Disrupted mothering in Iranian mothers with breast cancer: a hybrid concept analysis.

BACKGROUND: Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model. METHODS: The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed. RESULTS: In the theoretical phase, the following attributes were determined: "disturbance in maternal identity and roles", "maternal insensitivity and unresponsiveness: disconnection physically and psychologically", "the career disruption process" and "biographical disruption". The fieldwork phase explored three themes including "the unbalance between multiple roles", "role failure", and "reduced maternal sensitivity". The final synthesis yielded that the main integrated elements of mothering disruption are "disease as threating maternal role and identity", "inability to interpret and respond to child behaviors and needs", and "support for transitioning from being patient toward maternal competency". CONCLUSION: With a deeper understanding of the term 'disrupted mothering' or 'mothering disruption', healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes.

Patient-centred communication for women with breast cancer: Relation to body image perception.

AIMS AND OBJECTIVES: This study aimed to determine the predictive values of patient-centred communication (PCC) and patient's characteristics on the body image (BI) perception in postmastectomy patients. BACKGROUND: Patient-centred communication has been touted as a means of addressing BI issues, especially for postmastectomy patients. DESIGN AND METHODS: This predictive correlational study was conducted on 275 surgically treated breast cancer patients admitted to the Oncology Departments of two hospitals in Tabriz, Iran. These patients were selected using a convenience sampling method. The Body Image after Breast Cancer Questionnaire (BIBCQ) and patient-centred communication questionnaire (PCCQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data. Reporting was in accordance with the STROBE guideline. RESULTS: A multivariable model significantly predicted BI perception in participants using surgery type and time elapsed following surgery. Participants' limitations were significantly affected by surgery type and participants' perception of the nurses' PCC skills. Arm concern was significantly affected by surgery type and nurses' PCC skills. CONCLUSION: Patient-centred skills in nurse-patient communication are critical for resolving BI difficulties such as arm concerns and limitations regarding the disease and its treatment. RELEVANCE TO CLINICAL PRACTICE: Patient-centred communication skills can be taught nurses in the clinical setting to help alleviate patients' BI problems.

Investigation of factors affecting the tendency to choose the type of delivery in pregnant women referring to hospitals of Ardabil Province in 2016.

BACKGROUND AND PURPOSE: Childbirth is one of the most challenging events in a married woman's life and it has important emotional consequences for each woman. It is also a multidimensional process that has physical, physiological, psychological, emotional, cultural, and social dimensions. The aim of this study was to investigate the factors affecting the tendency to choose the type of delivery in pregnant mothers in hospitals of Ardabil Province in 2016. METHODOLOGY: This study is a cross-sectional research that was conducted on 300 pregnant women who were referred to the hospitals for delivery during 3 months in 2016. Data collection tools was a five-part questionnaire including demographic, awareness, attitude, abstract norm questionnaires (other's role) in choosing delivery method, and Behavioral Intention Questionnaire was used in choosing the type of delivery. RESULTS: Statistically, there was not any significant relationship between level of awareness and type of delivery in pregnant mothers (P = 0.07). The mean scores of attitude in mothers with a tendency to natural delivery were 35.75 ± 14.43, and in mothers with a tendency to cesarean was 46.3 ± 10.96. ANOVA test showed statistically a significant relationship between attitude toward cesarean and type of delivery (P < 0.05). Chi-square test showed statistically a meaningful relationship between the recommendations of acquaintances, mothers, husbands, and doctors with choosing a type of delivery (P < 0.05). CONCLUSION: Regarding the results of research, especially the positive attitude and high level of awareness in the choice of natural delivery, the promotion of natural delivery will be possible with education.

Process of coping with mastectomy: a qualitative study in Iran.

BACKGROUND: Breast cancer is the most prevalent cancer among Iranian women and mastectomy comprises 81% of surgeries for treatment of breast cancer. Mastectomy may create feelings such as deformation or impairment in patients, cause body-image disorder, and reduce sexuality and sexual activity which in turn may entail mental disorders. The study aimed to elaborate coping processes. MATERIALS AND METHODS: A grounded theory method was used in conducting this study. Twenty Iranian participants undergoing mastectomy were recruited with purposive sampling. An open, semi-structured questionnaire were developed. Obtaining consent, conversations were recorded and immediately transcribed after each session. Data analysis was carried out with the constant comparative method using the Strauss Corbin approach. RESULTS: Analyzing the collected data, the study came up with seven main categories which affected the coping process in patients with breast cancer, namely: reactions to mastectomy; loss and death contest; reconstruction of evaluation system; consent for undergoing mastectomy; reactions and troubles after loss; confrontation of loss and health; and reorganization and compatibility with changes. CONCLUSIONS: The results of the study indicated: when patients become informed of their breast cancer and the necessity of undergoing mastectomy as the treatment, they probably pass through seven categories to adapt after mastectomy. Having insight about them is likely to contribute medical personnel in leading patients to the highest degree of feeling healthy.

Beliefs and behaviors of breast cancer screening in women referring to health care centers in northwest Iran according to the champion health belief model scale.

BACKGROUND: Breast cancer is the most common cancer in women. All ages are susceptible and more than 90% of the patients can be cured with early diagnosis. Breast self-examination (BSE) and mammography can be useful for this aim. In this study we examined the components of the Champion health belief model to identify if they could predict the intentions of women to perform such screening. MATERIALS AND METHODS: A total of 380 women aged 30 and above who had referred to health-care centers were assessed for use of breast cancer screening over the past year with a modified health belief model questionnaire. Logistic regression was applied to identify leading independent predictors. RESULTS: In this study 27% of the women performed BSE in the last year but only 6.8% of them used mammography as a way of screening. There were significant differences regarding all components of the model except for perceived severity between women that underwent BSE. over the past year and those that did not. Findings were similar for mammography. Regression analysis revealed that intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers to BSE while intentions to perform mammography were predicted by perceived barriers. CONCLUSIONS: This study indicated that self-efficacy can support performance of BSE while perceived barriers are important for not performing both BSE and mammography. Thus we must educate women to increase their self-efficacy and decrease their perceived barriers.

Breast cancer in Ardabil province in the north-west of Iran: an epidemiological study.

Breast cancer accounts for about 26% of all newly diagnosed cancers in women aged 20 to 59 years. As part of a basic program for cancer control, the present cross sectional descriptive study was conducted with the objective of determining the epidemiology of breast cancer in Ardabil province during 2003-2010. Necessary information on 469 recorded cases of breast cancer in the registry were collected by check list from patient's files and then analyzed by statistical methods with SPSS.16 software. Some 455 of the patients (97%) were female, 329 (70.1%) residing in Ardabil. The mean age was 46.8 ± 13.6 and most were in the age group of 40 - 60. The most prevalent pathologic form was infiltrative ductal carcinoma with 316 cases (67.4%), the largest proportion being grade II (30.6%), but very many belonged to grades III and IV (40.5%). Breast cancer in Ardabil province appeared to slightly increase over the period studied. The results were similar to other places in Asia. With regard to this, more widespread studies are required to determine factors influencing the prevalence at low age and also how to promote early detection.