A study of breast cancer in korle bu teaching hospital: assessing the impact of health education

Pain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions. The study sought to select, develop, and validate context-appropriate unidimensional pain scales for pain assessment among adult post-operative patients. A mixed methods design was adopted. The study was conducted at two hospitals in Accra, Ghana. The qualitative phase involved 17 patients and 25 nurses, and the quantitative phase involved 150 post-operative patients. Qualitative data was collected iteratively through individual interviews and focus groups. Two existing pain scales (0–10 Numeric Rating Scale [NRS] and Wong-Baker FACES [FPS] scales) and one new pain scale (Colour-Circle Pain Scale–[CCPS]) were validated. The psychometric properties of the three scales were assessed when patients had fully recovered from anesthesia. The CCPS had higher scale preference than NRS and FPS. Convergent validity was very good and significant (0.70–0.75). Inter-rater reliability was high (0.923–0.928) and all the scales were sensitive to change in the intensity or level of pain experienced before and after analgesia such as paracetamol and diclofenac suppositories, injectable pethidine, and oral tramadol had been administered. Using a valid tool for pain assessment gives the clinician an objective criterion for pain management. Due to the subjective nature of pain, consideration of socio-cultural factors for the particular context ensures that the appropriate tool is used.

Dysmenorrhoea is a common problem of women at the reproductive age and may have negative effect on the education of females at various stages on the educational ladder.

Introduction: Globally breast cancer is the leading cause of cancer with an estimated 2.3 million new cases and 685,000 deaths in 2020. Late presentation is the hallmark of breast cancer in Ghana for which ignorance and fear are the major reasons fuelled largely by myths and misconceptions. Breast cancer awareness and education needs to start early to bring about a change in knowledge, attitude and practices. However, Breast cancer awareness activities in Ghana have usually targeted adult women.This study assessed the impact of breast cancer education among adolescent high school girls in Ghana.Methodology: A pre- post-test quasi experimental study was conducted at two senior high schools. A self-administered pre-educational questionnaire was followed by an educational intervention consisting of a drama, PowerPoint lecture, question and answer session and distribution of breast cancer information leaflets. After 3 months the same questionnaire was administered as a post-education test to assess the impact of the educational intervention. The total score for each domain was categorised into adequate knowledge > 50% and inadequate knowledge < 50%.Results: The number of participants in the pre-test and post-test were 1043 and 1274; the median ages [IQR] were 16.0 [15.0–17.0] for both the pre and post-test students. General knowledge on breast cancer at pre-education (29.1%) improved to 72.5% (p < 0.001). Knowledge on signs and symptoms improved from 33.1 to 55% (p < 0.001); knowledge on risk factors improved from 55.3 to 79.2% (p < 0.001), and knowledge on breast self-examination and screening improved from 9.8 to 22.2% (p < 0.001). The overall performance of the students improved from 17.2 to 59.4% (p < 0.001).Conclusion: There is inadequate knowledge about breast cancer and self-examination among senior high school girls in Ghana. Our breast cancer educational intervention was effective in improving general knowledge of breast cancer, risk factors, signs and symptoms and breast self-examination. The overall knowledge base improved from 17.2 to 59.4% 3 months post intervention, accompanied by an increase in the reported practice of breast self-examination and a greater belief that breast cancer is curable. This study has demonstrated the need for a school breast cancer educational program and that breast cancer education in high schools is effective.

Background: Risk estimates for women carrying germline mutations in breast cancer susceptibility genes are mainly based on studies of European ancestry women. Methods: We investigated associations between pathogenic variants (PV) in 34 genes with breast cancer risk in 871 cases [307 estrogen receptor (ER)-positive, 321 ER-negative, and 243 ER-unknown] and 1,563 controls in the Ghana Breast Health Study (GBHS), and estimated lifetime risk for carriers. We compared results with those for European, Asian, and African American ancestry women. Results: The frequency of PV in GBHS for nine breast cancer genes was 8.38% in cases and 1.22% in controls. Relative risk estimates for overall breast cancer were: (OR, 13.70; 95% confidence interval (CI), 4.03–46.51) for BRCA1, (OR, 7.02; 95% CI, 3.17–15.54) for BRCA2, (OR, 17.25; 95% CI, 2.15–138.13) for PALB2, 5 cases and no controls carried TP53 PVs, and 2.10, (0.72–6.14) for moderate-risk genes combined (ATM, BARD1, CHEK2, RAD51C, RAD52D). These estimates were similar to those previously reported in other populations and were modified by ER status. No other genes evaluated had mutations associated at P < 0.05 with overall risk. The estimated lifetime risks for mutation carriers in BRCA1, BRCA2, and PALB2 and moderate-risk genes were 18.4%, 9.8%, 22.4%, and 3.1%, respectively, markedly lower than in Western populations with higher baseline risks. Conclusions: We confirmed associations between PV and breast cancer risk in Ghanaian women and provide absolute risk estimates that could inform counseling in Ghana and other West African countries. Impact: These findings have direct relevance for breast cancer genetic counseling for women in West Africa.