JRSSEM 2022, Vol. 01, No. 7, 902 – 909
E-ISSN: 2807 - 6311, P-ISSN: 2807 - 6494
DOI : 10.36418/jrssem.v1i7.115
THE EFFECT OF MEDIA CADRES HANDBOOK ON BREAST
CANCER AND BREAST SELF-EXAMINATION (BSE) ON
KNOWLEDGE AND SKILLS OF HEALTH CADRES IN
TAMANSARI DISTRICT, TASIKMALAYA CITY
Sariestya Rismawati1
Yulia Herliani2
Laila Putri Suptiani3
1,2,3Department of Midwifery, Poltekkes Kemenkes Tasikmalaya
*Correspondence: lailaputrisupt[email protected]
Submitted: 29 January 2022, Revised: 10 February 2022, Accepted: 20 February 2022
Abstract. Health promotion about Breast Cancer and its Early Detection can be done by health
cadres. There are still many health cadres who do not understand breast cancer and how to detect
breast cancer early. The COVID-19 Pandemic conditions that limit direct interaction have limited
the process of developing the ability of cadres in this case to increase knowledge, so health
education is needed with media that is easy to understand and practical so that it can be used
flexibly anywhere and anytime. This cadre handbook has passed due diligence from material
experts, media experts and linguists, as well as passed a small-scale test on representatives of
health cadres in independent research with the results very feasible to use. Breast Cancer and Breast
Self-Examination (BSE) on Cadre Knowledge and Skills. The design used is a quasi-experimental
design with a one group pretest-posttest design. The sample in this study was health cadres in
Tamansari District, Tasikmalaya City. The sampling technique used is purposive sampling. The
research variables are knowledge and skills. The data used are primary data in the form of
questionnaire results and observations. Data analysis was carried out using two analytical
techniques, namely univariable and bivariable analysis. The bivariable analysis used was to
determine the effect of the cadre handbook on knowledge and skills using the Wilcoxon test. There
is an effect of cadre handbooks on knowledge and skills of cadres about breast cancer and breast
self-examination (p=0.000). The effect of the cadre handbook on breast cancer and Breast Self-
Examination (BSE) on the knowledge and skills of health cadres in Tamansari District, Tasikmalaya
City.
Keywords: handbook of health cadre; breast cancer; breast self-examination (BSE)
Sariestya Rahmawati, Yulia Herliani, Laila Putri Suptiani | 903
DOI : 10.36418/jrssem.v1i7.115
INTRODUCTION
Cancer is a condition in which cells have
lost their normal control and mechanism,
resulting in abnormal, fast and
uncontrolled growth, and threatens the
lives of individual sufferers (Risdayanti &
Herlina, 2020). Based on Basic Health
Research (Germano, Swiss, & Casaccia,
2010), the prevalence of tumor/cancer in
Indonesia is 4.3 per 1000 population and
cancer is the 7th leading cause of death
(5.7%) after stroke, TB, hypertension, injury,
perinatal and DM. The incidence of breast
cancer in Indonesia is 42.1 per 100,000
population with an average death rate of 17
per 100,000. Data from the West Java
Provincial Health Office in 2009, there were
594 cases of breast cancer, while data from
the Tasikmalaya City Health Service in 2020,
it was found that 47 people had breast
cancer and 2 people died (Tasikmalaya City
Health Office, 2020). According to
(Hidayati, Salawati, & Istiana, 2013);
(Tahmooresi, Afshar, Rad, Nowshath, &
Bamiah, 2018) breast cancer can be found
at an early stage by means of early
detection. This detection is done by doing
a “breast self-examination” or what is
known as BSE.
