A hermeneutic phenomenological study on the disease experience among young women with breast cancer.

Objective: Women diagnosed with breast cancer under the age of 40 face distinctive physical and psychosocial challenges resulting from the disease's pathological features and the developmental aspects associated with their youth. This study aims to investigate the lived experience of breast cancer among this group of young women. Methods: Participants were purposefully selected from online communities and chat rooms in South Korea. A total of 15 young women with breast cancer were included in this study, and data were gathered through three focus group interviews. The interviews were transcribed verbatim and analyzed using the hermeneutic phenomenology method. Results: Four essential themes emerged based on four lifeworld existentials: lived body, lived time, lived space, and lived others. These four essential themes were: a wounded and sick body, life robbed of youth and elderly years, crossroads of growth discovered at life's extremes, and a steadfast companion on a solitary journey. Conclusions: Young women with breast cancer face unique challenges due to the intersection of a severe illness and its impact during their formative years. This study offers valuable insights for crafting customized interventions that directly target the physical and psychosocial requirements of young breast cancer survivors, ultimately enhancing their quality of life.

Machine Learning-Based Prediction of Abdominal Subcutaneous Fat Thickness During Pregnancy.

Objective: Current evidence regarding the safety of abdominal subcutaneous injections in pregnant women is limited. In this study, we developed a predictive model for abdominal skin-subcutaneous fat thickness (S-ScFT) by gestational periods (GP) in pregnant women. Methods: A total of 354 cases were measured for S-ScFT. Three machine learning algorithms, namely deep learning, random forest, and support vector machine, were used for S-ScFT predictive modeling and factor analysis for each abdominal site. Data analysis was performed using SPSS and RapidMiner softwares. Results: The deep learning algorithm best predicted the abdominal S-ScFT. The common important variables in all three algorithms for the prediction of abdominal S-ScFT were menarcheal age, prepregnancy weight, prepregnancy body mass index (categorized), large fetus for gestational age, and alcohol consumption. Conclusion: Predicting the safety of subcutaneous injections during pregnancy could be beneficial for managing gestational diabetes mellitus in pregnant women.

The lived experiences of pregnancy planning after breast cancer in women of childbearing age: A phenomenological study.

Objective: This phenomenological study aimed to explore the lived experiences of planning for pregnancy after breast cancer in women of childbearing age. Methods: The study comprised 15 women with breast cancer who were considering pregnancy and childbirth. Individual in-depth interviews were conducted between November 2022 and March 2023, and the verbatim transcripts were analyzed using Colaizzi's phenomenological method. Results: Four theme clusters emerged: (1) deepening desires amidst hardships, (2) endless worries about an uncertain future, (3) unveiling the meaning of having a child, and (4) perpetual deliberations regarding unresolved dilemmas. Over time, the participants' longing for children intensified, despite the contradiction of their reduced fertility. They expressed concerns about the potential risks and challenges of pregnancy in breast cancer patients, but they attributed value to having a child as a means to restoring their health, reclaiming their ordinary lives, and providing motivation for a healthier future. The participants found making decisions regarding pregnancy to be difficult and were often influenced by others. Conclusions: This study underscores the unique challenges faced by women with breast cancer who are making fertility-related decisions. The findings contribute to a better understanding of these challenges and offer valuable insights for the development of decision aids that support shared decision-making for pregnancy after breast cancer.

Body Acceptance Scale for Women with Breast Cancer: Development and Validation of a Measurement.

PURPOSE: Breast cancer and its treatment result in drastic physical changes that can negatively affect a woman's body image. Body acceptance in women with breast cancer is crucial in enhancing their body image and overall quality of life. Despite its significance, there are currently no specific tools to measure body acceptance among cancer patients. This study aimed to develop a Body Acceptance Scale for Women with Breast Cancer (BAS-BC). DATA SOURCES: The scale's initial items were generated based on a conceptual framework of body acceptance and were reviewed by three clinical and five experiential experts. A preliminary instrument was developed through a content validity assessment by six clinical experts and a pilot test with 20 women with breast cancer. Validity and reliability were evaluated via an online survey of 411 women who had undergone breast cancer surgery. CONCLUSION: The scale consists of 17 items across six factors (encountering, understanding, adaptation, return to daily life, successful transition, and leap into the future). The scale's validity-including construct validity, cross-validity, known-groups validity, and criterion validity-was satisfactory, exhibiting a Cronbach α of .91. The BAS-BC demonstrated good validity and reliability. IMPLICATIONS FOR NURSING PRACTICE: The BAS-BC will contribute to improving the quality of life of female breast cancer survivors by providing fundamental information for future research. The BAS-BC may enable nurses to provide tailored interventions to promote body acceptance.

