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1.
Hu Li Za Zhi ; 66(6): 90-97, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802459

RESUMO

This report discusses an experience of taking care of a breast cancer patient with rapidly deteriorating, fungating wounds and herpes simplex virus wounds and describes the physical and psychological effects on the patient and the related decreases in the quality of life of both the patient and her caregivers. Nursing care was implemented from December 14th, 2017 to January 23rd, 2018. Data collection was performed through direct caregiving, observation, interviews, and chart review. Three major problems were identified: difficulties with wound care, psychological distress of the patient, and the coping problems of the caregivers. Based on these problems, nursing interventions were implemented. During the period, fungating wound care guidelines were used to teach the patient and her caregivers the core principles of fungating wound management. Meanwhile, the COPE framework (creativity, optimism, planning, and expert information) was applied to train the patient and her caregivers how to develop problem-solving skills and build self-confidence. Finally, the patient and her family successfully overcame these challenges. The patient was relieved of stress and anxiety, became better able to self-manage her symptoms, sustain hope for the future, and improve her perception of body self-image. We suggested that the patient and her family be considered a single, supportive unit and then helped them cope with the disease and build self-care confidence in order to improve their life quality and to coexist with the disease. We hope that our clinical experience will be taken as a reference by patient caregivers.


Assuntos
Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Cuidadores/psicologia , Feminino , Humanos , Qualidade de Vida , Estresse Psicológico
2.
Health Qual Life Outcomes ; 17(1): 165, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690327

RESUMO

BACKGROUND: Breast cancer is the second most prevalent malignancy in Ethiopia and severely affects patients' health-related quality of life (HRQOL). We aimed to assess HRQoL, factors influencing HRQoL, and utilities among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS: A hospital-based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from December 2017 to February, 2018. A total of 404 breast cancer patients were interviewed using the validated Amharic version of the European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), EORTC QLQ-BR23, and Euro Quality of Life Group's 5-Domain Questionnaires 5 Levels (EQ-5D-5 L) instruments. Mean scores and mean differences of EORTC- QLQ-C30 and EORTC- QLQ-BR23 were calculated. One-way ANOVA test was employed to determine the significance of mean differences among dependent and independent variables while stepwise multivariate logistic regression was used to identify factors associated with the global quality of life (GQOL). Coefficients and level specific utility values obtained from a hybrid regression model for the Ethiopian population were used to compute utility values of each health state. Data was analyzed using SPSS version 23. RESULTS: The mean age of patients was 43.94 ± 11.72 years. The mean score for GQoL and visual analog scale was 59.32 ± 22.94 and 69.94 ± 20.36, respectively while the mean utility score was 0.8 ± 0.25. Predictors of GQoL were stage of cancer (AOR = 7.94; 95% CI: 1.83-34.54), cognitive functioning (AOR = 2.38; 95% CI: 1.32-4.31), pain (AOR = 7.99; 95% CI: 4.62-13.83), financial difficulties (AOR = 2.60; 95% CI: 1.56-4.35), and future perspective (AOR = 2.08; 95% CI: 1.24-3.49). CONCLUSIONS: The overall GQoL of breast cancer patients was moderate. Targeted approaches to improve patients' HRQoL should consider stage of cancer, cognitive functioning, pain, financial status and worries about the patient's future health. This study also provides estimates of EQ-5D utility scores that can be used in economic evaluations.


Assuntos
Neoplasias da Mama/psicologia , Qualidade de Vida , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Medição da Dor , Inquéritos e Questionários
3.
Health Qual Life Outcomes ; 17(1): 153, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615531

