Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
12
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Basic conditions and self-care
requirements (Dorotea Orem) for
breast cancer prevention in women in a
municipality of Nariño, Colombia
Nicoll Dayana Campos Mercado1
Carmen Ofelia Narváez Eraso2
Tatiana Carolina Rosero Bastidas3
Yesid Alexander Yarpaz Espinoza4
To reference this article / Cómo citar este
artículo / Para citar este artigo: Campos-Mercado,
N. D., Narvaéz-Eraso, C. O., Rosero-Bastidas, T. C.,
& Yarpaz-Espinoza, Y. A. (2025). Basic conditions and
self-care requirements (Dorotea Orem) for breast
cáncer prevention in women in a municipality of Nariño,
Colombia. Revista Criterios, 32(2), 1 2-2 7. https://doi.
org/10.31948/rc.v32i2.4650
Reception date: January 24, 2025
Review date: May 29, 2025
Approval date: June 20, 2025
Abstract
The study aimed to describe the basic conditions necessary for universal self-
care and development in women in a Nariño municipality to prevent breast
cancer. The method employed was a relational and cross-sectional design. The
random sample consisted of 165 women. Information was collected using the
free version of the Orem assessment instrument, and the data were analyzed
with SPSS version 21. The results highlight some basic conditioning factors.
Among them are that most women are adults and that their family, sociocultural
system, and life pattern support disease prevention. The universal self-care
requirements mainly relate to environmental factors, activity, rest, and social
interactions. Most developmental self-care requirements include having a pet,
avoiding exposure to smoke, attending the health center, performing breast
1 Nurse. E-mail: nicollda.campos@umariana.edu.co
2 Master in Epidemiology. Professor, Universidad Mariana. E-mail: cnarvaez@umariana.edu.co
3 Nursing student. E-mail: tatianaca.rosero@umariana.edu.co
4 Nursing student. E-mail: yyarpaz@umariana.edu.co
Article result of the research entitled: Factores condicionantes básicos y familiares que están relacionadas con los requisitos de
autocuidado universal y de desarrollo según D. Orem para la prevención del cáncer de mama en mujeres en el municipio de Nariño
(N) 2023-2024.
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
13
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
self-examinations, not smoking, not drinking alcohol, experiencing menarche
before age 12, not using oral contraceptives, and maintaining a normal weight.
The statistical relationship was p<0.05 for the following conditioning factors:
marital status, family communication, religion, and place of residence, regarding
the developmental self-care requirement entitled Attendance at the Health
Center. The basic conditioning factor ‘Family communication’ was related to the
developmental self-care requirement: Performance of breast self-examination.
The basic conditioning factor ‘Place of residence’ was related to the developmental
self-care requirement: Exposure to smoke from firewood. Finally, the basic
conditioning factor ‘Religion’ was related to the universal self-care requirement:
Doing sports. In conclusion, although family background is a strong conditioning
factor, there are self-care possibilities that favor prevention.
Keywords: breast cancer; self-care; breast; primary prevention; risk; health
Condicionantes básicos y requisitos de
autocuidado (Dorotea Orem) para prevención
del cáncer de mama en mujeres de un
municipio nariñense
Resumen
El objetivo del estudio consistió en describir factores condicionantes básicos
relacionados con los requisitos de autocuidado universal y del desarrollo en
mujeres de un municipio nariñense para prevenir cáncer de mama. El método
utilizado fue relacional y transversal. La muestra fue aleatoria conformada por
165 mujeres. Para la recolección de la información, se aplicó el instrumento de
valoración de Orem versión libre; los datos se analizaron en el programa SPSS
versión 21. Los resultados señalan algunos de los condicionantes básicos, entre
ellos: la mayoría se encuentra en la adultez; su sistema familiar, sociocultural y
patrón de vida favorecen la prevención de la enfermedad. Entre los requisitos
de autocuidado universal se encuentran los siguientes: la mayoría refiere
factores ambientales, actividad-descanso e interacción social, y entre los
requisitos de autocuidado del desarrollo: la mayoría refiere tener algún animal
doméstico, no tiene exposición al humo, asiste al centro de salud, se realiza
el autoexamen de mama, no fuma, no ingiere licor, menarca antes de los 12
años, no consumo de anticonceptivos orales y cuenta con un peso normal. La
relación estadística fue de p<0,05 de los siguientes factores condicionantes:
estado civil, comunicación familiar, religión y lugar de residencia con el requisito
de autocuidado del desarrollo denominado: Asistencia al centro de salud. El
factor condicionante básico comunicación familiar se relacionó con el requisito
de autocuidado del desarrollo denominado: Realización del autoexamen de seno.