Community education and knowledge is an
important part that must be improved to
improve this condition (Thiel et al., 2013);
(Cannon et al., 2016). To accelerate the
achievement of these improvement goals,
health education and knowledge
dissemination are needed (Green, Ottoson,
García, Hiatt, & Roditis, 2014). Health
promotion about Breast Cancer and its
Early Detection can be done by health
cadres. From the preliminary studies that
have been carried out, it turns out that
there are still many health cadres who do
not understand about breast cancer and
how to detect breast cancer early, so they
have difficulty in socializing this problem to
the public, especially WUS. The COVID-19
Pandemic conditions that limit direct
interaction have limited the process of
developing the ability of cadres in this case
to increase knowledge (Iyengar,
Upadhyaya, Vaishya, & Jain, 2020);
(Tshishonga, 2014), so health education is
needed with media that is easy to
understand and practical so that it can be
used flexibly anywhere and anytime. To
minimize these limitations, a guide book
for cadres has been compiled that covers
the topic of breast cancer and breast self-
examination so that cadres can more easily
understand and provide education to
women of childbearing age (Browne et al.,
2018); (Connelly, Lauber, Niederdeppe, &
Knuth, 2014); (Mitchell & Fantasia, 2016).
This cadre handbook has passed due
diligence from material experts, media
experts and linguists, as well as passed a
small-scale test on representatives of
health cadres in independent research with
the results very feasible to use (Merriel et
al., 2021); (Van Ginneken et al., 2017). As a
follow-up to the independent research,
further research is needed to see the effect
of the media that has been compiled (Yu,
Duan, & Cao, 2013). Based on the
description of the background, the authors
are interested in conducting research on
"The Effect of Cadre Handbook Media on
Breast Cancer and Breast Self-Examination
(BSE) on Knowledge and Skills of Health
Cadres in Tamansari District, Tasikmalaya
City".
904 | The Effect of Media Cadres Handbook on Breast Cancer and Breast Self-Examination
(BSE) on Knowledge and Skills of Health Cadres in Tamansari District, Tasikmalaya City
The problem in this study is whether
there is an effect of the cadre handbook on
breast cancer and Breast Self-Examination
(BSE) on the knowledge and skills of health
cadres in Tamansari District, Tasikmalaya
City.
The purpose of this study was to
determine the effect of the cadre handbook
on breast cancer and Breast Self-
Examination (BSE) on the knowledge and
skills of health cadres in Tamansari District,
Tasikmalaya City.
METHODS
This study aims to determine the effect
of the Cadre Handbook on Breast Cancer
and Breast Self-Examination on Cadre
Knowledge and Skills with a quasi-
experimental design with a one group
pretest-posttest design (Azlina, Setyowati,
& Budiati, 2021). This research was
conducted in April-June 2021 in Tamansari
District, Tasikmalaya City. The population in
this study were all health cadres in
Tamansari District, Tasikmalaya City. The
sample was taken by purposive sampling,
with the criteria that health cadres were
recorded as active in activities, physically
and mentally healthy. The data used are
primary data in the form of questionnaire
results and observations. Data analysis was
carried out using two analytical techniques,
namely univariable and bivariable analysis.
Bivariable analysis used is the Wilcoxon test
analysis.
RESULTS AND DISCUSSION
The research was carried out according
to the plan. Prior to health education, all
targets were given pre-test questions to
determine the extent of knowledge about
breast cancer and breast self-examination
as well as BSE skills, then after the activity,
post-test questions were given to see if
there was an increase in knowledge after
health education.
1. Knowledge of Cadres about Breast
Cancer
Based on the results of the pre-test
and post-test it can be seen in the table
below:
Table 1. Frequency Distribution of Cadre Knowledge about Breast Cancer
in Tamansari District, Tasikmalaya City in 2021
No
Category
Pre-test
Post-test
F
%
F
%
1
Good
3
10
23
77
2
Enough
17
57
7
23
3
Less
10
33
0
0
TOTAL
30
100
30
100
From table 1 it can be seen that the
knowledge of health cadres about
breast cancer and breast self-
examination before health education is
carried out is in the good category as
many as 3 people (10 %), enough
Sariestya Rahmawati, Yulia Herliani, Laila Putri Suptiani | 905
category is 17 people (57%) and less
category is 10 people (33%), while
knowledge of cadres after health
education is in good category as many
as 23 people (77%) and enough
category 7 people (23%). According to
Kurniasih (2014), books act as sources
of information that are communicative,
interesting and not boring. This can be
seen from the results of the pre-test
knowledge of health cadres about
breast cancer that there is an increase
in knowledge.