RESUMO

BACKGROUND: The Functional Assessment of Cancer Therapy-Breast (FACT-B) is the most commonly used scale for assessing quality of life in patients with breast cancer. The lack of preference-based measures limits the cost-utility of breast cancer in China. The goal of this study was to explore whether a mapping function can be established from the FACT-B to the EQ-5D-5 L when the EQ-5D health-utility index is not available. METHODS: A cross-sectional survey of adults with breast cancer was conducted in China. All patients included in the study completed the EQ-5D-5 L and the disease-specific FACT-B questionnaire, and demographic and clinical data were also collected. The Chinese tariff value was used to calculate the EQ-5D-5 L utility scores. Five models were evaluated using three different modelling approaches: the ordinary least squares (OLS) model, the Tobit model and the two-part model (TPM). Total scores, domain scores, squared terms and interaction terms were introduced into models. The goodness of fit, signs of the estimated coefficients, and normality of prediction errors of the model were also assessed. The normality of the prediction error is determined by calculating the root mean squared error (RMSE), the mean absolute deviation (MAD), and the mean absolute error (MAE). Akaike information criteria (AIC) and Bayes information criteria (BIC) were also used to assess models and predictive performances. The OLS model was followed by simple linear equating to avoid regression to the mean. RESULTS: The performance of the models was improved after the introduction of the squared terms and the interaction terms. The OLS model, including the squared terms and the interaction terms, performed best for mapping the EQ-5D-5 L. The explanatory power of the OLS model was 70.0%. The AIC and BIC of this model were the smallest (AIC = -705.106, BIC = -643.601). The RMSE, MAD and MAE of the OLS model, Tobit model and TPM were similar. The MAE values of the 5-fold cross-validation of the multiple models in this study were 0.07155~0.08509; meanwhile, the MAE of the TPM was the smallest, followed by that of the OLS model. The OLS regression proved to be the most accurate for the mean, and linearly equated scores were much closer to observed scores. CONCLUSIONS: This study establishes a mapping algorithm based on the Chinese population to estimate the EQ-5D-5 L index of the FACT-B and confirms that OLS models have higher explanatory power and that TPMs have lower prediction error. Given the accuracy of the mean prediction and the simplicity of the model, we recommend using the OLS model. The algorithm can be used to calculate EQ-5D scores when EQ-5D data are not directly collected in a study.


Assuntos
Neoplasias da Mama/psicologia , Modelos Estatísticos , Qualidade de Vida , Adulto , Algoritmos , Teorema de Bayes , China , Estudos Transversais , Feminino , Humanos , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
4.
BMC Womens Health ; 19(1): 122, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640681

RESUMO

BACKGROUND: Incidence of breast cancer in the Kingdom of Saudi Arabia (KSA) has increased in recent years. Screening helps in early detection of cancer and early diagnosis and timely treatment of breast cancer lead to a better prognosis. Women in the healthcare profession can have a positive impact on the attitudes, beliefs, and practices of general public. Therefore, it is important that the healthcare workers themselves have adequate knowledge and positive attitudes. We conducted a study to assess the knowledge, attitudes, and practices related to breast cancer screening among female healthcare professionals. METHODS: A cross-sectional study was conducted on female health professional of KFMC (King Fahad Medical City). Data was collected using a pre-designed, tested, self-administered questionnaire. The questionnaire included specific sections to test the participants' knowledge, attitude, and practices related to cervical cancer and its screening. Data analysis was done using descriptive statistics. RESULTS: A total of 395 health care workers participated in this study. The mean age of the participants was 34.7 years. Participants included physicians (n = 63, 16.0%), nurses (n = 261, 66.1%), and allied health workers (n = 71, 18.0%). Only 6 (1.5%) participants had a good level of knowledge of breast cancer and 104 (26.8%) participants demonstrated a fair level of knowledge. Overall, 370 (93.7%), 339 (85.8%), and 368 (93.2%) participants had heard of breast self-examination, clinical breast examination, and mammography, respectively. A total of 295 (74.7%) participants reported practicing breast self-examination, 95 (24.1%) had undergone clinical breast examination, and 74 (18.7%) had ever undergone mammography. CONCLUSION: The knowledge, attitudes, and practices related to breast cancer screening were found to be lower than expected. Active steps are required to develop educational programs for the health care staff, which might empower them to spread the knowledge and positively influence the attitudes of female patients in the hospital.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Autoexame de Mama/psicologia , Estudos Transversais , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Mamografia/psicologia , Pessoa de Meia-Idade , Arábia Saudita , Inquéritos e Questionários , Neoplasias do Colo do Útero/psicologia , Saúde da Mulher
5.
Ig Sanita Pubbl ; 75(3): 181-187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31645060

