; it must also be determined how effective it is. Thus a study must be designed to assess the effectiveness of having nurses performed structured training in self-examination techniques. The overall research mode will be ethnographic.

Ethnographic techniques have traditionally proven to be the most effective in eliciting information about sensitive behaviors and about behaviors that people are likely to lie about. Women are likely to over-report their incidence of self breast examination; therefore an ethnographic study is indicated. Moreover, such a study is not only more likely to elicit accurate information about the incidence of breast self-examination but it is also more likely to elicit reasons why women do or do not perform self-exams.

Ethnographic data can include quantitative elements, thus allowing for a comparison of similar data to previous studies. The data collection process comprises interviews with nurses and patients both preceding the training and at fixed.