Body image and its relationship with coping strategies: The views of Iranian breast cancer women following surgery.

OBJECTIVE: Breast cancer treatments not only affect body image but also other aspects of women's lives. Women try to accept their appearance through coping strategies. This study aimed to determine the relationship between body image and coping strategies in women with breast cancer following surgery in southeast Iran. METHODS: This is a descriptive study with correlational design. This study recruited 180 women with breast cancer following surgery via convenience sampling (71 women with mastectomy, 109 women with breast conservative surgery). Data were collected by a three-part questionnaire: Background data; Body Image Scale; Body Image Coping Strategies Inventory, and were analyzed by SPSS 19 and descriptive and analytical statistics (independent t, ANOVA, Pearson's correlation coefficient and linear regression). RESULTS: The mean score of body image was 14.31 ± 6.61 (ranged from 0 to 30), and coping strategies was 46.16 ± 13.26 (ranged from 0 to 87). According to the mean scores, the women were, on average, satisfied with their body image. The most frequent strategy used was "positive rational acceptance" with a mean score of 23.30 ± 6.19 and the least used strategy was "avoidance" with a mean score of 10.35 ± 4.50. A significant relationship was observed between body image and coping strategies (r = .34, p = .001); women who felt worse about their own body image were found to use more coping strategies. CONCLUSION: Women using positive rational acceptance were likely to report favorable body image. Thus, promoting positive attitude regarding physical appearance and coping skills screening by trained nurses is recommended for all breast cancer patients after their surgery. Such screenings can result in an appropriate flow of information between nurses and patients about the body image and coping skills applied. Being aware of their positive coping strategies can help women, and prepare them to use the coping strategies required to improve their body image and to enhance their quality of life.

Studying the effect of structured ostomy care training on quality of life and anxiety of patients with permanent ostomy.

Patients with ostomy are faced with several physical, psychological, and social challenges and need to be prepared to overcome these challenges. Studies have shown that training plays an important role in helping patients to adapt with ostomy, live with it, and improve their psychological well-being and quality of life (QOL). Therefore, the present study aimed to determine the effect of structured ostomy care training on QOL and anxiety of the patients with permanent ostomy. In this randomised clinical trial study, 60 eligible participants were recruited from the only ostomy clinic in Kerman, Iran. They were selected using a purposive sampling method and randomly assigned to either a control group that received routine ostomy care or an intervention group that attended oral and practical training and a question and answer session by a trained ostomy nurse and received an ostomy information booklet besides their routine care. Outcome variables were anxiety and QOL in general and its physical, mental, social, and spiritual dimensions in detail. By using the anxiety subscale of Hospital Anxiety and Depression Scale (HADS) and City of Hope-quality of life [COH-QOL], data were collected before and 2 months after intervention in both groups. Data were analysed by SPSS version 19 using χ², analysis of variance (ANOVA), independent t, and paired t test and multiple regression analysis. The results showed that the intervention group had significantly lower mean scores in anxiety (P = .001) and a higher mean score in overall QOL (P = .009) compared with the control group. The most significant increase was observed for psychological, social, and physical aspects, and the least was in the spiritual aspect, all of which improved after intervention. After controlling the effects of confounding variables such as age, ostomy period, and number of children, the structured training programme still had a positive effect on QOL. Structured ostomy care training, including face-to-face education and personal practice of using ostomy equipment, along with written material provided by the ostomy nurse specialist, may lead to an increase in the overall QOL and a decrease in the perceived anxiety level in patients. This type of training is not routinely delivered to ostomy patients in our health care setting, so it is feasible to prepare surgical wards and to educate nurses to work with their patients before and after ostomy creation. Furthermore, to ease patients' religious concerns, we recommend counselling, and the support of religious leaders in the Muslim community may play a key role to adaptation regarding religious matters after ostomy surgeries and alleviate patients' concerns.

Mirror therapy effect on shoulder pain and disability and quality of life of mastectomy women: a randomized clinical trial.

PURPOSE: To investigate mirror therapy (MT) influence on shoulder pain/disability and quality of life in mastectomy women. MATERIALS AND METHODS: Sixty unilateral mastectomy women were recruited and randomly assigned to an MT group (N = 30) or a sham therapy (ST) (N = 30). Women in the MT and ST group attended a nurse-led, unsupervised, 30 min a day, five days a week, and at home training program for three weeks with and without a mirror, respectively. Shoulder pain and disability scale and QOL outcomes were assessed at baseline and 3 months after intervention. RESULTS: Shoulder pain and disability were significantly improved in the MT group but there was not meaningful difference between groups in the EORTC-QOL scales except for some functional scores of QLQ-BR23 scale in the MT group after 3 months follow-up. CONCLUSIONS: Nurses should instruct MT as a rehabilitation program to mastectomy patients during or after hospitalization to reduce their post-op shoulder pain and disability. This intervention may have also positive impact on their self-care outcomes. It is recommended that further studies should be performed with nurse-supervised exercises, a validated tool for measuring QOL for a long period after surgery, and a longer follow-up period at least for 6 months.Implication for rehabilitationThis study aimed to investigate whether an unsupervised, nurse-led mirror therapy (MT) can alleviate shoulder pain and disability of mastectomy patients and improve their quality of life.Our findings indicated that nurse-led MT as a novel rehabilitation option for mastectomy patients, may reduce shoulder pain and disability even after long period after the surgery.Rehabilitation centers can equip rooms for MT so breast cancer women can use it immediately after mastectomy.Mirror therapy can be used as a rehabilitation method for mastectomy patients because it is easy-to-use, inexpensive, and without the need to attend a rehabilitation center.Rehabilitation centers can provide mirrors along with nursing instructions to women who want to use this method at home.