RESUMO

The American College of Sports Medicine states that 150 minutes per week of moderate aerobic activity improves quality of life, also in patients treated for cancer. Physical activity before, during, and after oncological treatments increases rates of survival, interval free from sickness, and side effects of treatment. The importance of physical exercise is often underestimated in Oncology, above all because of the need for an individualized approach and for a lack of recommendations that are valid for everyone. The literature now states that rehabilitation and exercise are as important as medical care. The National Cancer Institute in Aviano (Italy) has started a rehabilitation program for patients treated for breast cancer, followed by an assisted path to encourage physical activity. Thanks to various co-production processes, this program allows women to benefit from a personalised plan and it will be possible to assist patients and encourage physical activity through use of a mobile app. A synergy between the health and fitness worlds has been created, through co-production, accustoming patients to exercise during and following treatments.


Assuntos
Neoplasias da Mama , Exercício , Tutoria , Qualidade de Vida , Neoplasias da Mama/psicologia , Exercício/fisiologia , Exercício/psicologia , Terapia por Exercício , Feminino , Humanos , Itália
6.
Medicine (Baltimore) ; 98(40): e17454, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577773

RESUMO

To examine the current situation of patient delay and to identify factors associated with patient delay among women with breast cancer in China.A total of 283 women, aged 23 to 83 years old and with histologically confirmed breast cancer, were investigated in this cross-sectional study. The women were recruited from seven selected hospitals in Sichuan Province, China. Face-to-face interviews using a structured questionnaire were performed.Among the 283 participants, the range of patient delay was 0.2 to 900 days with a median patient delay of 50 days. A total of 35.8% of patients waited ≥90 days to access medical treatment after symptom onset. Binary logistic regression analysis showed that the main predictors of patient delay were knowledge of breast cancer symptoms (OR = 0.716, 95%CI:0.637-0.804, P = .000), external health locus of control (OR = 1.173, 95%CI:1.087-1.266, P = .000), breast self-examination/physical examination (OR = 0.065, 95%CI: 0.007-0.590, P = .015), perceived health competence (OR = 0.873, 95%CI:0.808-0.944, P = .000), family support (OR = 0.911,95%CI:0.847-0.981, P = .013), pain stimulation (OR = 0.191, 95%CI:0.046-0.792, P = .023) and age (OR = 1.028, 95%CI:1.000-1.058, P = .049).These factors explained 41.0% of the variance.Information on the current situation and predictors of patient delay in Chinese women with breast cancer might provide meaning insights into the early diagnosis of breast cancer. The results of this study may help health professionals develop specific clinical practice strategies to reduce patient delay of initial treatment as a way to improve outcomes for women with breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico , Diagnóstico Tardio , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , China , Estudos Transversais , Feminino , Humanos , Controle Interno-Externo , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
7.
Eur J Oncol Nurs ; 42: 116-125, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31520865

RESUMO

PURPOSE: This study aimed to investigate the effects of progressive muscle relaxation (PMR) and mindfulness meditation (MM) on fatigue, coping styles, and quality of life (QOL) in patients with early breast cancer receiving adjuvant paclitaxel. METHODS: The participants were randomly assigned to either a 12-week (PMR) (n = 31) and MM (n = 32) interventions or control group (CG) (n = 29). The intervention groups continued PMR or MM for 20-min every day, for a total of 12 weeks. The CG received only a single time attention-matched education (15-min) on breast cancer before the start of the paclitaxel regimen. Data collection tools included the Patient Information Form, Brief Fatigue Inventory (BFI), Brief COPE, and Functional Living Index-Cancer (FLIC). Data were collected at baseline, week 12, and week 14. RESULTS: A significant reduction in the BFI scores was reported in the PMR and MM groups when compared with the CG at weeks 12 and 14 (p = .002). Similarly, the use of emotional support and positive reframing sub-dimension scores of Brief COPE were significantly higher in the PMR and MM than in the CG at weeks 12 (p = .017) and 14 (p = .042). Furthermore, the planning and active coping sub-dimension scores were significantly higher in the PMR and MM than in the CG at week 14 (p = .000). Regarding QOL scores, no significant differences were observed between the groups at weeks 12 (p = .486) and 14 (p = .095). CONCLUSIONS: PMR and MM are effective interventions that if initiated concurrently with the adjuvant paclitaxel demonstrate similar effects on fatigue and coping styles.