Experiences of peer support activities and the need for a metaverse-based program in young women with breast cancer: A qualitative study.

Objective: This study aimed to explore young breast cancer survivors' experiences of peer support activities and their need for a metaverse-based peer support program. Methods: This qualitative content analysis study involved 15 young women with breast cancer under the age of 40. Participants with diverse experiences in peer support activities were purposefully selected. Data were collected in March 2023 through three focus group interviews and three additional individual interviews. Saturation was reached when no new themes emerged from the interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis. This study ensured the trustworthiness of the data based on criteria including truth value, applicability, consistency, and neutrality. Results: Four categories emerged: advantages, disadvantages, preferences for peer support activities, and the need for metaverse-based peer support programs. Participants valued peer support activities for exchanging information, nurturing empathy, and encouraging healthy behaviors. Challenges included information confusion, peer conflict, isolation, and stigma. Preferences for group composition, size, and medium varied; however, all participants agreed on the importance of operational guidelines. Participants expected a metaverse-based peer support program to provide safe and enjoyable experiences despite concerns about unfamiliar platforms. Conclusions: This study highlights the unique needs and preferences of young breast cancer survivors regarding peer support activities. Well-organized and tailored peer support can significantly enhance their quality of life. These findings provide valuable insights for developing effective metaverse-based peer support programs to meet the needs of young women with breast cancer.

Body image alteration in women with breast cancer: A concept analysis using an evolutionary method.

Objective: Women with breast cancer experience changes in body image, a key predictor of overall quality of life. Body image alteration has been recognized in scholarly circles and is actively being researched on; however, a comprehensive conceptualization of body image alteration from an oncological perspective is insufficient. Therefore, this study aimed to analyze the concept of body image alteration in women within the context of breast cancer based on Rodgers' evolutionary method. Methods: A literature search using a combination of the keywords "breast neoplasms" and "body image" was conducted via PubMed, CINAHL, EMbase, PsycInfo, KISS, and RISS. Peer-reviewed journal articles related to body image alteration in women with breast cancer, published from 2001 to 2020, were included in this study. Results: Three critical attributes of body image alteration were identified: "dismantling the existing body image," "transitioning to the altered body," and "re-integrating a new body image." Antecedents included "breast cancer and its treatment," "awakening to the sociocultural norms of a feminine body," and "triggering events for reflecting on one's body." The consequences were "psychological well-being or distress," "strengthening or breakdown of intimate relationships," "enhancement or impairment of social functioning," and "adherence or resistance to breast cancer treatment." Conclusions: This study provides comprehensive conceptualizations that encompass individual, interpersonal, and sociocultural components and cover both negative and positive changes in body image from a long-term perspective. This may offer a useful framework that can be used to develop effective interventions for body image improvement and accelerate further research.

Body acceptance in women with breast cancer: A concept analysis using a hybrid model.

BACKGROUND: Women with breast cancer undergo drastic physical changes which can impact their body image. Accepting the altered body has recently been highlighted as the key to body image improvement, however, there is no clear definition or conceptualization of it. This study clarified the concept of body acceptance in women with breast cancer, using a hybrid model. METHODS: In the theoretical phase, the attributes and working definitions of the concept were identified through an extensive literature review. Individual in-depth interviews were conducted during the fieldwork phase to elucidate the concept and verify the attributes derived from the theoretical phase. Finally, in the final analytic phase, the findings were compared and integrated. RESULTS: The theoretical and fieldwork phases included 20 out of the 579 articles extracted from the literature search and five women who had undergone breast cancer surgery, respectively. Body acceptance was defined as "acknowledging, normalizing, and overcoming changes in body appearance and function caused by breast cancer and its treatment". CONCLUSIONS: Body acceptance has been identified as a key factor directly related to the overall quality of life. This study provides a theoretical basis for developing effective interventions and consequently facilitates their provision in practice.