El factor condicionante básico lugar de residencia se relacionó con el requisito
de autocuidado del desarrollo denominado: La exposición al humo (leña).
Finalmente, el factor condicionante básico religión tuvo relación con el requisito
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
14
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
de autocuidado universal denominado: Realizar deporte. En conclusión, se puede
afirmar que el antecedente familiar en primer grado es un condicionante fuerte,
pero también existen posibilidades de autocuidado que favorecen la prevención.
Palabras clave: cáncer mamario; autocuidado; mama; prevención primaria;
riesgo; salud
Condições básicas e requisitos de
autocuidado (Dorotea Orem) para a
prevenção do câncer de mama em mulheres
de um município de Nariño, Colômbia
Resumo
O objetivo do estudo foi descrever as condições básicas necessárias para o
autocuidado universal e o desenvolvimento de mulheres em um município de
Nariño para prevenir o câncer de mama. O método utilizado foi relacional e
transversal. A amostra aleatória foi composta por 165 mulheres. As informações
foram coletadas usando a versão gratuita do instrumento de avaliação Orem, e
os dados foram analisados usando o programa SPSS versão 21. Os resultados
apontam alguns dos fatores condicionantes básicos. Entre eles estão o fato de
que a maioria das mulheres é adulta e que sua família, sistema sociocultural e
padrão de vida favorecem a prevenção de doenças. Os requisitos universais de
autocuidado estão relacionados principalmente a fatores ambientais, atividade,
descanso e interações sociais. A maioria dos requisitos de autocuidado para
o desenvolvimento inclui ter um animal de estimação, evitar a exposição à
fumaça, ir ao posto de saúde, fazer o autoexame das mamas, não fumar, não
beber álcool, ter menarca antes dos 12 anos, não usar anticoncepcionais orais
e manter um peso normal. A relação estatística foi de p<0,05 para os seguintes
fatores condicionantes: estado civil, comunicação familiar, religião e local de
residência, em relação ao requisito de autocuidado do desenvolvimento intitulado
‘Comparecimento ao Centro de Saúde’. O fator condicionante básico ‘Comunicação
familiar’ foi relacionado ao requisito de autocuidado de desenvolvimento
‘Realização do autoexame das mamas’. O fator condicionante básico, ‘Local de
residência’ estava relacionado ao requisito de autocuidado no desenvolvimento:
Exposição à fumaça de lenha. Por fim, o fator condicionante básico ‘Religião’
foi relacionado ao requisito de autocuidado universal: Praticar esportes. Em
conclusão, embora o histórico familiar seja um forte fator condicionante, há
possibilidades de autocuidado que favorecem a prevenção.
Palavras-chave: câncer de mama; autocuidado; mama; prevenção primária;
risco; saúde
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
15
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Introduction
Cancer is a global public health problem. By
2020, it accounted for one-quarter of new cases
worldwide. In Latin America and the Caribbean,
the proportion of women under 50 affected by
cancer was nearly twice that in North America
(Pan American Health Organization [PAHO]
& World Health Organization [WHO], n.d.).
Although the disease affects both women and
men, the incidence rate in men is much lower
(Ortiz-Montalvo et al., 2023).