Assuntos
Adaptação Psicológica , Treinamento Autógeno , Neoplasias da Mama/psicologia , Fadiga/terapia , Meditação , Qualidade de Vida , Adulto , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Fadiga/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Atenção Plena
8.
Ann Agric Environ Med ; 26(3): 450-455, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559802

RESUMO

INTRODUCTION AND OBJECTIVE: Working at night and in shifts, as well as an unhealthy lifestyle, may increase the risk of breast cancer in nurses who therefore should frequently perform breast self-examination (BSE). The aim of the study was to investigate the performance of BSE among Polish nurses, its accuracy, sources of knowledge and skills, self-assessment of own competences and preparation to educate women about BSE. MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted in a group of female nurses (N=1,242). An anonymous, self-administrated questionnaire was used for data collection. To properly assess the BSE a four-item scale was made of the type single best answer multiple choice question. Each item referred to one agreed principle of performing BSE. RESULTS: Regularly BSE was performed by 56.1% nurses, 67.3% pre-menopause nurses 2-3 days after cessation of menstruation and 30.4% post-menopause women on a chosen day of the month. About 98% examined visually and by palpation; 58.9% did so in two positions. In the accuracy scale of BSE, the average number of points was 2.8 out of 4. All (4 points) or almost all (3 points) recommendations of accurate BSE were met by 61.4% of the nurses. Self-assessment of knowledge and BSE practical skills were considered as good or very good by 93.5% and 88.8% nurses, respectively. The self-evaluation of nurses' knowledge and BSE skills was significantly correlated with the result on the accuracy scale or this BSE. CONCLUSIONS: Many deficiencies concerning frequency, times and BSE techniques were revealed among Polish nurses. There is a discrepancy between the high self-assessment of competences and the accurate practice of BSE. Nurses' preparation in Poland in BSE is insufficient and requires improvement.


Assuntos
Neoplasias da Mama/psicologia , Autoexame de Mama , Enfermeiras e Enfermeiros/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Polônia , Inquéritos e Questionários , Adulto Jovem
9.
Eur J Oncol Nurs ; 42: 134-140, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31526966

RESUMO

PURPOSE: To translate and validate the Chinese version of the Demoralization Scale among breast cancer patients. METHOD: A cross-sectional, descriptive correlational design was employed. From September 2016 to May 2017, 203 breast cancer survivors completed the survey. Content, construct, concurrent and divergent validity and internal consistency of the Chinese version of the Demoralization Scale were evaluated. RESULTS: The proposed factor structures of the Demoralization Scale in previous studies cannot be confirmed using confirmatory factor analysis in the present study. Moreover, four factors were extracted by exploratory factor analysis, which accounted for 58.66% of the variance. Each subscale yielded satisfactory internal consistency with coefficient alphas ranging from 0.720 to 0.894. Relationships/differences between demoralization, quality of life, despair and depression provide initial support for the concurrent/divergent validity. Given these results, the Chinese version of the Demoralization Scale appears to be both valid and reliable. CONCLUSIONS: Our results preliminary supported that the Chinese version of the Demoralization Scale is a reliable and valid instrument for assessing demoralization among mainland Chinese breast cancer patients, and the factor structure of this measurement needs to be further addressed in future studies.


Assuntos
Neoplasias da Mama/psicologia , Adulto , Grupo com Ancestrais do Continente Asiático , China , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Emprego , Análise Fatorial , Feminino , Humanos , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
10.
Eur J Oncol Nurs ; 42: 126-133, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31522057

RESUMO

PURPOSE: Breast cancer patients have many needs, including strategies to cope with the associated distress, during and after cancer treatment. Establishing and implementing adequate social and emotional support for these women, to reduce the detrimental effects of stress resulting from their treatment and disease, is the need of the hour. This study aims to assess how women, diagnosed and treated for breast cancer, combat emotional stress using mechanisms of coping and control and emotional defense, as well as to identify potential groups among them, with different long-term patterns and needs. METHODS: 98 patients belonging to a local breast cancer support association (ALMOM), were enrolled in this study. A questionnaire specifically designed for them was administered, and its internal consistency and reliability assessed. A hierarchical clustering was employed to classify the women. The questionnaire focused on four sections, including personal feelings, coping strategies, environmental influences and maladaptive coping. RESULTS: An adequate internal reliability was obtained with Cronbach's α near or greater than 0.60. Personal feelings were significant and clearly correlated with coping strategies and maladaptive coping. Three groups of women with different patterns of emotional characteristics and needs were identified: positivist, unsafe, and hopeless women, with different long-term emotional needs to be satisfied. CONCLUSIONS: Psychological therapeutic interventions should be maintained in many breast cancer patients over time, even after treatment completion, in order to consolidate adaptive and sustainable responses.