The implementation of community-
based social support efforts through
increasing knowledge and the active
role of Posyandu cadres in socializing
breast cancer health cadres are
expected to help disseminate the
knowledge and skills they have
acquired to the wider community so
that public knowledge about cervical
cancer and breast cancer and their
prevention increases. Public awareness
needs to be increased so that they are
willing to carry out early detection of
cervical cancer and breast cancer on a
regular basis.
2. Cadre Skills in Performing BSE
Based on the results of the pre test
and post test assessments can be seen
in the table below:
Table 2. Frequency Distribution of Cadre Skills in conducting BSE
in Tamansari District, Tasikmalaya City in 2021
No
Category
Pre-test
Post-test
F
%
F
%
1
Good
0
0
30
100
2
Enough
0
0
0
0
3
Less
30
100
0
0
TOTAL
30
100
30
100
From table 4.2 it can be seen that
the skills of health cadres in performing
BSE before health education were
implemented were in the less category
as many as 30 people (100%), while
cadre skills after health education are in
the good category as many as 30
people (100%).
Books have a role not only to
present essential and strategic
information, but also to be useful as
problem solving tools. In this case, the
cadre handbook is used as a
guidebook/guideline to convey a topic
regarding breast self-examination.
From the results of this study, it can be
seen that there is a change in the skills
of health cadres in carrying out BSE.
In addition, people who are trained
by health cadres are able and aware to
carry out BSE examinations as an early
detection of breast cancer. With the
increasing knowledge, awareness, and
ability of the community to carry out
early detection of cancer, it is hoped
that the morbidity and mortality rates
of cervical cancer and breast cancer can
decrease.
3. Effect of the Cadre Handbook on Breast
Cancer and BSE on the knowledge and
906 | The Effect of Media Cadres Handbook on Breast Cancer and Breast Self-Examination
(BSE) on Knowledge and Skills of Health Cadres in Tamansari District, Tasikmalaya City
skills of Health Cadre in Early Detection
of Breast Cancer.
Before the results of the influence
test were carried out, a normality test
was carried out using Shapiro Wilk,
based on the analysis, it was obtained:
Table 3. Normality Test
Kolmogorov-Smirnova
Shapiro-Wilk
Statistics
df
Sig.
Statistics
df
Sig.
Knowledge_Pre
137
30
156
963
30
379
Knowledge_Post
189
30
008
897
30
007
Skill_Pre
537
30
000
275
30
000
Skill_Post
253
30
000
848
30
001
a. Lilliefors Significance Correction
Based on this analysis, the
knowledge data is normally distributed
while the data for skills is not normally
distributed.
After the normality test was carried
out, the effect was tested using
Wilcoxon analysis. From the results of
the analysis, it was obtained:
The independent variables in this
study consisted of knowledge and
skills. The relationship between
independent variables is shown in the
following table.
Table 4. Relationships Between Variables
Relationship between Variables
Correlation
Coefficient
(Rw)
Value p
Knowledge with cadre handbooks
-4.813
0.000
Skills with cadre handbooks
-4.850
0.000
Information: Rw= Wilcoxon
Based on the table, it is known that
Asymp Sig (2 -tailed) is 0.000. Because
the value of 0.000 is smaller than <0.05,
it can be concluded that there is a
difference between the results of
knowledge and skills for the pre-test
and post-test, so it can be concluded
that there is an effect of using the Cadre
Handbook on Breast Cancer and BSE on
the knowledge and skills of Health
Cadres. in Early Detecting Breast
Cancer.
Handbooks are also known as
manuals or manuals. Handbooks
usually contain detailed and technical
descriptions of a particular field. A
cadre handbook is a guidebook or
guide for cadres to convey a certain
topic. The cadre handbook in this study
is a guide book that can be used by
health cadres to provide health
promotion or information to women of
childbearing age about breast cancer
Sariestya Rahmawati, Yulia Herliani, Laila Putri Suptiani | 907
and breast self-examination (BSE).
