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Breast Self-Examination (BSE) Education: An Auxiliary Preventive Measure or a Source of Anxiety?
Dimitra Tsintsiou1, Michael Kourakos2, Maria Lavdaniti1
1Nursing, International Hellenic University, Thessaloniki, GRC.
Abstract:
Introduction Breast self-examination (BSE) is promoted as a component of breast self-awareness and a preventive measure, yet its psychosocial impact remains debated. This study aimed to evaluate the effects of BSE education on self-efficacy, health anxiety, and health locus of control among Greek women. Materials and methods A prospective cohort of 298 women (mean age 48.7 ± 10.7 years) participated in a structured BSE educational intervention. Psychosocial parameters were assessed at baseline, 6, and 12 months using validated scales: general self-efficacy, health anxiety, and multidimensional health locus of control. Statistical analyses included repeated-measures ANOVA, post hoc comparisons, and regression modeling to explore temporal changes and predictors. Results BSE practice increased markedly from 44.3% (n = 132) at baseline to 92.2% (n = 271) at six months and 85.0% (n = 250) at 12 months (Cochran's Q = 188.96, p < 0.001). Self-efficacy and health anxiety scores remained stable over time (p = 0.570 and p = 0.955, respectively). Health locus of control subscales revealed small but statistically significant declines in internal control (baseline: 19.2 ± 4.9; 12 months: 18.1 ± 4.6; p < 0.001) and in attribution to "powerful others" and "chance" (p = 0.040 and p = 0.039). Regression analyses indicated that prior scores were the strongest predictors of 12-month outcomes, with age associated with greater reliance on "powerful others" (β = 0.107, p = 0.040). No increase in health anxiety was observed despite the rise in BSE practice. Conclusions BSE education significantly enhanced preventive behavior without increasing health anxiety or altering general self-efficacy. These findings support BSE education as a complementary strategy for breast health awareness, emphasizing its role in early care-seeking rather than as a substitute for formal screening.
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