Assuntos
Neoplasias da Mama/psicologia , Estresse Psicológico/prevenção & controle , Adaptação Psicológica , Adulto , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Estudos Transversais , Emoções , Feminino , Humanos , Assistência de Longa Duração , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
11.
BMC Womens Health ; 19(1): 116, 2019 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519195

RESUMO

BACKGROUND: Breast cancer is the most prevalent cancer in women, and in those with a positive family history, it is important to perform mammography. One of the probable barriers in doing mammography is fatalism. METHODS: This is a descriptive/cross-sectional study conducted on 400 women residing in Isfahan, Iran, randomly selected in 2017. Sampling was done randomly among the enrolled women in Health Integrity System. The data collection tool was a questionnaire regarding the demographic-fertility information and fatalism. The data analysis was done by SPSS software. A P-value < 0.05 was considered statistically significant. RESULTS: The results showed that the mean rate of fatalism was 59.5 ± 23.2 in women with the experience of mammography, and 65.9±18.7 in women without the experience. Moreover, the mean rate of fatalism was 73.1±15.2 in subjects with a family history of breast cancer, and 59.3 ± 22.5 in those no family history related to this condition. Accordingly, fatalism was statistically significant associated (P < 0.001) with a family history of breast cancer and experience of mammography. There was no significant relationship between demographic information and fatalism (P > 0.05). CONCLUSION: The results indicated that fatalism in women with no experience of mammography was higher than in those with a positive history. Regarding the necessity of mammography in women with a family history of breast cancer, the required interventions seem to be essential to changing the viewpoints of women regarding the importance and effect of mammography as a screening method for breast cancer.


Assuntos
Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/psicologia , Predisposição Genética para Doença/psicologia , Mamografia/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Irã (Geográfico) , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Inquéritos e Questionários
12.
Eur J Oncol Nurs ; 42: 103-109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31479846

RESUMO

PURPOSE: This pilot study aimed to evaluate the effect of an 8-weeks-yoga intervention on quality of life and upper extremity edema volume in women with breast cancer related lymphedema. METHODS: This was a controlled trial with pre-post design. A total of 40 women with breast cancer related lymphedema were randomly assigned into an intervention or control groups. The intervention group participated in a yoga exercise class for 8 weeks, in a twice a week instructor-led practice and once a week home practice. Outcomes were EORTC QLQ_C30 to measure quality of life, and water displacement volume-meter to measure upper extremity edema volume. The outcomes were evaluated at baseline, 4th and 8th week. Data were analyzed using SPSS. RESULTS: Four weeks after the intervention, a significant difference was observed between the groups with respect to role functioning of quality of life (P = 0.03). Eight weeks after the intervention, a significant difference was observed between groups concerning physical and emotional functioning of quality of life (P < 0.05). The changing trend in physical, role, emotional, and cognitive functioning had increased, and in some scales such as fatigue, pain, insomnia, and financial difficulties the scores were reduced in the intervention group. Regarding edema volume, no significant difference was found between both groups on the 4th and 8th week after the intervention (P > 0.05). CONCLUSION: As yoga exercise might improve physical, role, and emotional functioning of quality of life as well as reduce fatigue, pain, and insomnia, using this intervention can be suggested amongst women with breast cancer related lymphedema.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Linfedema/terapia , Qualidade de Vida , Extremidade Superior , Ioga , Adulto , Neoplasias da Mama/patologia , Fadiga/diagnóstico , Fadiga/etiologia , Fadiga/prevenção & controle , Feminino , Humanos , Linfedema/etiologia , Linfedema/patologia , Pessoa de Meia-Idade , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle
13.
BMC Cancer ; 19(1): 839, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455311

