Evaluation of the self-care program for the health of middle-aged women (Breast cancer and cervical cancer): Findings from a six-month follow-up - Payesh (Health Monitor)
Mon, May 18, 2026
OPEN ACCESS
Volume 25, Issue 3 (May-June 2026)                   Payesh 2026, 25(3): 387-399 | Back to browse issues page

Ethics code: IR.TUMS.VCR.REC.1397.1087


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Maftoon F, Naghizadeh Moghari F, Allameh M R, Aeenparast A, Mohammad K, Farahani A et al . Evaluation of the self-care program for the health of middle-aged women (Breast cancer and cervical cancer): Findings from a six-month follow-up. Payesh 2026; 25 (3) :387-399
URL: http://payeshjournal.ir/article-1-2897-en.html
1- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
2- Ministry of Health and Medical Education, Tehran, Iran
3- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (69 Views)
Objective (s): Breast and cervical cancers are important global health challenges in the world. Between 30 to 50 percent of cancers could be prevented through avoiding risk factors. Thus, self-assessment and self-care have effective role in this way.
The objective of this study was evaluating the self-assessment and self-care program for middle-aged women in ministry of health regarding breast and cervical cancer.
Methods: This study was a pre-post interventional study. The study population was the middle-aged women (30 – 59 years old) who were covered by medical science universities. They were divided randomly in 2 groups as case and control ones, and their self-assessment and self-care condition regarding breast and cervical cancer was assessed. Then only case group received an educational program as intervention and after six months the data were gathered again from case and control groups. Chi 2 and logistic regression were used to define the effect of the educational program on the participants.
Results: In this study, 1960 middle-aged women were assessed. About 90% of studied cases were married, most of them had high school level education and also most of them were households. About cervical cancer in case group "risk factor assessment'' increased to 83% , " knowledge of risk factors" increased to 80% and both were improved compared to control group(p<0.05).  About breast cancer in case group "risk factor assessment'' increased to 95% , " knowledge of risk factors" increased to 83% and both were improved compared to control group(p<0.05). Also regression analysis showed that education, intervention program, receiving middle age services and being a health ambassador were effective in improving indexes in both cervical and breast cancers. In addition to these factors in cervical cancer, being married is another effective factor.
Conclusions: Although there were some limitations due to Covid 19 pandemic, the results show the intervention was effective. And the continuous implementation of this health program could play an important role in improving self-care and self-assessment and consequently in preventing and early diagnosis of breast and cervical cancer. Also, the awareness of risk factors in women's cancers needs to be improved yet. On the other hand, for assessing long term indexes, continuous studies are recommended.
Full-Text [PDF 1530 kb]   (36 Downloads)    
type of study: Case-control | Subject: Health Metrics
Received: 2025/05/20 | Accepted: 2026/02/10 | ePublished ahead of print: 2026/04/26 | Published: 2026/05/6

References
