الفهرس 
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Abstract
Nowadays, there is a rapid change in the world and the health and quality life expectancy of individual’s increases. Men’s health refers to a state of complete physical, mental, and social well-being, as experienced by men, and not merely the absence of disease or infirmity. These often relate to structures such as male genitalia or to conditions caused by hormones specific to, or most notable in males. Moreover, the literature shows that many men are unaware of testicular cancer, disease symptoms, and TSE in order to diagnose symptoms or early diagnosis (WHO, 2016 and Saab et al., 2018).
Testicular cancer is the most common type of cancer in the urogenital system in men aged 15-34, Testicular cancer is a highly treatable disease when diagnosed at an early stage, and become more common around the world and especially in white race. In addition, the etiology of testicular cancer is not known exactly, it can occur in both testicles. It is reported that the most important risk factor is past cryptorchidism undescended testicle, Klinefelter’s syndrome, infertility, history of testicular cancer in a first-degree relative, estrogen level in intrauterine life, twinning, consanguineous marriage, at father or sibling testicular cancer, testicular trauma, and inguinal hernia are among the risk factors (Sayar et al., 2021).
Nowadays, there is no primary method to prevent Testicular cancer (TC). TC is the most common malignancy and the third leading cause of cancer deaths in male adolescents and young adults. Early detection of testicular cancer can be achieved by testicular self-examination (TSE). Testicular self-exam (T.S.E) is the practice in which a man checks himself (scrotum) for any abnormalities in his testicles for signs and symptoms of testicular cancer (T.C) (Pietrzyk et al., 2020).
Aim of the study:
The aim of this study was to assess the adult male awareness regarding testicular self-examination for early detection of testicular cancer through the following objectives:-
1- Assessing Adult Male’s Knowledge about Testicular Self Examination & Testicular Cancer.
2- Assessing Adult Male’s practice regarding Testicular Self Examination.
3- Assessing Adult Male’s attitude regarding Testicular Self Examination.
Research Questions:
1- Is there a relation adult male’s socio- Demographic status and their knowledge?
2- Is there relation between adult male’s knowledge and their practice?
3- Is there relation between adult male’s attitude and their practice?
Research design
A descriptive exploratory research design was utilized in this study.
Setting
The study was conducted at outpatient clinic of Dermatology and Andrology at El Demerdash Hospital at Al Abbasia Zone, Cairo city- Egypt.
Subjects
The study subjects included a purposive randomly sample (270) adult males from mentioned setting, A sample calculated by power 8 sample for calculation purpose to give power of 80% (Jones et al., 2003). from beginning of July 2022 to the end of December 2022.
Inclusion Criteria
Only Adult males.
Age >20 years’ old.
Exclusion Criteria
Failure to obtain consent or any patient who declined to participate was excluded from the study.
Tools of Data Collection
Data for this study was collected by using the following tools.
Tool: Structured interviewing questionnaires were used for the data collection:
This tool was developed by the researcher based on related literature (Richard & Solove 2017; National Organization for Rare Disorders. Testicular Cancer, 2019; and Ibitoye et al., 2022) and consisted of four parts as the following:
Part I: Socio-demographic characteristics about adult male including age, sex, education level, social status, occupation (job), residence, smoker, health problem, medication for this disease, and monthly income.
Part 11: Knowledge adult male regarding testicular self-examination: This part used to assess adult male’s knowledge regarding testicular self-examination & testicular cancer which include (17 items) as: structure of testes, function of testes, types of testicular tumors, treatment for testicles tumors the source of information about testicular cancer and testicular self-examination.
Part III: Adult males practices towards testicular self-examination: This part used to assess adult male’s practice regarding testicular self-examination which include (13 item) as: Examine each testicle gently with both hands, …etc
Part IV: Adult males attitude towards testicular self-examination: This part used to assess adult’s male’s attitude regarding testicular self-examination as which include (10 item) as: feel comfortable during a testicular self-exam, All men should do a testicular self-examination for testicle, discussing with my friends about testicular self-examination,….etc
Pilot Study:
A pilot study was conducted on 10% of the study subjects (27 adult male). The aim of the pilot study was to determine clarity, applicability of the tools and to estimate the time required for fulfilling the questionnaire sheets. Total time needed to complete the total sheets by adult male was ranged between (50-70) minutes. Those participants in the pilot study were included in the main study sample. Based on the pilot study, no modifications were done and the final version was prepared for distributing to the adult male.