In Colombia, 10 out of every 100,000 people
have this disease. By 2022, there were 17,018
new cases reported among the 2,296,840 total
cases worldwide. The adjusted mortality rate
showed a slight increase from 2005 onwards,
remaining stable over the last five years
(Ministerio de Salud y Protección Social, 2015).
According to the study by Yépez et al. (2022),
the overall incidence of cancer in Nariño from
2023 to 2017 was 3,759 cases: There were
1,608 cases in men (an age-standardized rate
(ASR) of 169.4 cases per 100,000 man-years)
and 2,151 cases in women (an ASR of 176.6
cases per 100,000 woman-years). Breast
cancer is among the most common tumors in
women, accounting for 19.7% of cases, and has
a higher mortality rate (12.2%) than stomach
and cervical cancer (Yépez et al., 2022).
Regarding the geographical distribution in
Nariño, the problem is most prevalent in
the central subregion, which includes the
municipalities of Pasto and Nariño, among
others. In the municipality of Nariño, there were
60.2 new cases among women per 100,000
people in 2021 (Instituto Departamental de
Salud de Nariño, 2023).
It is important to note that breast cancer is
multifactorial. Endocrine-reproductive factors
include the use of hormonal contraceptives
and hormone therapy, as well as endogenous
estrogen levels, obesity, age at menarche, late
menopause, breastfeeding, number of children,
and age at first pregnancy. One environmental
risk factor is exposure to ionizing radiation.
Biological factors include family medical
history, age, and gender. There is also a
group of lifestyle risk factors that are no less
important, including excessive tobacco or
alcohol consumption, lack of physical activity,
and poor diet. It should be noted that this type
of cancer is greatly affected by healthy lifestyle
choices (García et al., 2017).
In her theory on self-care, Dorothea Orem
defines the term as «the set of intentional actions
that a person performs to control internal or
external factors that may compromise their
life or future development» (Prado et al., 2020,
p. 841). Self-care is the behavior of caring for
oneself. One assumption that follows is that
everyone can care for themselves. This self-
care is learned mainly through communication
in interpersonal relationships throughout life
(Marcos & Tizón, 2013). In this sense, people
who want to lead healthy lifestyles should
consider health information, as it contributes
to physical and emotional well-being.
The following concepts derive from this theory:
Basic Determining Factors (BDFs) refer
to a series of internal and external variables
that modify the ability to perform self-care
in terms of quality and quantity. Therefore,
BDFs can affect people’s lives, health, and
development. Identified in 1958, these factors
were not listed by the Nursing Development
Conference Group until the early 1970s. The
BDFs proposed by Orem are not absolute
and can be modified when new factors are
identified (Ruiz et al., 2019). The following
FCBs are included in this study:
- Related to the person’s evolutionary
period: age, stage of development,
marital status.
- Related to the family system: marital
status, family characteristics, children,
family communication, support person,
family history.
- Related to the sociocultural system: place
of residence, race, religion, educational
level, job, type of employment relationship,
socioeconomic status.
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
16
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
- Related to lifestyle: eating and drinking
habits, hygiene and personal care,
interpersonal and social relationships,
stress and anxiety management, personal
beliefs and values.
Other terms used in her theory include the so-
called “self-care requirements”. A ‘requirement’
is defined as an activity that a person must
perform to take care of themselves. Orem
proposes three types of requirements. Two
types were considered for the study, and self-
care requirements in health deviations were
excluded because they apply to people with
illnesses or medical diagnoses. Therefore, they
are equivalent to specific care according to
pathology (Marcos & Tizón, 2013).
Universal self-care requirements refer to
the care all human beings must maintain for
their overall well-being. These requirements
include factors related to the environment (use
of public services), activity and rest (sleep and
rest habits, hours slept, physical activity, and
exercise), and solitude and social interaction
(belonging to a social group, communicating
with one’s environment, and customs) (Marcos
& Tizón, 2013).