Community involvement as a
community where breast cancer clients
live is certainly very necessary in an
effort to provide social support to
breast cancer clients. One of the efforts
to improve the quality of life of breast
cancer clients is the formation of social
support from the community where
breast cancer clients are located.
Several studies state that perceived
adequate social support is an important
factor for a better quality of life and
lower levels of psychological distress.
This reflects the importance of paying
attention to activities that enhance and
maintain social support systems for
breast cancer patients (Witdiawati,
2018).
Program efforts and social support
from the community are certainly
needed to improve the quality of life of
cancer patients (Witdiawati, 2018).
Thus, the contribution of families as
providers of care and strengthening the
capacity of health cadres is very
important. Lack of exposure to the
public and health cadres about breast
cancer is predicted to be the cause of
the lack of social support for clients
with breast cancer. This support will
appear along with the increasing
knowledge and attitudes of the
community towards the problem of
breast cancer. Therefore, it is necessary
to carry out an activity to increase the
capacity of cadres in recognizing and
preventing breast cancer so that
community-based social support can
be increased. In the Ottawa Charter
strategy, it is stated that one of the
efforts for health promotion is to
strengthen community action. Through
the involvement and empowerment of
the community (health cadres) it is
hoped that social support for breast
cancer clients can increase.
CONCLUSIONS
There is an effect of the cadre
handbook on breast cancer and Breast Self-
Examination (BSE) on the knowledge and
skills of health cadres in Tamansari District,
Tasikmalaya City. There is an increase in the
knowledge about breast cancer and skills of
cadres (breast self-examination/ BSE). The
cadre handbook in this study is a guide
book that can be used by health cadres to
provide health promotion or information to
women of childbearing age about breast
cancer and breast self-examination (BSE).
Through the involvement and
empowerment of the community (health
cadres) it is hoped that social support for
breast cancer clients can increase.
REFERENCES
Azlina, Fitri Ayatul, Setyowati, Setyowati, &
Budiati, Tri. (2021). Female health
education package enhances
knowledge, attitudes, and self-efficacy
of housewives in cervical cancer
screening. Enfermería Clínica, 3(2),
S215–S219.
https://doi.org/10.1016/j.enfcli.2020.12
.025
Browne, Alacoque L., Charmsaz, Sara,
Varešlija, Damir, Fagan, Ailis, Cosgrove,
Nicola, Cocchiglia, Sinéad, Purcell,
Siobhan, Ward, Elspeth, Bane, Fiona, &
Hudson, Lance. (2018). Network
908 | The Effect of Media Cadres Handbook on Breast Cancer and Breast Self-Examination
(BSE) on Knowledge and Skills of Health Cadres in Tamansari District, Tasikmalaya City
analysis of SRC-1 reveals a novel
transcription factor hub which
regulates endocrine resistant breast
cancer. Oncogene, 3(5), 2008–2021.
Cannon, Danielle, Buys, Nicholas, Sriram,
Krishna Bajee, Sharma, Siddharth,
Morris, Norman, & Sun, Jing. (2016).
The effects of chronic obstructive
pulmonary disease self-management
interventions on improvement of
quality of life in COPD patients: A meta-
analysis. Respiratory Medicine, 2(2), 81–
90.
Connelly, Nancy A., Lauber, T. Bruce,
Niederdeppe, Jeff, & Knuth, Barbara A.
(2014). How can more women of
childbearing age be encouraged to
follow fish consumption
recommendations? Environmental
Research, 3(5), 88–94.
https://doi.org/10.1016/j.envres.2014.0
8.027
Germano, Isabelle, Swiss, Victoria, &
Casaccia, Patrizia. (2010). Primary brain
tumors, neural stem cell, and brain
tumor cancer cells: where is the link?
Neuropharmacology, 5(6), 903–910.
https://doi.org/10.1016/j.neuropharm.