Tablet PC-based competency evaluation for nursing students in three Asian countries: Cross-sectional comparative study.

AIM: This study evaluated a practical competency evaluation for nursing students in three Asian countries using tablet PC-based tests. The need to evaluate practical competencies in a non-face-to-face manner continues to pose challenges in nursing education. DESIGN: This study presents descriptive comparative research on a tablet PC-based evaluation of practical competencies in three countries. METHODS: tablet PC-based clinical practice competency evaluation was conducted among nursing college students in Korea, Vietnam and Mongolia. In total, 124 students answered 65 questions for practical competency evaluation and items on its usefulness. RESULTS: Students from Korea had the highest score of nursing competencies (41.6 points; n = 59, SD 6.02), followed by those from Vietnam (26.3 points; n = 30, SD 4.97) and Mongolia (18.4 points; n = 35, SD 5.36). Scores for usability showed an inverse relationship with competency scores. Questions incorporating video showed the lowest proportion of low-discrimination items. CONCLUSIONS: This research recognized that using video which provides contextual elements can increase item discrimination. These findings suggest that incorporating video into evaluation items in tablet-PC-based tests is useful for international comparison.

The Development and Application of Drama-Combined Nursing Educational Content for Cancer Care.

With the recent increase in the number of cancer patients, it is important to educate nursing students using pedagogical techniques that nurture understanding and empathy for cancer patients. This study examined nursing students' experiences caring for cancer patients after receiving drama-combined nursing education for cancer care (DCC), which consisted of three elements: lectures, dramatic scenarios, and debriefing. The lectures dealt with cancer statistics, diseases, and nursing, and the dramatic scenarios depicted both breast cancer patients and lung cancer patients. Sixty-seven junior-year nursing students attended a 90 min DCC session developed by the authors. Focus group interviews were conducted to explore students' educational experiences, and the following three themes were derived using the thematic analysis method: 'understanding the lives of patients with severe diseases and their families', 'seeing a nursing role model provide patient-centered care', and 'projecting an image of oneself as a future nurse'. Using drama in nursing education for cancer patients provided an opportunity for students to imagine the clinical experiences of cancer patients, helping them to understand patients' points of view and reflect on their self-images as future nurses. The DCC developed for nursing students in this study is a promising way to deliver distinctive and meaningful learning experiences.

[The Lived Experience of Body Alteration and Body Image with Regard to Immediate Breast Reconstruction among Women with Breast Cancer].

PURPOSE: The purpose of this study was to explore the lived experience of body alteration and body image with regard to immediate breast reconstruction among women with breast cancer. METHODS: Data were collected from July to December 2020 through individual in-depth interviews with 15 women who had undergone immediate breast reconstruction due to breast cancer. Verbatim transcripts were analyzed using Colaizzi's phenomenological analysis. RESULTS: The following four theme clusters emerged. First, "revalued meaning of breasts due to cancer" illustrated the fact that cancer removal surgery brought the participants to reconsider the meaning of their breasts. Second, "had no choice but breast reconstruction" demonstrated the participants' decision-making process of not wanting to lose breasts. Third, "unsatisfied breasts despite reconstruction" portrayed the distress due to the unexpected surgical outcomes. Finally, "restarted everyday routines with the altered body" described the healing process of the participants by accepting their changed body. CONCLUSION: In Korea, where family-centeredness and fidelity are highly valued, women perceived their breasts not only as a symbol of femininity but as the mediator connecting the self to family. Despite the distress related to imperfect breasts, the participants were thankful for their reconstructed breasts. Breast reconstruction helped them return to daily life as the psychological trauma of breast cancer was healed. The participants rebuilt their body image by accepting their scarred new body. This may allow health professionals to provide constructive and culturally appropriate counseling in advance by providing insight into women's perception of their body image with regard to breast reconstruction.