"Lighthouse in the dark": a qualitative study of the role of breast care nurse specialists in Israel.

This study gains insight into the role of the breast care nurse specialist through an analysis of thank you letters written by women with breast cancer in a tertiary hospital in Israel. Descriptive content analysis was used to analyze 125 thank you letters. The findings revealed three aspects of the role of the breast care nurse specialist: instrumental, cognitive, and emotional. The women described these aspects as "paving the way through bureaucracy" (instrumental), being a "traffic light at a crossroad in life" (cognitive), and treating each one of them "as if I am your only patient" (emotional). This analysis highlighted the significance of the breast care nurse specialist in a holistic and integrative role that fills a gap within the biomedical healthcare system. Transferability of the findings to other nurse specialist roles in different clinical settings should be investigated.

[Sexual functioning and information needs in women with premature menopause following breast cancer treatment].

BACKGROUND: Breast cancer is the most common malignant disease among women in Israel and the western world. Approximately 4,000 women a year are diagnosed with breast cancer in Israel and about 900 die as a result of the disease. Large numbers of women who had breast cancer are struggling to cope with sexually oriented difficulties. They feel ashamed and embarrassed in front of their doctor or nurse regarding what they might think about them, for instance if they dare to ask a question regarding a non life-threatening subject. PURPOSE: The aims of this research are: 1. To describe the changes in physiological and sexual function among young Israeli women who survived breast cancer and as a consequence experience premature menopause. 2. To understand their information needs regarding sexual functioning. 3. To examine if and to what extent these needs were met by the professional staff. This research was based on the fact that the professional staff provides the patients with information regarding the surgery, the effects of chemotherapy and nutrition but avoids providing substantial information about predicted altered sexual functions and premature menopause. Research shows that medical staff members ignore this crucial information due to personal, professional and social reasons. METHODS: In a cross-sectional convenience sample, data was collected from 82 women who had been diagnosed with grade 1-2 breast cancer and were treated by one or more of four interventions: surgery, chemotherapy, radiation and hormonal therapy. They were asked to fill out a four-part self-questionnaire. FINDINGS: 1. Premature menopause differs from physiological menopause by the symptom acuteness and intensity. 2. Women treated with chemotherapy reported more sexual function difficulties in comparison to other treatments. 3. Women treated with chemotherapy reported increased sexual pleasure and decreased dyspareunia over time following the completion of treatment. 4. Most women reported no significant influence on their ability to experience orgasm during treatments. 5. Almost all the women received a considerable amount of information about treatments and their side effects, but limited information about sexual function, and were very interested in receiving more information on this subject. CONCLUSION: Breast cancer is becoming more widespread amongst young women. Therefore, it is very important for the medical staff, despite the difficulties, to prepare women treated for breast cancer for the effects of this treatment on sexual function and premature menopause.

Perceptions of Israeli women with breast cancer regarding the role of the Breast Care Nurse throughout all stages of treatment: a multi center study.

PURPOSE OF THE RESEARCH: The role of the Breast Care Nurse (BCN) is well established in Israel. The purpose of this study is to examine the impact of the BCN on Israeli women with breast cancer at all stages of disease from diagnosis, through treatment and follow-up. METHODS: This was a descriptive multi-center study on 321 women with non-metastatic breast cancer who completed their treatment <5 years before. Data collection took place in seven institutions in Israel, both in hospital and in the community. The women completed two questionnaires: a demographic questionnaire and the Ipswitch Patient Questionnaire looking at various aspects of care. Also included was one qualitative open question. Data analysis was performed checking for outliers and illogical observations. KEY RESULTS: In most areas investigated the women perceived the overall contribution of the BCN as very high, with 87% reporting a general contribution of very high or high. It was found that 53% of the women received information about the position from the nurse herself. In 61.3% of the cases, initial contact with the BCN was made at the time of diagnosis. The qualitative findings concerning the open question are also reported. CONCLUSIONS: According to the perceptions of women with breast cancer in Israel, BCN support is an important part of the patient's ability to manage their diagnosis and related care. The multi-disciplinary breast cancer team should incorporate BCN specialists as part of their holistic care.