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Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa

PURPOSE: Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports suc...

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Autores principales: Dickerson, Lindsay K., Rositch, Anne F., Lucas, Susan, Harvey, Susan C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Clinical Oncology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646899/
https://www.ncbi.nlm.nih.gov/pubmed/29094089
http://dx.doi.org/10.1200/JGO.2016.008086
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author Dickerson, Lindsay K.
Rositch, Anne F.
Lucas, Susan
Harvey, Susan C.
author_facet Dickerson, Lindsay K.
Rositch, Anne F.
Lucas, Susan
Harvey, Susan C.
author_sort Dickerson, Lindsay K.
collection PubMed
description PURPOSE: Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers. METHODS: Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy. RESULTS: The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10). CONCLUSION: Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable.
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spelling pubmed-56468992017-11-01 Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa Dickerson, Lindsay K. Rositch, Anne F. Lucas, Susan Harvey, Susan C. J Glob Oncol ORIGINAL REPORTS PURPOSE: Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers. METHODS: Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy. RESULTS: The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10). CONCLUSION: Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable. American Society of Clinical Oncology 2017-03-27 /pmc/articles/PMC5646899/ /pubmed/29094089 http://dx.doi.org/10.1200/JGO.2016.008086 Text en © 2017 by American Society of Clinical Oncology http://creativecommons.org/licenses/by/4.0/ Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by/4.0/
spellingShingle ORIGINAL REPORTS
Dickerson, Lindsay K.
Rositch, Anne F.
Lucas, Susan
Harvey, Susan C.
Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title_full Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title_fullStr Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title_full_unstemmed Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title_short Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
title_sort pilot educational intervention and feasibility assessment of breast ultrasound in rural south africa
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646899/
https://www.ncbi.nlm.nih.gov/pubmed/29094089
http://dx.doi.org/10.1200/JGO.2016.008086
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