1. Balou H A, Joukar F, Yeganeh S, Hassanipour S, Naghipour M, Baghaee M, et al. Epidemiological study of different types of cancers among adults Persian Guilan cohort study. Journal of Guilan University of Medical Sciences 2023; 31: 274-285 [Persian] [DOI:10.32598/JGUMS.31.3.1748.5]
2. Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. Journal of Clinical Oncology 2013;31: 782-93 [DOI:10.1200/JCO.2011.40.8922]
3. Zende Del K. Cancer in Iran (Comparative report on cancer statistics in Iran and the world in 2010 and forecast for the next 15 years), 1st Edition, National Institute of Health Research of Iran, Tehran, 1403 [Persian]
4. Hosseini S S, Yousefi Z, Emadzadeh M, Homaei Shandiz F, Hokamabadi P, Salehi M, Shojaei, P Salehi M. Changes in the prevalence and epidemiology of female genital cancers in northeastern Iran in a 35-year study. Iranian Journal of Gynecology, Obstetrics and Infertility 2019; 22: 11-18 [Persian]
5. Hadavandsiri F, Allahqoli L, Rahimi Y, Salehiniya H, Ghazanfari Savadkoohi E, Akbari ME. Cancer incidence in Iran in 2016: A study based on the Iranian National Cancer Registry. Cancer Reports 2024; 7: e1967 [DOI:10.1002/cnr2.1967]
6. Shiyanbola OO, Arao RF, Miglioretti DL, Sprague BL, Hampton JM, Stout NK, Kerlikowske K, Braithwaite D, Buist DSM, Egan KM, Newcomb PA, Trentham-Dietz A. Emerging trends in family history of breast cancer and associated risk. Cancer Epidemiology, Biomarkers & Prevention 2017; 26: 1753-1760 [DOI:10.1158/1055-9965.EPI-17-0531]
7. Pharoah PD, Day NE, Duffy S, Easton DF, Ponder BA. Family history and the risk of breast cancer: a systematic review and meta‐analysis. International Journal of Cancer 1997; 71: 800-9 https://doi.org/10.1002/(SICI)1097-0215(19970529)71:5<800::AID-IJC18>3.0.CO;2-B [DOI:10.1002/(SICI)1097-0215(19970529)71:53.0.CO;2-B]
8. Liu L, Hao X, Song Z, Zhi X, Zhang S, Zhang J. Correlation between family history and characteristics of breast cancer. Scientific Reports 2021; 11: 6360 [DOI:10.1038/s41598-021-85899-8]
9. Sattin RW, Rubin GL, Webster LA, Huezo CM, Wingo PA, Ory HW, Layde PM. Family history and the risk of breast cancer. Jama 1985; 253:1908-13 [DOI:10.1001/jama.1985.03350370104033]
10. Colditz GA, Kaphingst KA, Hankinson SE, Rosner B. Family history and risk of breast cancer: nurses' health study. Breast Cancer Research and Treatment 2012;133: 1097-104 [DOI:10.1007/s10549-012-1985-9]
11. Li Y, Song W, Gao P, Guan X, Wang B, Zhang L, Yao Y, Guo Y, Wang Y, Jiang S, Sun S. Global, regional, and national burden of breast, cervical, uterine, and ovarian cancer and their risk factors among women from 1990 to 2021, and projections to 2050: findings from the global burden of disease study 2021. BMC Cancer 2025; 25: 330 [DOI:10.1186/s12885-025-13741-9]
12. Alavi A, Shahsavari S, Mahboobi M, Banihashemi SH. Factors related to cervical cancer screening among women in Bandar Abbas, Iran: A cross-sectional study. Journal of Preventive Medicine 2022; 9: 360-375 [Persian]
13. Banihashemi SH, Mirabbasi SA, Azizi Kutenaee M. Demographic characteristics, knowledge, and accessibility of cervical cancer screening services in women living on the outskirts of Bandar Abbas city, southern Iran. Journal of Preventive Medicine 2024; 10: 342-355 [Persian]
14. World Health Organization. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. World Health Organization, 2021. Available from: https://www.who.int/publications/i/item/9789240030824. accessed 2025 May 17
15. Jadgal MS, Alizadeh-Siuki H. The effect of an educational program based on Protection Motivation Theory (PMT) in adopting preventive behaviors from uterine cervical neoplasm among women referring to health centers in Torbat Heydariyeh city. The Journal of Tolooebehdasht 2024; 23 :1-15 [DOI:10.18502/tbj.v23i2.16094]