Self-care requirements for development
are the conditions necessary for life and
maturation. These conditions mitigate the
effects of various situations at different
stages of human development, including
childhood, adolescence, maturity, and old age
(Marcos & Tizón, 2013). Self-care is inherent
in the implementation of healthy lifestyles
and activities that prevent disease. These
include living with animals, exposure to
toxins (e.g., smoke), visiting health centers,
performing breast self-examinations, getting
mammograms, smoking, consuming alcohol,
experiencing menarche and menopause, and
maintaining a healthy body weight.
With the clarity provided by Dorothea Orem’s
theory, this study enables us to deduce that
Orem’s nursing language, referring to basic
health determinants, has an equivalent in
epidemiological language. In the health-illness
process, these determinants are called ‘social
determinants of health’.
In light of this situation, the study aimed to
describe and relate the FCBs and self-care
requirements outlined by Dorothea Orem to
breast cancer prevention among women in a
municipality in Nariño.
Methodology
A relational and cross-sectional study exploring
and describing the statistical relationship
between FCB and the universal self-care and
developmental requirements proposed by
Dorothea Orem, applied to the topic of breast
cancer prevention.
The study population consisted of 2,200 women
from urban and rural areas of the municipality
under study, of whom 1,726 were over 18 years
of age (Alcaldía Municipal de Nariño, 2022).
The sample was calculated with a confidence
level of 93%, positive variability of 0.5, negative
variability of 0.5, and an error rate of 7%.
Finally, 165 women were included in the study.
Inclusion Criteria
- Women residing in the municipality of
Nariño.
- Women without a medical diagnosis of
breast cancer.
- Women who sign the informed consent
form and agree to participate in the study.
Exclusion Criteria
- Women who are pregnant.
Type of sampling
Consecutive; that is, women were recruited
by verbal invitation during market days
in the municipality under study, until
the sample was complete. To collect the
information, the assessment guide based on
Dorotea Orem’s general theory of self-care,
by López and Moreno (2010), freely available
online, was used.
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
17
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
The research authors created the assessment guide to provide greater clarity. The data obtained
were organized and tabulated in an Excel database created specifically for the research and then
exported to SPSS version 21. Univariate analysis was performed, followed by bivariate analysis
between the variables cited. For the statistical relationship, the Chi-square test statistic was used,
and a p-value <0.05 was accepted as significant.
The study was approved at a regular meeting of the CIPRO Nursing Program Research Committee.
Informed consent was obtained, which includes respect for bioethical principles in research and
respect for human dignity. According to Resolution 8430 of 1993, the research was classified as
non-risk research.
Results
The largest proportion of women are between the ages of 30 and 39, representing 46.7% (77);
80% (132) are adults; in terms of marital status, 38.2% are married (63); 87.3% belong to a
nuclear family (144); of this percentage, 46.1% have between one and two children (76); 95.2%
reported that their family communication was excellent or good (157); 36.4% receive support from
their husband (60). Regarding family history of breast cancer, 78.8% reported having it (130). 61%
live in urban areas (101); 58% are of mixed race (96), and 71% are Catholic (117 women).
In terms of educational level, 38.2% have completed high school (63 women), and 85% are employed
(140). Of those employed, 53% are self-employed (87). 63% belong to the socioeconomic stratum
1 (104). Regarding eating and drinking habits, 50% consider theirs to be good (83), and 54.5%
report having good hygiene and personal care (90). 78.8% say that they have good interpersonal
and social relationships (130). 76.4% say that they manage their stress and anxiety (126). Finally,
81.8% consider personal beliefs and values important (135 women) (see Table 1).