RESUMO

BACKGROUND: Identification of specific needs in patients with cancer is very important for the provision of patient-centered medical service. The aim of this study was to investigate the unmet needs and related factors of Korean breast cancer survivors. METHODS: A multicenter, cross-sectional, interview survey was performed among 332 Korean breast cancer survivors. The Comprehensive Needs Assessment Tool for cancer patients was administered to survivors who gave written informed consent to participate. Data were analyzed using t-test, ANOVA and multiple regression analysis. RESULTS: The level of unmet needs was highest in the domain 'Information and education' (mean ± SD; 1.70 ± 1.14) and the item with the highest level of unmet needs was 'Needed help in coping with fear of recurrence' (2.04 ± 1.09). Unmet needs were correlated with age, stage, multiplicity, HER2, treatment state, marital status, employment, psychosocial status, and problems in EQ-5D dimensions. In multiple regression analysis, the 50-59 age group showed a higher level of recognition for physical symptom needs and the unemployed group expressed greater needs for information and education. Survivors with multiplicity had greater needs in the domains of healthcare staff and physical symptom. The stress group showed high levels of needs in all domains except religious support. The group with thoughts of suicide showed higher levels of unmet needs for physical symptom. CONCLUSION: Most prevalent unmet needs in Korean breast cancer survivors were found in the 'information and education' domain. The 50-59 age group, unemployment, multiplicity, stress and suicidal thoughts were associated with higher levels of unmet needs among Korean breast cancer survivors. Our findings revealed more vulnerable breast cancer survivors with unmet needs and physicians should take a precision approach to satisfy unmet needs of these survivors.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Necessidades e Demandas de Serviços de Saúde , Adulto , Idoso , Análise de Variância , Neoplasias da Mama/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância em Saúde Pública , República da Coreia/epidemiologia , Fatores Socioeconômicos
14.
Asian Pac J Cancer Prev ; 20(8): 2373-2378, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450908

RESUMO

Breast cancer is the most common cancer among women. The present study investigated the stage of breast cancer screening adoption and the role of some of the cognitive predictors in a sample of Iranian married women. There were a total of 334 married women clients of eight health centers in Kermanshah city, the west of Iran, were randomly selected to participate voluntarily. Women filled out a self-report questionnaire. Data were analyzed by SPSS version 20 using One-way ANOVA, χ2-test, Fisher's exact test, and bivariate correlations statistical tests at 95% significant level. The mean age was 39.75 years [SD: 7.73]. Nearly 58.4%, 26.9%, 3%, 9.6%, and 2.1% of the respondents were reported pre-contemplation, contemplation, preparation, action, and maintenance of breast cancer screening adoption, respectively. There was a significant association between age (P=0.005), and positive family history of breast cancer (P=0.037), perceived susceptibility (P=0.005), perceived severity (P=0.001) and knowledge of symptoms (P=0.018) with breast cancer stage of screening adoption. Our findings can provide better knowledge for the development and implementing of stage-targeted breast cancer screening adoption promotion programs. We conclude that it seems that the focus of health planner should be to rise to perceived severity; perceived susceptibility and knowledge of symptoms of breast cancer about the promotion of breast cancer screening adoption an Iranian woman.


Assuntos
Neoplasias da Mama/psicologia , Cognição/fisiologia , Suscetibilidade a Doenças/psicologia , Detecção Precoce de Câncer/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Índice de Gravidade de Doença , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários
15.
Health Qual Life Outcomes ; 17(1): 143, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31420041