16. Rezaianzadeh A, Dehghani SL, Mousavi M, Rezaeianzadeh R. The incidence of uterus cancer in Iran: A systematic review. Women's Health Bulletin 2017; 4: 1-4 [DOI:10.17795/whb-42917]
17. Kianpour M, Taleghani F, Noroozi M, Savabi-Esfahani M, Boroumandfar Z, Changiz T, Ravankhah Z, Javanmard SH, Hashemi MS. Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol. Women's Midlife Health 2022; 8: 7 [DOI:10.1186/s40695-022-00077-8]
18. Zhang S, Xu H, Zhang L, Qiao Y. Cervical cancer: Epidemiology, risk factors and screening. Chinese Journal of Cancer Research 2020; 32: 720 [DOI:10.21147/j.issn.1000-9604.2020.06.05]
19. Kashyap N, Krishnan N, Kaur S, Ghai S. Risk factors of cervical cancer: a case-control study. Asia-Pacific Journal of Oncology Nursing 2019; 6: 308-314 [DOI:10.4103/apjon.apjon_73_18]
20. Agustiansyah P, Sanif R, Nurmaini S. Epidemiology and risk factors for cervical cancer. Bioscientia Medicina: Journal of Biomedicine and Translational Research 2021; 5: 624-31 [DOI:10.32539/bsm.v5i7.326]
21. Ramachandran D, Dörk T. Genomic risk factors for cervical cancer. Cancers 2021; 13: 5137 [DOI:10.3390/cancers13205137]
22. Singh S, Narayan N, Sinha R, Sinha P, Sinha VP, Upadhye JJ. Awareness about cervical cancer risk factors and symptoms. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2018; 7: 4987-4991 [DOI:10.18203/2320-1770.ijrcog20184953]
23. Delam H, Izanloo S, Bazrafshan MR, Eidi A. Risk factors for cervical cancer: An epidemiological review. Journal of Health Sciences & Surveillance System 2020; 8: 105-109
24. Stevanato KP, Santos LD, Pelloso FC, Borghesan DH, Consolaro ME, de Almeida R, Huber IM, Egger P, Alarcão AC, de Souza RR, Ribeiro HF. Breast cancer and cervical cancer: a comparison of the period before and during the COVID-19 pandemic. BMC Women's Health 2024; 24: 485 [DOI:10.1186/s12905-024-03325-3]
25. Conte L, De Nunzio G, Lupo R, Mieli M, Lezzi A, Vitale E, Carriero MC, Calabrò A, Carvello M, Rubbi I, Federico M. Breast cancer prevention: the key role of population screening, Breast Self-Examination (BSE) and technological tools. survey of Italian women. Journal of Cancer Education 2023; 38: 1728-1742 [DOI:10.1007/s13187-023-02327-3]
26. Masawa G, Mboineki JF. Assessing breast self-examination knowledge, attitude and practice as a secondary prevention of breast cancer among female undergraduates at the University of Dodoma: a protocol of analytical cross-sectional study. Frontiers in Epidemiology 2024; 4: 1227856 [DOI:10.3389/fepid.2024.1227856]
27. Milosevic M, Jankovic D, Milenkovic A, Stojanov D. Early diagnosis and detection of breast cancer. Technology and Health Care 2018; 26: 729-759 [DOI:10.3233/THC-181277]
28. Coleman C. Early detection and screening for breast cancer. Seminars in oncology nursing 2017; 33: 141-155 [DOI:10.1016/j.soncn.2017.02.009]
29. Khatib OM, Modjtabai A. Guidelines for the early detection and screening of breast cancer. World Health Organization, Regional Office for the Eastern Mediterranean 2006. Available from: https://applications.emro.who.int/dsaf/dsa696.pdf .accessed 2025
30. Kolak A, Kamińska M, Sygit K, Budny A, Surdyka D, Kukiełka-Budny B, Burdan F Primary and secondary prevention of breast cancer. Annals of Agricultural and environmental Medicine 2017; 24: 553-549 [DOI:10.26444/aaem/75943]
31. Basu P, Mittal S, Vale DB, Kharaji YC. Secondary prevention of cervical cancer. Best Practice & Research Clinical Obstetrics & Gynaecology 2018; 47: 73-85 [DOI:10.1016/j.bpobgyn.2017.08.012]
32. Viveros-Carreño D, Fernandes A, Pareja R. Updates on cervical cancer prevention. International Journal of Gynecological Cancer 2023; 33: 394-402 [DOI:10.1136/ijgc-2022-003703]
