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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)

Department / School

Graduate Nursing

First Advisor

Margaret Hegge


breast cancer diagnosis, testis cancer diagnosis, medical screening


Health care has changed from curing illness to preventing disease and health promotion. The health care trends of the 1990s emphasize the patient's responsibilities in early detection of illness; therefore, patient education has become an increasingly important part of today's health care (Walker, 1993). Because of these new trends in health care, two self care activities, testicular self-examination (TSE), breast self-examination (BSE), the clinical examination of each and mammography have been encouraged in the detection of specific cancers. Nurse practitioners, who by virtue of their nursing background, have already been shown to focus on health promotion and disease prevention, would be effective providers of quality cancer screening (Reed & Selleck, 1996; Safriet, 1992). Breast cancer and testicular cancer claim the lives of more men and women in the U.S. each year. The prognosis for recovery from breast and testicular cancer is directly related to the stage of the disease at which it is diagnosed. Early detection of either breast or testicular malignancy has proven to have reduced morbidity and mortality (Leslie, 1994). This study examined the similarities and differences in BSE and TSE instruction and in the frequency of clinical examination among nurse practitioners.
This study utilized a descriptive comparative non-experimental survey approach which reflected Orem's Conceptual Framework. Nurse practitioners in South Dakota were surveyed (a=62). The tool used with this sample yielded a high reliability by a Chronbach's alpha of 0.9702 on the likert type scale questions.
Nurse practitioners were perceiving barriers for their patients which may prevent the NP from even discussing the topic. The literature indicated that patients have many barriers that prevent them from asking about TSE; therefore, it should be the task of the NP to address the barriers and alleviate fears. The top three barriers to TSE NPs believe patients experience were embarrassment, refusal of TSE teaching, and fear of finding cancer.
The top two barriers that the nurse practitioner experienced to TSE were time constraints and forgetfulness. Barriers to TSE that the NP perceive the facility imposing on them were time constraints and reimbursement issues. Ona whole, the facility had little Or no effect on teaching TSE to patients.
With more emphasis placed on the importance of breast cancer than testicular cancer one would expect to have decreased barriers for BSE. In fact, this is true, nurse practitioners still perceived many barriers for their patients, but not to the extreme that they did for their male patients with TSE. The top three barriers to BSE NPs believe patients experience were fear of finding cancer, embarrassment, and refusal of BSE teaching.
The top two barriers that the nurse practitioner experienced with BSE were time constraints and forgetfulness. Barriers to BSE that the NP's perceive the facility imposed on them were time constraints and reimbursement issues. On a whole, the facility had little or no effect on teaching BSE to patients.

Library of Congress Subject Headings

Breast -- Cancer -- Diagnosis
Testis -- Cancer -- Diagnosis
Medical screening



Number of Pages



South Dakota State University


Copyright © 1998 Darcy Kaberna. All rights reserved