RESUMO

PURPOSE: Because the currently available questionnaires to evaluate sexual changes on breast cancer women only address the sexual sphere with a few questions our purpose was to develop a questionnaire that assesses changes in sexual dysfunction and satisfaction in women treated for breast cancer. METHODS: A sample was selected of women aged between 18 and 65 who had had surgery for breast cancer, completed neoadjuvant/adjuvant chemotherapy treatment and could be receiving adjuvant hormonal treatment, with an active sex life at least 3 months before starting treatment. Metastatic disease was excluded. A questionnaire structured in 4 dimensions was developed. The MOS SF-12 and QLQ-BR23 questionnaires were also provided. The following metric properties were evaluated: item analysis; internal consistency; temporal stability; construct validity; concurrent, convergent and divergent validity; and feasibility. RESULTS: Three samples were recruited: a pilot sample of 20; a reduction sample of 152; and a validation sample of 148. The presence of 6 dimensions was confirmed: 1) Loss of sex drive; 2) worsening of body image; 3) psychological coping; 4) discomfort during intercourse; 5) satisfaction with sexual relations; and 6) satisfaction with breast reconstruction. Good goodness-of-fit statistics were obtained (χ2/df = 1.5, GFI = 0.9, AGFI = 0.84, CFI = 0.959, RMSEA = 0.062). Reliability was good (α = 0.855), as was test-retest stability (r = 0.838). The correlation with the convergent questionnaires proved to be higher than that obtained with generic measurements. CONCLUSIONS: We were able to develop a short questionnaire (17 items) capable of measuring sexual satisfaction in women with breast cancer with good metric properties.


Assuntos
Neoplasias da Mama/psicologia , Orgasmo , Qualidade de Vida , Inquéritos e Questionários/normas , Adaptação Psicológica , Adulto , Idoso , Imagem Corporal/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
16.
Riv Psichiatr ; 54(4): 160-167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379381

RESUMO

BACKGROUND: Breast cancer diagnosis and treatments have a strong impact on women's lives. This study aimed to evaluate the changes in emotional traits in women aged 38-50 years over a three-year period. METHOD: By cross-sectional study design, a sample of n. 126 patients in range age 38-50 has been recruited in different timing of cancer disease, in order to evaluate the patients' emotional traits (variables: anxiety, anger, psychological distress, and depression) at the time of diagnosis, and 6, 12, 18, 24, and 36 months after diagnosis. Anger, anxiety, psychological distress, and depression were evaluated. RESULTS: Results showed significant differences in each emotional variable during treatment. Anxiety showed a decreasing trend, whereas anger tended to improve significantly. At 12 and 24 months from the diagnosis, patients seemed more aware about their own psychological needs compared with the period immediately after the diagnosis (T0) and during the treatments. Women who had recently received a diagnosis (T0) seemed more resilient in their responses in facing an emergency. CONCLUSIONS: Increased survival rate after breast cancer diagnosis is strongly linked to the management of emotional weakness of BC women because of modified living. Patients need to be supported to regain their life after clinical treatments though tailored psychological treatment along survivorship, not only in primary treatment.


Assuntos
Neoplasias da Mama/psicologia , Emoções , Sobrevivência , Adulto , Ira , Ansiedade/diagnóstico , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Testes Psicológicos , Autorrelato , Estresse Psicológico/diagnóstico , Taxa de Sobrevida , Fatores de Tempo
17.
Eur J Oncol Nurs ; 42: 14-20, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446259

RESUMO

PURPOSE: Symptoms experienced by breast cancer patients often cluster together in groups known as "symptom clusters". The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT). METHODS: Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points. RESULTS: This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster. CONCLUSION: Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/radioterapia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Neoplasias da Mama/psicologia , Dor do Câncer/diagnóstico , Dor do Câncer/epidemiologia , Análise por Conglomerados , Depressão/diagnóstico , Depressão/epidemiologia , Dispneia/diagnóstico , Dispneia/epidemiologia , Análise Fatorial , Fadiga/diagnóstico , Fadiga/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/epidemiologia , Análise de Componente Principal , Avaliação de Sintomas/métodos
18.
Eur J Oncol Nurs ; 42: 42-49, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446263

RESUMO

PURPOSE: Treatment decisions, such as breast reconstruction is made by the dyad patient-physician, but close others can have an influence on the process. Shared decision-making models include close others but current studies generally investigate physician-patient interactions only. Moreover, little is known about couples' interactions throughout the breast cancer journey and treatment decision-making. Thus, the aim of the present study was to explore couples' experiences of mastectomy and breast reconstruction decision-making, the month following the mastectomy. METHOD: Ten unstructured individual interviews, with five couples facing mastectomy for breast cancer, were conducted. A dyadic interpretative phenomenological analysis (IPA) was carried on the data set. RESULTS: Eight super-ordinate themes emerged from the data. Couples' experiences were marked by the experience of the disease, the mastectomy and the impact they produced. The relationships with health professionals and partners were also important. Partners were not only supportive and protective, but directly (i.e., couples talk about treatments) and indirectly influenced (i.e., women make a decision taking into consideration how it will impact their couple) the women in their decision to have or not a breast reconstruction. The interpretative accounts underline how women and partners cope with the disease thinking about the aftertreatment. CONCLUSIONS: This study explains for the first time how intimate partners influence breast reconstruction decision-making and how couples cope individually with the disease immediately after mastectomy. Health professionals need to involve partners more in the treatment decision-making process as the women consider and talks to them about the choices they have to make.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Tomada de Decisões , Mamoplastia , Mastectomia , Adaptação Psicológica , Adulto , Feminino , Heterossexualidade , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Parceiros Sexuais
19.
Int J Behav Med ; 26(5): 551-561, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31364038