33. Perkins Rebecca B, Wentzensen Nicolas, Guido Richard S, Schiffman Mark. Cervical cancer screening: a review. Jama 2023; 330: 547-558 [DOI:10.1001/jama.2023.13174]
34. Alfaro K, Maza M, Cremer M, Masch R, Soler M. Removing global barriers to cervical cancer prevention and moving towards elimination. Nature Reviews Cancer 2021; 21: 607-608 [DOI:10.1038/s41568-021-00396-4]
35. Basoya S, Anjankar A. Cervical cancer: early detection and prevention in reproductive age group. Cureus 2022; 14: e3131 [DOI:10.7759/cureus.31312]
36. Cheraghi F, Borzo SR, Katiban M, Maghsoudi Z. The effect of applying orem self-care model on quality of life in iranian patients: a systematic review study. Iranian Journal of Systematic Review in Medical Sciences 2023; 1: 30-40 [Persian]
37. Alligood MR. Nursing theory: Utilization & application. 5th Edition, imprint of Elsevier: Missouri, 2013
38. Sayadi A, Abedini S, Abedini S, Kamal Zadeh H. Self-care and health literacy in Iranian elderly: a review. Journal of Modern Medical Information Science 2023; 9:80م-89 [Persian]
39. Bozorgi N, shah Hosseini Z. The Effective Techniques to Promote Self-care Behaviors in Women of Reproductive Age: A narrative review study. Current Research in Medical Sciences 2017; 2: 19-30 [Persian]
40. Farahmand F, Khorasani P, Shahriari M. Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards. ARYA Atheroscler 2019; 15: 44-52
41. Babazadeh T, Dianatinasab M, Daemi A, Nikbakht H. A, Moradi F, Ghaffari-Fam S. Association of self-care behaviors and quality of life among patients with type 2 diabetes mellitus: Chaldoran county, Iran. Diabetes & Metabolism Journal 2017; 41: 449-456 [DOI:10.4093/dmj.2017.41.6.449]
42. Jahromi MK, Ramezanli S, Taheri L. Effectiveness of diabetes self-management education on quality of life in diabetic elderly females. Global Journal of Health Science 2014; 7: 10-5 [DOI:10.5539/gjhs.v7n1p10]
43. Mohamadian H, Bazarghani A, Latifi SM, Moradgholi A. Effect of motivational interviewing on hypertension, self-care and quality of life of rural aged people: application of health belief model. Journal of Education and Community Health 2019; 6: 95-101 [Persian] [DOI:10.29252/jech.6.2.95]
44. Bagheri M, Bagheri M, Niknami S. The effect of educational intervention on knowledge and self-care of elderly people with type 2 diabetes. Journal of Gerontology 2018; 3: 1-10 [Persian] [DOI:10.29252/joge.3.2.21]
45. Gholamnejad H, Darvishpoor-Kakhki A, Ahmadi F, Rohani C. Self-actualization: self-care outcomes among elderly patients with hypertension. Iranian Journal of Nursing and Midwifery Research 2019; 24: 206-212 [DOI:10.4103/ijnmr.IJNMR_95_18]
46. Glanz KE, Lewis FM, Rimer BK. Health behavior and health education: Theory, research, and practice. Fifth Edition, Jossey-Bass/Wiley: New York City, 1990: 45-65
47. Prochaska JO, DiClemente CC. Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research & Practice 1982;19: 276-288 [DOI:10.1037/h0088437]
48. Luszczynska A, Schwarzer R. Social Cognitive Theory. Predicting Health Behaviour 2015: 127-169
49. World Health Organization. WHO guideline on self-care interventions for health and well-being. World Health Organization, 2022
50. Lurgain JG, Ouaarab-Essadek H, Mellouki K, Malik-Hameed S, Sharif A, Brotons M, Bruni L, Peremiquel-Trillas P. Exploring self-care and cervical cancer prevention attitudes and practices among Moroccan and Pakistani immigrant women in Catalonia, Spain: a comparative qualitative study. BMC Public Health 2024; 24: 388 [DOI:10.1186/s12889-023-17445-2]
