INCLUSIVE DISCUSSION FORUM FOR BLIND AND SIGHTED ABOUT BREAST HEALTH

The online discussion forum is a learning tool that allows communication and exchange of knowledge, questions, curiosities among participants. In health education, nurses can use online teaching and their tools to educate blind and sighted women in an inclusive way about breast health. It should be noted that blind people face accessibility barriers in health services, whether physical, attitudinal or lack of accessible educational health materials. The present study aimed to analyze discussions between blind and sighted women in inclusive discussion forums on breast cancer. It consists of a descriptive, qualitative study, based on the analysis of the discussions held in the forum activities of the Mammary Health Online Course. Held from October 2015 to January 2016. Blind and sighted women participated and were included as criteria of inclusion to be over 18 years, basic computer domain, Internet access. For blind women, they were also asked to master the use of screen readers and voice synthesizers. Women with other associated disabilities were excluded.

The Online Mammary Health Course is hosted in the Modular Object-Oriented Dynamic Learning Environment (Moodle) and presents five lectures that are:
1 Introduction to the use of Moodle;
2 What is Breast Cancer ?;
3 Early Detection of Breast Cancer;
4 The Early Detection of Breast Cancer in the Brazilian Unified Health System;
5 Let's see what you've learned?

We analyzed the discussions in Lecture 2 - Discussion Forum about some experience in relation to Breast Cancer; and in Lecture 3 - Discussion forum about the accomplishment of some of the tests of early detection and about how this experience was. National and international ethical aspects were respected. A total of 131 women were enrolled, of whom 60 were blind and 71 were sighted. These were distributed in 4 classes, with an average of 30 participants per class. Because of the evasion of 85 students, there were only 46, divided between 17 blind women and 29 sighted. Unanimously, both blind and sighted women met someone who was diagnosed with breast cancer, with relatives and close people predominating. Fear of mutilation and death was emphasized. There was a lack of knowledge or misconceptions about the subject, since some women reported lack of knowledge about the age to perform mammography, others related pain as a mandatory symptom of breast cancer, lack of knowledge about risk factors related to women's reproductive cycle. Regarding the exams, the fear of performing mammography was related to pain and possible positive diagnosis, as well as to excess radiation. Breas self-examination is still poorly performed due to lack of knowledge about technique, especially among blind women. Some women agreed on the need for a more detailed explanation of the exams before they were performed, to reduce anxiety and fear. It was noticed the presence of myths and taboos among all the women on the disease as well as on the conduct of the tests. So, discussion forum presented itself as an inclusive environment for debate and exchange of blind and sighted women experiences, allowing a gradual approach to the theme, being essential for motivation and learning in online education.