RESUMO

BACKGROUND: There are significant geographic inequalities in cancer survival with poorer survival rates in non-metropolitan areas compared to major cities. Physical activity (PA) can reduce cancer recurrence and prevent cardiovascular disease. However, few survivors participate in sufficient PA and the prevalence of inactivity is significantly higher in non-metropolitan survivors. The study investigated non-metropolitan survivors' recollections regarding PA advice received following cessation of active treatment, their knowledge of PA guidelines, and the factors that impact on PA behaviour change. METHOD: Sixteen individuals (14 women and 2 men) with breast (n = 8), endometrial (n = 4) or colorectal cancer (n = 4), with a mean age of 60 years (SD = 12) completed semi-structured interviews as part of a larger study to examine the acceptability and utility of wearable trackers to increase PA. Interviews explored survivors' recollections regarding the advice they received concerning PA following active treatment, knowledge of PA guidelines for cancer survivors and the influences on PA behaviour change. Interview transcripts were analysed using thematic analysis. RESULTS: Four main themes emerged: (i) insufficient knowledge of guidelines, (ii) support from the treating oncology team, (iii) external accountability, and (iv) barriers to PA. CONCLUSIONS: Survivors' knowledge of PA guidelines was limited and they did not often recall their oncologists making specific recommendations concerning PA. Survivors' referred to the desire for accountability and monitoring in order to successfully change PA. Lack of motivation was the main barrier to PA participation. Other barriers included age, health status, and lack of facilities or exercise programs.


Assuntos
Sobreviventes de Câncer/psicologia , Exercício/psicologia , Motivação , Adulto , Idoso , Neoplasias da Mama/psicologia , Neoplasias Colorretais/psicologia , Neoplasias do Endométrio/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Fatores Socioeconômicos
20.
Health Psychol ; 38(10): 888-899, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31343218

RESUMO

OBJECTIVE: Previous research has shown that up to 50% of breast cancer survivors prescribed tamoxifen do not take it as recommended, which is associated with increased risk of recurrence and mortality. Little research has attempted to identify modifiable psychosocial factors associated with tamoxifen nonadherence. This study aimed to examine how tamoxifen adherence rates change over a year and to identify modifiable predictors of nonadherence. METHOD: Three hundred and forty-five breast cancer survivors who were in their first year of tamoxifen prescription were sent questionnaires at 4 points over a 12-month period. Questionnaires assessed demographic and clinical factors, side effects, beliefs about the illness and medication, social support, distress and tamoxifen adherence. Adherence was assessed using the Medication Adherence Rating Scale. Latent Growth Modeling was used to identify predictors of tamoxifen nonadherence. RESULTS: Reported rates of nonadherence increased over time (37-48%). Several demographic, clinical, and psychosocial variables were associated with nonadherence. Women who were nonadherent were more likely to be from a minority ethnic group, to have more negative medication beliefs and to have lower confidence in their ability to take tamoxifen. CONCLUSIONS: These demographic and clinical variables can be used to identify women at higher risk of nonadherence. The modifiable psychosocial variables can be used as the basis for psychological interventions to improve adherence in this population. Interventions should focus on both intentional and unintentional nonadherence. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Neoplasias da Mama/psicologia , Antagonistas de Estrogênios/uso terapêutico , Adesão à Medicação/psicologia , Tamoxifeno/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/mortalidade , Sobreviventes de Câncer , Antagonistas de Estrogênios/farmacologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Tamoxifeno/farmacologia , Fatores de Tempo
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