Browsing by Author "Ariyaratne, M."

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Educational intervention on breast cancer early detection: effectiveness among target group women in the district of Gampaha, Sri Lanka
(Asian Pacific Organization for Cancer Prevention, 2015) Vithana, P.C.; Ariyaratne, M.; Jayawardana, P.
PURPOSE: The present study concerns the effectiveness of an educational intervention for improving knowledge, attitudes and practices (KAP) of breast cancer early detection among target group women (TGW) in the district of Gampaha, Sri Lanka. MATERIALS AND METHODS: The study was a community-based intervention. Two medical officer of health areas in Gampaha district were selected using random sampling as intervention (IA) and control (CA). Public health midwives (PHMs) in the IA were exposed to the educational intervention first, conducted the same among the TGW through PHMs. KAP was assessed using an interviewer- administrated questionnaire among 260 TGW from each area selected using cluster sampling before and six months after the intervention. RESULTS: The overall median scores for KAP among TGW in IG increased significantly from pre intervention level of 54% (IQR: 46-59%), 50% (IQR: 41-59%), and 0% (IQR: 0-20%) to post intervention level of 77% (IQR: 72-82%), 68% (IQR: 59- 76 %) and 40% (IQR: 20-60%) respectively. In CG, overall median scores for KAP remained almost the same at pre intervention 54% (IQR:44-59%), 50% (IQR:36-59%) and 0% (IQR: 0-20%) and post intervention 54% (IQR:46-59%), 50% (IQR:36-64%) and 0% (IQR: 0-20%) respectively. CONCLUSIONS: The educational intervention was found to be effective.
Qualitative assessment of breast cancer early detection services provided through well woman clinics in the district of Gampaha in Sri Lanka
(Asian Pacific Organization for Cancer Prevention, 2013) Vithana, P.V.; Hemachandra, N.N.; Ariyaratne, M.; Jayawardana, P.
BACKGROUND: Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detection can lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public health midwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions on improving existing breast cancer early detection services provided through Well Woman Clinics. MATERIALS AND METHODS: A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in the Gampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. RESULTS: All the PHMs had a firm realization on the need of breast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacy of training, lack of skills and material to provide health education, inability to provide privacy during clinical examination, shortage of stationery, lack of community awareness and motivation. The suggestions for the improvements of the programme identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. CONCLUSIONS: Results of the FGDs can provide useful information on components to be improved in breast cancer early detection services. Study recommendations were training programmes at basic and post basic levels on a regular basis and supervision for the sustainance of the breast cancer early detection program.
Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka
(Asian Pacific Organization for Cancer Prevention, 2013) Vithana, P. V.; Ariyaratne, M.; Jayawardana, P.
BACKGROUND: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. AIM: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. METHODS: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. RESULTS: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. CONCLUSIONS: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE