BREAST SELF EXAMINATION: RELIABILITY QUESTIONED??

Breast Self Examination (BSE) is the process of self screening of breast cancer. That we all know!!
However, while there are numerous research going on at student/faculty level about knowledge and attitude of BSE, interesting is the fact that BSE has long been discarded as the screening process. 

According to World Health Organization (2012), there is minimal evidence supporting the efficacy of BSE as a screening method. Kosters and Gotzchse (2003) conducted a meta-analysis in order to explore the efficacy of BSE. Two studies which included 3,88,535 women were included in the review. The analysis revealed that BSE led to unwanted distress, anxiety and greater number of invasive procedures. The false positive results were also greater in population of women who had undergone BSE as compared to the women who had not undergone BSE. 

However, it is still promoted!! What could be the reason?

Although WHO (2012) recommends against its use as screening method, it states that it can be used as the method of raising awareness and empowering women. Thus, nurses should be aware of the Evidence Based Practice that follows. While suggesting the patient about BSE, it is necessary to help them understand the possibility of false positive results and undue stress that it may bring along with it.

The student nurses who are searching for a research topic could use this one, i.e. the Changing practice of Breast Self Examination (BSE) or The knowledge/attitude of changing practice of BSE??

Hence, Breast Self Examination is the method of raising awareness and empowering women by helping them to understand and take control of their body,  NOT A RELIABLE SCREENING METHOD. 

References:
World Health Organization. (2012) Breast Cancer: Prevention and Control [Online]. Available from: https://www.blogger.com/blogger.g?blogID=3036035428696811962#editor/target=post;postID=1369389078637849683 [Accessed 18 February 2016].

Koster, J.P and Gotzsche, P.C. (2003) Regular Self Examination or Clinical Examination for Early Detection of Breast Cancer. Cochrane Database Systematic Review. 

Challenge: Are women in developed societies facing less domestic violence than the women in developing societies?

Domestic violence towards women in Nepal is currently at its heights. The figures from data and statistics are self explanatory of the burden of this social problem in Nepal. Domestic violence is the act of actual or potential harm inflicted in the form of physical or verbal act that affect the physical, mental and social health of the victim. The perpetrators of domestic violence against women have been identified as the male partner, mother-in-law, father-in-law and other members of the male partner's family. These facts are not what interests me and there are plenty of articles that have been published to elucidate these facts. Why does the woman hesitate to speak against the violence is the question that I have been searching the answer to.

The most important answer that I have found is self-esteem or wish to maintain their reputation intact. The woman chooses not to make the formal complaint or not to share these incidences with the family as she does not want the family members/society members/friends to show the pity or make sarcastic comments to her. The study by Poudel et al (2014) revealed many cases of violence are unrecorded and the prevalence of psychological violence is greater than other forms of violence in Nepal. The dilemma in complaining is further fuelled by the inability of the government to criminalize the act of violence. The most significant problem is bore by the women themselves. If they were strong enough to stand against these acts with their head held high, the situation could have been different. After all, it is not her mistake that she has been exposed to such acts of violence. What could be the remedy in these situations? The first thought in our mind could be education?? policies?? laws?? but all these interventions will go in vain until and unless women overcome their so called perception about the intact reputation. This is very difficult to achieve.

 A family that she has accepted as her own, inflicting acts of violence beyond her expectations is set to traumatize her emotionally. In my view, the acts of domestic violence that occurs in developed societies have higher chances of not being reported. Several researches around the world show that the undeveloped countries are at higher risk of domestic violence, they bear greater risk of domestic violence etc, but the question is whether the incidences of violences in the developed countries are reported. The women from these societies are educated and bold but are they bold enough to let down their intact reputation and report that the persons whom they fell in love with are the ones hurting them now? The mysterious nature of human behavior, the veracity of self-reported incidences and the trajectory of the violence are all too tedious but not impossible to understand.