الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Breast cancer has become a health priority for most low and middle income countries due to its increasing incidence, lack of early detection and adequate treatment. BC is curable when detected at an early stage, so there is an urgent need for early detection for BC. MS is the main recommended test for early detection of BC.
The current study was conducted to study MS utilization behavior among female employees and the factors affecting it in Alexandria, identify some factors based on the Health Belief Model that determine the likelihood of MS utilization behavior in terms of health beliefs, knowledge about BC and its risk factors, access and need for MS and to identify perceived social support for MS utilization.
The study was conducted in Alexandria Directorate of Education and its districts’ offices, Alexandria University administration and its faculties, Alexandria Directorate of Health Affairs and its districts’ offices and Alexandria Directorate of Social Solidarity and its districts’ offices.
A cross sectional approach was used for implementation of the study. The target population was female employees aged 40 years and older. The sample was equally divided between the previously mentioned workplaces in Alexandria governorate.
A predesigned interview questionnaire was used to collect data. It comprised the following: socio-demographic data, habits, reproductive history, family history, culture affiliation, access to MS, reproductive health screening behavior, MS utilization behavior, need for MS, knowledge about BC and MS, perceptions towards BC and MS, perceived threat {susceptibility and severity}, perceived benefits of MS, perceived barriers to MS, {personal barriers, economic barriers, health care system barriers} and perceived social support and intention to utilize MS.
Data were analyzed using the statistical package for social Sciences (SPSS), version 17 statistical software. Descriptive statistics were used for summarization of data. Frequency distribution, cross tabulations and graphs were done. The mean and standard deviation were calculated and a scoring system was done.
The study revealed the following main results:
-The majority of the females 92.5% had bad RH utilization.
- More than two thirds of females (69.7%) had bad MS utilization.
-The overall knowledge score percent about BC was poor among 72% of studied female.
-The overall knowledge score percent about MS was poor among 76.3% of studied female.
-The overall knowledge score percent about BC, and MS was poor among 72% of studied female.
-The perceived susceptibility to BC was high among 77.3% of females and moderate among 24% of them.
-The perceived seriousness of BC was high among 90.3% and moderate among 9.7% of them.
-The perceived benefit of screening was high among 82.7% of females and moderate among 17.3% of them.
-The perceived barriers to MS were high among 64.3% of females and moderate among 35.7% of them.
-The perceived social support was high among 67%, moderate among 30.7% and low among 2.3% of females.
- More than one fifth of females with secondary education and higher were fair utilizers of MS.
- Females who work at the educational sector were bad utilizers of MS while those who work at the university sector were fair utilizers of MS.
- Postmenopausal females had better utilization of MS.
- The majority of female employees who had poor accessibility to MS were bad utilizers of MS (89.7%) and females who had good accessibility to MS area were fair and good utilizers of MS (43.6% and 23.6% respectively).
-High perceived susceptibility to BC and perceived severity, benefits, and social support, and lower barriers were associated with higher MS utilization.
-Females who had no intention to utilize the service were bad utilizers (97.7%). The MS utilization increased with the increase in intention. The latter increased with increase in the level of education.
The main conclusions of the study are:
•The majority of female employees had poor knowledge about signs and symptoms, risk factors, and protective factors of BC and about MS.
•The perception of the studied females was high concerning susceptibility to and seriousness of BC and benefits of screening.
•The majority of female employees in all sectors had poor MS practice which reflects limited understanding of the screening strategy despite the efforts of government.
•Increasing the females’ knowledge about BC and accessibility to screening areas are important strategies influencing their decisions about whether or not to participate in cancer preventive practices.
•Perceived need, age, menopause, intention and occupation showed significant direct effects on MS utilization (p<0.05).
•Intention to utilize MS increased by increasing the level of education, knowledge of BC and MS, accessibility to MS and perceived need.
The main recommendations of the study are:
•Improving awareness about BC through education. The Ministry of Health and women development facilities should play a leading role in increasing female awareness through launching health educational programs even for illiterate and poorly educated women.
• Applying regular systematic screening for BC throughout the whole country with special emphasis on females aged forty years and older.
•Referring females with suspected lesions to specialized health facilities for further investigations.
•Encouraging the establishment of data base to health insurance facilities about females forty years and older, and call the target group for screening.
•Instituting free BC screening in all health facilities at different times to remove the financial, accessibility and unsuitable time barriers to MS.
•Developing MS campaigns.