Table 1
Basic determining factors in women in the municipality of Nariño 2024 n= 165
Determining factors
D. Orem Variable Category %
Personal evolutionary
timeline
Age
20 to 29 years old 28,5
30 to 39 years old 46,7
40 to 49 years old 21,2
Over 50 3,6
Development status Young adult 20
Adult 80
Family system
Marital status
Single 31,5
Married 38,2
Common-law
marriage 28,5
Widow 1,8
Family characteristics Nuclear family 8 7, 3
Extended family 12,7
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
18
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Determining factors
D. Orem Variable Category %
Family system
Children
026,6
1-2 children 46,1
More than 2 children 27, 3
Family communication
Excellent 75,2
Good 20
Regular 4,8
Supportive person
Husband 36,4
Child 19,4
Parents 26,1
Other 18
Family history of the
disease
Yes 78,8
No 21,2
Sociocultural system
Place of residence Rural 39
Urban 61
Race
Mestizo 58
White 33,3
Black 1,2
Afro-Colombian 7,9
Religion Profess 97,1
Not profess 3,0
Educational level
Primary 15
High school 38,2
Technical or
technological degree 34
University degree 12,1
None 1,2
Work Yes 85
No 15
Type of employment
relationship
Employee 47
Independent worker 53
Socioeconomic status
Status 1 63
Status 2 33
Status 3 3,6
Lifestyle Eating and hydration habits
Good 50
Fair 28,5
Poor 21,8
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
19
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Determining factors
D. Orem Variable Category %
Lifestyle
Hygiene and personal care
Good 54,5
Fair 21,2
Poor 24,2
Interpersonal and social
relationships
Good 78,8
Fair 10,3
Poor 11
Stress and anxiety
management
Yes 76,4
No 23,6
Personal beliefs and values
Very important 81,8
Moderately important 9,1
Not very important 9,1
Among the universal self-care practices that promote health, 76.6% of women (126) use all public
services; 98.78% (163) sleep and rest for more than eight hours; 68.49% (113) practice physical
activities, exercise, or play sports; 70.90% (117) do not belong to any social group, and 91.5%
(151) consider themselves to have good or excellent communication with the people around them.
Among their habits, cooking was the most popular activity, with 44.84% of women reporting it as
their favorite (see Table 2)
Table 2
Universal self-care requirements in breast cancer prevention among women in the municipality of
Nariño 2024 n = 165
Variable Category %
Environmental factor Public Services Yes 76,6
No 23,4
Activity and rest
Sleep and rest habits Yes 98,8
No 1,2
Number of hours slept
per day
>8 hours
<8 hours
99
1
Physical activities and
exercise
Yes 68,5
No 31,5
Practicing a sport Yes 68,5
No 31,5
Loneliness and social
interaction
Belonging to a social
group
Yes 29
No 71
Women’s communication
with their environment
Excellent, Good 91,5
Fair, Poor 8,5
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
20
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Variable Category %
Loneliness and social
interaction Women’s customs
Cooking 44,8
Going to church 33,9
Other (walking, exercise) 21,2
68.5% reported having some type of domestic animal —cat, dog— (113 women); 55.2% reported
no exposure to smoke (91); 76.4% frequently attended the health center (126); 69.1% perform
breast self-exams (114); 1.2% undergo mammograms (2); 56.4% do not smoke or drink alcohol
(93); 56.4% report having had their first menstruation before the age of 12, and 4.8% are already
in menopause (8); 92.7% do not take oral contraceptives (153) and 53.4% are of normal weight
(88 women) (see Table 3).
Table 3
Percentage distribution of self-care requirements for breast cancer prevention among women in
the municipality of Nariño 2024 n = 165
Self-care requirements for development
Variables Category %
Living with animals Yes 68,5
No 31,5
Exposure to smoke (cooking with wood) Yes 44,8
No 55,2
Visits to the health center Yes 76,4
No 23,0
Breast self-examination Yes 69,1
No 31
Mammogram Yes 1,2
No 98,8
Smoking Yes 12,1
No 87,9
Alcohol consumption Yes 22
No 81,8
Reproductive history: Age at menarche <12 years old 56,4
>12 years old 43,6
Reproductive history: Menopause Yes 4,8
No 95,2
Reproductive history: Oral contraceptive use Yes 7, 3
No 92,7
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
21
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Self-care requirements for development
Variables Category %
Weight: Body mass index (BMI) Normal 53,4
Overweight-obesity 46,6
A statistical relationship of p<0.05 was observed when crossing the implicit variables ‘Universal
self-care requirements’ and ‘Development self-care requirements’ of the FCBs of the surveyed
women in the following aspects: marital status, intra-family communication (good and excellent),
religion, and urban residence. These aspects are also related to frequent visits to a health center.