51. Centers for Disease Control and prevention. https://www.cdc.gov/cancer/php/interventions/.
52. Mon HM, Robb KA, Demou E. Effectiveness of workplace cancer screening interventions: a systematic review. BMC Cancer 2024; 24: 999 [DOI:10.1186/s12885-024-12649-0]
53. Lu M, Moritz S, Lorenzetti D, Sykes L, Straus S, Quan H. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC Public Health 2012; 12: 413 [DOI:10.1186/1471-2458-12-413]
54. Liu X, Wang Y, Gao B, Lu X, Wang Y, Lu W. Modeling optimal combination of breast and cervical cancer screening strategies in China. BMC Women's Health 2025; 25: 56 [DOI:10.1186/s12905-025-03573-x]
55. Ifediora CO. Re-thinking breast and cervical cancer preventive campaigns in developing countries: the case for interventions at high schools. BMC Public Health 2019; 19: 503 [DOI:10.1186/s12889-019-6890-2]
56. Whitehead L, Kirk D, Chejor P, Liu W, Nguyen M, Balczer C, Lan C, Evans M. Interventions, programmes and resources that address culturally and linguistically diverse consumer and carers' cancer information needs: a mixed methods systematic review. BMC Cancer 2025; 25: 599 [DOI:10.1186/s12885-025-13931-5]
57. Ralaidovy AH, Gopalappa C, Ilbawi A, Pretorius C, Lauer JA. Cost-effective interventions for breast cancer, cervical cancer, and colorectal cancer: new results from WHO-CHOICE. Cost Effectiveness and Resource Allocation 2018; 16: 38 [DOI:10.1186/s12962-018-0157-0]
58. Chen Q, Zhao J, Xue X, Xie X. Effect of marital status on the survival outcomes of cervical cancer: a retrospective cohort study based on SEER database. BMC Women's Health 2024; 24: 75 [DOI:10.1186/s12905-024-02907-5]
59. Seyrafi N, Homayuni A, Hosseini Z, Aghamolaei T, Ghanbarnejad A, Mouseli A. Effectiveness of educational intervention on women's participation to cervical cancer screening: a quasi-experimental study based on PEN-3 model. BMC Cancer 2022; 22: 1226 [DOI:10.1186/s12885-022-10331-x]
60. Programs National Cancer Institute. Evidence-Based Cancer Control. Retrieved April 20, 2025, from https://ebccp.cancercontrol.cancer.gov/searchResults.do.
61. Dsouza JP, Broucke SV. DOST: A consolidated health behavior model that maps factors influencing cancer screening uptake. Archives of Public Health 2025; 83: 70 [DOI:10.1186/s13690-025-01517-3]
62. Henderson V, Tossas-Milligan K, Martinez E, Williams B, Torres P, Mannan N, Green L, Thompson B, Winn R, Watson KS. Implementation of an integrated framework for a breast cancer screening and navigation program for women from underresourced communities. Cancer 2020; 126 2481-2493 [DOI:10.1002/cncr.32843]
63. Shafti V, Ghalandari M. Knowledge about pap smear test, cervical cancer and human papilloma virus among women referred to gynecology clinic of Tonekabon shahid Rajaei hospital in 2016. Medical Sciences Journal of Islamic Azad university 2018; 27: 294-300[Persian]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and Permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 All Rights Reserved | Payesh (Health Monitor)

Designed & Developed by : Yektaweb