Fieldwork
The actual fieldwork started at the beginning of July 2022 to the end of December 2022. The researcher met the director of Dermatology and Andrology at El Demerdash Hospital either medical or nursing to explain the aim of the study to gain their approval for data collection. The researcher collected data by himself through meeting the study subjects and explaining the purpose of the study to them in the study settings.
The questionnaire sheets were distributed and completed by the study subjects. The researcher was present all the time during fulfilling the forms to answer any questions. Total time needed to complete the total sheets by adult male was ranged between (30-45) minutes. The researcher was present all the time during fulfilling the forms to answer any questions. Also, The researcher checked the completeness of each filled sheet after the study subjects completed it to ensure the absence of any missing data.
Ethical Considerations:
Prior study conduction, the research approval was obtained from the Scientific Research Ethical Committee in Faculty of Nursing, Ain Shams University. In addition, an approval was obtained from the director of Dermatology and Andrology at El Demerdash Hospital either medical or nursing before starting the study. The researcher was assure anonymity and confidentiality of the study subject data and informed them about research purposes. All participant were informed about the study aim, process, and they allowed to choose to participate or not in the study and they have the right to withdraw from the study at any time. Ethics, values, culture and beliefs was respected.
Results:
The total knowledge about testicular self-examination and illustrated that 67.0% of the studied adult male achieved satisfactory level of knowledge about testicular self-examination with score above 50%, while 33.0% of them achieved unsatisfactory level of knowledge about testicular self-examination with score less than 50%.
The average responses for the studied adult males was 34 with ±SD equal 31.76±6.13 respectively. And there is highly significant relation among knowledge items with p value of 0.001.
That 80.4 % of the studied subjects have done above 60% of the practice related to testicular self-examination, which is considered satisfactory level of practice, while only 19.6 % of them have done practice lower than 60% which is represented unsatisfactory.
The average responses for the studied adult males was 20 with ±SD equal 22.33±4.67 respectively. And there is highly significant relation among practice items with p value of 0.001.
Total number and percentage of the studied adult male according to their attitude regarding testicular self-examination and indicated that 38.5% of the studied adult males have positive attitude toward testicular self-examination, while 61.5% of the studied adult males have negative attitude toward testicular self-examination.
There was highly statistical significant correlation between total score of knowledge and total score of practice with p value 0.001,
There is statistically significant correlation with total score of attitude and p value is 0.027. Regarding correlations between total score of practice and total score of knowledge, there is highly statistically significant correlation
Conclusion:
This study aimed to assess the adult male awareness regarding testicular self-examination for early detection of testicular cancer and found that more than two thirds of adult male had satisfactory level of total knowledge regarding testicular self-examination. Also, the majority of them had satisfactory level of practice toward testicular self-examination whereas more than half of them had negative attitude toward testicular self-examination for early detection of testicular cancer. It was reported that a statistically significant correlation between total score of knowledge and practice and attitude regarding testicular self-examination.
Recommendations:
Based on the study findings, the following recommendations are suggested in order to:
1. Develop educational programs that can increase knowledge and skill to TSE. Improving information dissemination about TSE and TC also helps to reduce the presentation of adult males at advanced stages of TC and may reduce costs incurred in their management.
2. Develop Posters, pamphlets, lectures, films, and audio tapes have demonstrated a positive increase in testicular self-examination compliance. In addition, regular testicular self-examinations may help adult males take greater responsibility of their personal health and reduce anxiety related to certain cancers.
3. Developing TC and TSE awareness educational programs as part of School Health curricula that includes health belief scale assessment to do TSE following information provision. This could be done by trained school nurses, teachers or physical education instructors.