Good and excellent intra-family communication is related to performing breast self-exams. Living
in an urban area is connected to not being exposed to smoke from cooking with firewood. Practicing
a religion was linked to participating in sports.
Table 4
Basic conditioning factors, universal development requirements, and development requirements
that showed statistical correlation
Basic Conditioning Factors Universal self-care or
developmental requirements P value*
Marital status (married, common-law
marriage)
Attendance at a health center 0,036
Family communication (good and excellent) Attendance at a health center 0,007
Practicing a religion Attendance at a health center 0,003
Living in an urban area Attendance at a health center 0,007
Family communication (good and excellent) Breast self-examination 0,006
Living in an urban area No exposure to smoke (wood-
burning stove)
0,011
Practicing a religion - playing sports Playing sports 0,017
* chi-square test
Discussion
The study examined the basic health determinants of a group of women from a municipality in
Nariño and their statistical relationship with the universal self-care and development requirements
proposed by Orem’s theory for breast cancer prevention.
Considering the basic conditioning factors of the women who participated in the study, who reported
being free of breast cancer as they do not have a medical diagnosis of this type and whose ages
are between 30 and 39 years old, the risk in them is low. However, the risk changes in cases where
there is a family history. The study found that 78.8% of participants had a family history of breast
cancer in a first-degree relative, such as a mother, sister, or daughter.
Some studies report that a first-degree consanguineous family history increases the risk of
developing the disease by 1.8 times (Jacobo-Galindo et al., 2014), a situation that must be addressed
when discussing prevention, given that only a low percentage of participating women have had
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
22
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
a mammogram, specifically women over 50
years of age. Mammograms can facilitate
early diagnosis, and lack of awareness hinders
opportunities for cure (Obregón et al., 2024).
This study reported that a significant
percentage of women (69.1%) perform breast
self-exams as an appropriate practice for
detecting lesions. These practices lead them
to consult and attend health centers not only
when they feel ill, but also as a preventive
measure (76.4%).
Although marital status is reported as a
protective factor thanks to social support
and reinforcement of healthy habits, several
studies report high percentages of women
who developed breast cancer despite being
married. In this context, social support for
married women and women in open union,
especially when accompanied by positive
family relationships, promotes good preventive
practices. This is evident through its statistical
relationship with frequent health center visits
(p=0.007) and breast self-exams (p=0.006).
This factor could positively influence their
preventive practices against breast cancer.
Married women and those in stable relationships
are more likely to get regular checkups than
single women or those in less supportive family
environments. This was shown in a study
in Spain, in which 72% of married women
regularly undergo mammograms, compared to
60% of single women who do not undergo these
tests (Asociación Española Contra el Cáncer,
2023). This difference may be related to the
emotional and financial support that being in
a relationship provides, which makes it easier
to access medical services and encourages
greater participation in preventive programs.
Orem points out that people are responsible for
maintaining their health and well-being. For her,
self-care begins with awareness; there must be
a desire to be well and to follow through with
a plan. Orem (as cited in Naranjo et al., 2017)
states that people with greater knowledge and
self-care skills tend to make more informed
decisions about their health. This is reflected
among women with higher levels of education.
In this study, 38.1% of participants had at
least a high school education and were more
likely to engage in preventive practices, such
as mammograms and breast self-examinations
(Castillo et al., 2016). Similarly, 69.1% of
participants reported performing breast self-
examinations.
