“The Level of Awareness Among Female Nursing students Regarding Breast Cancer”

QUESTIONNAIRE

The following information will be used as important variables significant to the study.
Direction: Please fill-in the needed information as asked.

Part I. Profile Characteristics

1. Age: 15-16 __ 21-22 __

17-18 __ 23-24 __
19-20 __ 25-26 __

2. Year Level
1st year __ 3rd year__
2nd year__ 4th year__

3. Civil Status
Single __ Married__
Widow__ Separated/Divorced__

4. Religion
Islam __ Catholic __
Others pls. specify__________

5. Tribe
Pls. specify ____________

Part II. On the level of awareness regarding breast cancer below are several items related
to cancer. Rate the level of your awareness by encircling an item that closely corresponds
to your choice.

Scale: 1- Not aware 3- Aware to some extent

2- Aware to a little extent 4- Aware to a great extent

Items 1 2 3 4
1 Breast cancer is the leading cause of cancer deaths in the Philippines
2 Breast cancer is also the leading cause of cancer among women
3 Female breast usually slightly larger/ smaller, higher/lower or different
shaped to the other side
4 Breast cancer is always by a genetic abnormality as result of aging
5 Breast cancer is due to an abnormality inherited from your mother or
father
6 Lifestyle like drinking habit, smoking can cause breast cancer
7 Being overweight, obese or physically inactive can cause breast cancer
and may to death
8 Early pregnancy is a risk factor of having breast cancer
9 There is a procedure to detect early symptoms of breast cancer
1 The procedure is done monthly
0
1 Some changes in breast are caused by constant irritation from poor
1 fitting brassiere
1 High dietary intale of fat increases breast cancer risk
2
1 Women ages 40 and above should have a screening mammogram
3 every year
1 Between the age of 20-29 women should have clinical breast exam
4 every 3 years
1 Longer breast feeding may help reduce having breast cancer
5
1 Women who were breastfed as infants lowers risks in developing
6 breast cancer
1 Signs and symptoms can include a lump or thickening in or near the
7 breast; a change in the size or shape of the breast; nipple discharge,
tenderness, or retraction (turning inward); and skin irritation,
dimpling, or scaliness.
1 breast cancer is not contagious
8
1 A woman who had breast cancer in one breast has an increased risk of
9 getting cancer in her other breast
2 A woman's risk of breast cancer is higher if her mother, sister, or
0 daughter had breast cancer
2 The older a woman is when she has her first child, the greater her
1 chance of breast cancer
2 Women who had their first menstrual period before age 12 are at an
2 increased risk of breast cancer.
2 Women who never had children are at an increased risk of breast
3 cancer
2 Women who had radiation therapy to the chest (including breasts)
4 before age 30 are at an increased risk of breast cancer
2 Women with breast cancer have many treatment options such as
5 surgery, radiation therapy, chemotherapy, hormone therapy, and
biological therapy
2 Eating fresh mushrooms helps decrease risk of breast cancer
6
Part III. Health Practices
The following items are possible health practices and beliefs related to the prevention of
cancer that you might use.
Please encircle your answer.

Scale 1- Always 3- Rarely

2- Sometimes 4- Never

Items 1 2 3 4
1 I perform self-breast examination
2 I visit physician for check-up
3 I undergo mammography
4 I wear well fitting, supportive brassiere
5 I also teach self-breast examination to my friends
6 I check my both breast every after menstrual period
7 I check my breast if there are changes of size and shape
8 I examine each of my underarm for abnormalities
9 I used the finger pads of the 3 middle finger when checking my breast
1 I wear brassiere even when I’m sleeping
0
1 I eat balanced diet
1
1 I do smoke
2
1 I drink alcohol
3 I exercise regularly
1
4
1 I use oral contraceptive pills
5
1 I eat vegetables and fruits
6