2009.12.019
Green, Lawrence W., Ottoson, Judith M.,
García, César, Hiatt, Robert A., & Roditis,
Maria L. (2014). Diffusion theory and
knowledge dissemination, utilization
and integration. Frontiers in Public
Health Services & Systems Research,
3(1).
Hidayati, Aprilia, Salawati, Trixie, & Istiana,
Siti. (2013). Pengaruh pendidikan
kesehatan melalui metode ceramah
dan demonstrasi dalam meningkatkan
pengetahuan tentang kanker payudara
dan ketrampilan praktik sadari (Studi
pada Siswi SMA Futuhiyyah Mranggen
Kabupaten Demak). Jurnal Kebidanan,
1(1), 1–8.
https://doi.org/10.26714/jk.1.1.2012.1-
8
Iyengar, Karthikeyan, Upadhyaya, Gaurav
K., Vaishya, Raju, & Jain, Vijay. (2020).
COVID-19 and applications of
smartphone technology in the current
pandemic. Diabetes & Metabolic
Syndrome: Clinical Research & Reviews,
4(5), 733–737.
https://doi.org/10.1016/j.dsx.2020.05.0
33
Merriel, Abi, Dembo, Zione, Hussein, Julia,
Larkin, Michael, Mchenga, Allan, Tobias,
Aurelio, Lough, Mark, Makwenda,
Charles, & Coomarasamy, Arri. (2021).
Assessing the impact of a motivational
intervention to improve the working
lives of maternity healthcare workers: a
quantitative and qualitative evaluation
of a feasibility study in Malawi. Pilot and
Feasibility Studies, 7(1), 1–15.
Mitchell, Allison, & Fantasia, Heidi Collins.
(2016). Understanding the effect of
obesity on fertility among
reproductive-age women. Nursing for
Women’s Health, 2(4), 368–376.
https://doi.org/10.1016/j.nwh.2016.07.
001
Risdayanti, Risdayanti, & Herlina, Nunung.
(2020). Hubungan Antara Faktor
Psikososial dan Faktor Lingkungan
dengan Kualitas Hidup Pasien Kanker
yang Menjalani Kemoterapi di RSUD
Abdul Wahab Sjahranie Samarinda.
Borneo Student Research (BSR), 1(3),
2118–2129.
Tahmooresi, M., Afshar, A., Rad, B. Bashari,
Sariestya Rahmawati, Yulia Herliani, Laila Putri Suptiani | 909
Nowshath, K. B., & Bamiah, M. A. (2018).
Early detection of breast cancer using
machine learning techniques. Journal of
Telecommunication, Electronic and
Computer Engineering (JTEC), 2(3), 21–
27.
Thiel, Chase E., Connelly, Shane, Harkrider,
Lauren, Devenport, Lynn D.,
Bagdasarov, Zhanna, Johnson, James F.,
& Mumford, Michael D. (2013). Case-
based knowledge and ethics education:
Improving learning and transfer
through emotionally rich cases. Science
and Engineering Ethics, 2(1), 265–286.
Tshishonga, N. (2014). Cadre deployment
and its implications on service delivery
in South Africa: A human development
capability approach. Journal of Public
Administration, 4(3), 891–908.
Van Ginneken, Nadja, Maheedhariah,
Meera S., Ghani, Sarah, Ramakrishna,
Jayashree, Raja, Anusha, & Patel,
Vikram. (2017). Human resources and
models of mental healthcare
integration into primary and
community care in India: Case studies
of 72 programmes. PloS One, 2(6), 178–
194
Yu, Yang, Duan, Wenjing, & Cao, Qing.
(2013). The impact of social and
conventional media on firm equity
value: A sentiment analysis approach.
Decision Support Systems, 5(4), 919–
926.
https://doi.org/10.1016/j.dss.2012.12.0
28
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for possible open access publication
under the terms and conditions of the Creative
Commons Attribution (CC BY SA) license
(https://creativecommons.org/licenses/by-sa/4.0/).