According to Obregón et al. (2024), the
number of children is a protective factor for
breast cancer. In this study, most women have
between one and two children (46.1%).
A large percentage of women identify with some
form of religion. While religion itself may not
influence breast cancer prevention practices,
it can act as a motivating agent given that
most religions encourage healthy habits such
as exercise and avoiding alcohol and smoking
(Requejo-Mas et al., 2023). In this case, there
is a statistical relationship between religion
and sports participation (p = 0.017).
In terms of place of residence, 61% of women
live in urban areas, which provides easier
access to health services, health centers,
parks, and other places that encourage sports.
Living in scattered and remote areas has
been considered a factor that contributes to
disease development and hinders prevention
(Cordero, 2021). This study revealed statistical
relationships between living in an urban
area and attending a health center (p=.003)
and between living in an urban area and
participating in sports (p=.017).
Similarly, living in an urban area provides easier
access to public services, such as natural gas
and electricity. In contrast, families in rural
areas must find alternative ways to obtain
energy, especially for cooking, such as using
firewood.
A study conducted in an area of China with high
breast cancer prevalence in 2024 examined the
relationship between drinking water properties
and breast cancer, focusing on the toxicity of
the contaminants present in the water. The
study found a correlation between high levels
of cancer and mortality and contaminants in
the water, composed of organic matter from
human waste. This matter includes oxidative
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
23
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
substances that promote cancer cell growth
and particles that contribute to cancer-related
mortality (Peng et al., 2024).
Another study indicates that certain non-
tuberculous bacteria present in treated sewage
may carry pathogens that travel through the
immune system and promote the development
of breast tumors. These microbes are associated
with breast cancer and are considered a risk
factor, particularly for older women. Therefore,
drinking water quality must be monitored to
prevent potential health risks (Maranha et al.,
2024). This shows how important access to
public services, especially drinking water, is.
In this study, a large percentage of women
(76.6%) considered these services to be
protective factors. According to Dorothea
Orem’s self-care theory, access to drinking
water is a fundamental requirement for self-
care and health promotion.
Sleep plays a key role in preventing breast
cancer. Sleep deprivation —generally defined
as getting less than seven hours of sleep per
night— has been associated with an increased
risk of obesity and metabolic syndrome. These
are factors that contribute to the development
of various types of cancer, including breast
cancer (Santisteban, 2019). Additionally, lack of
sleep can cause an increase in stress hormone
levels and inflammation in the body, both of
which have been linked to an increased risk
of cancer. Maintaining a healthy sleep pattern
helps with weight management and promotes
an active, healthy lifestyle, which is crucial
for cancer prevention (Santisteban, 2019). It
should be noted that adequate rest is practiced
in this study.
According to Dorothea Orem’s self-care
theory, sleep is essential for maintaining
women’s health and well-being. Orem argues
that self-care involves the knowledge and
practice of activities that promote health and
prevent disease. In this context, adequate
sleep is crucial not only for physical health
but also for mental and emotional well-being.
Research indicates that sleep deprivation is
associated with increased inflammation and
hormonal disturbances, which can facilitate
disease progression, including cancer
(González et al., 2019).
Regular physical exercise is an effective self-
care strategy for reducing breast cancer
risk in women. This protective effect has
been observed in premenopausal and
postmenopausal women alike (Oliva et al.,
2015). This suggests that physical activity has
a positive impact regardless of the stage of life.
It contributes to hormone level regulation and
reduces risk factors associated with adiposity,
both of which are essential to preventing
breast cancer. The World Health Organization
(WHO, 2024) recommends that adults engage
in at least 150 minutes of moderate-intensity
physical activity per week, including women.
31.5% of women never engage in such activity,
which is a worrying figure as a sedentary
lifestyle is associated with breast cancer.
Several studies have reported that exposure to
cigarette smoke increases the risk of developing
cancer, including breast cancer. Cigarette
smoke contains more than 70 carcinogenic
substances, such as polycyclic aromatic
hydrocarbons (PAHs) and nitrosamines, which
can induce DNA mutations. These mutations
increase the risk of developing breast cancer
(Osorio, 2020). Women who are exposed to
«secondhand smoke» are also at a higher risk
of developing this disease and others, especially
if the exposure is prolonged (Narváez-Eraso,
et al., 2019; Narváez-Eraso & Díaz-Delgado,
2019). Although 87.9% of the women in this
study do not smoke, a significant proportion
(44.8%) is exposed to smoke from cooking
fires. This smoke contains toxins, including
carbon monoxide, fine particles, and PAHs.
These substances are similar to those found
in tobacco smoke and have been linked to an
increased risk of breast cancer.
As for living with animals, although the
relationship between them and breast cancer
is unclear, there are no studies suggesting a
risk or protective relationship in this regard.
Among the requirements for healthy
development, late onset of menstruation
(after age 15) was considered because late
Basic conditions and self-care requirements (Dorotea Orem) for breast cancer
prevention in women in a municipality of Nariño, Colombia
24
Nicoll Dayana Campos Mercado
Carmen Ofelia Narváez Eraso
Tatiana Carolina Rosero Bastidas
Yesid Alexander Yarpaz Espinoza
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 12-27
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
menarche appears to protect against breast
cancer risk. Several studies have shown that
early menarche increases the risk of breast
cancer by almost six times compared to those
who experienced late menarche. These studies
also indicate that shorter exposure to estrogen
reduces stimulation of breast tissue and
decreases the likelihood of cellular changes
that can lead to cancer (Hierrezuelo et al.,
2023). The risk of breast cancer associated
with early menarche may be amplified in obese
women or those with hormonal risk factors,
such as prolonged contraceptive use. In the
present study, 43.63% of women experienced
menarche after age twelve, and few used oral
contraceptives.
Body mass index (BMI) is a crucial indicator
for assessing breast cancer risk, particularly
among postmenopausal women. The increased
risk is attributed to the hormonal environment
promoted by obesity, which is characterized
by elevated estrogen and other growth factor
levels produced by adipose tissue that favor
tumor proliferation (Hierrezuelo et al., 2023).
This study found that 46.61% of women were
obese or overweight.
Conclusions
According to Orem’s classification, the study
identified basic conditioning factors in the
female participants that provide some protection
against breast cancer. However, when designing
health education and promotion strategies, it is
important to consider risk factors. Furthermore,
a significant percentage of participants have a
family history of the disease.
Similarly, self-care requirements were identified
that manifest as protective practices. These
practices should be encouraged and reinforced
during health center visits and extramural
activities. Therefore, interventions that
promote women’s health empowerment are
essential. These interventions should provide
tools and skills that enable women to maintain,
preserve, or adopt a healthy lifestyle, thereby
reducing their risk of developing cancer.
Conict of interest
The authors declare that they have no conflicts
of interest: financial, political, intellectual,
racist, religious, or of any other kind.
Ethical Responsibilities
According to Resolution 8430 of 1993, the
research was classified as risk-free and approved
by the Research Committee of the Universidad
Mariana’s Nursing Program in the Faculty of
Health Sciences. The women participated
voluntarily after receiving information about
the study and signing an informed consent
form that outlined its purpose, as well as the
measures taken to ensure confidentiality and
protect data.
Sources of funding
The authors declare that they have not received
any financial support for this work.
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Contribution
Nicoll Dayana Campos Mercado: Formulation,
execution of the research process, writing of
the original draft.
Carmen Ofelia Narváez Eraso: Methodology,
analysis and interpretation, critical review, and
improvements to the article.
Tatiana Carolina Rosero Bastidas:
Formulation, execution of the research process.
Yesid Alexander Yarpaz Espinoza:
Formulation, execution of the research process.
Funding
Own resources.
Articial intelligence usage statement
In writing this article, the authors did not use
any artificial intelligence tools or services.