Context: Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran. Objective: To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985&1991). Method: This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level. Conclusion: It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.
Purpose: This phenomenological study aimed to identify breast cancer patients' experience of unkindness of healthcare providers. Methods: Ten participants who were diagnosed with breast cancer were recruited to participate in the study and asked to share their experience related to healthcare providers. Data were analyzed using the phenomenological method of Colaizzi. In-depth interviews were conducted from November, 2014 to March, 2015. Results: Seven consistent categories and fourteen theme clusters emerged from collected data. The seven themes were 'being treated thoughtlessly', 'not giving special services for breast cancer patients', 'cold and authoritative manner', 'incomplete explanation', 'not accepting an appeal', 'being sorry for having short consultation hours', and 'unskilled and careless treatment'. Conclusions: It is needed to develop health care services in the view of beneficiaries. This may reduce the patients' experience of unkindness of the healthcare providers and improve the satisfaction of health care service.
Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.
Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.
Background: Although the breast cancer incidence rate in Japan is lower than in western countries, the age-specific rates have markedly increased in recent years, along with the problems of declining birth rate and an aging population. Materials and Methods: We examined past trends of age-specific breast cancer incidence using data from the Osaka Cancer Registry from 1976 to 2010, and estimated future trends until 2025 based on the changes observed and population dynamics using a log linear regression model. Results: The age-specific breast cancer incidence rate has increased consistently from the 1970s, and the rates have caught up with those of Japanese-Americans in the US. Assuming the increasing tendency of age-specific breast cancer incidence to be constant, the average annual incidence of breast cancer will increase 1.7-fold from 2006-2010 to 2021-2025. Furthermore, the number of patients aged 80 years should increase 3.4-fold. Conclusions: The medical demand for breast cancer care in Japan may increase explosively in the future, particularly among the elderly. We need to prepare for such a future increase in demand for care, although careful monitoring is needed to confirm these results.
In Morocco, breast cancer is the most prevalent cancer in women and a major public health problem. Several Moroccan studies have focused on studying this disease, but more are needed, especially at the genetic and molecular levels. It is therefore interesting to establish the genetic and molecular profile of Moroccan patients with breast cancer. In this paper, we will highlight some pertinent hypotheses that may enhance breast cancer care in Moroccan patients. This review will give a precise description of breast cancer in Morocco and propose some new markers for detection and prediction of breast cancer prognosis.
In South Korea, female individuals in their forties show a high rate of incidence, with approximately 13% of the patients being <40 years. This statistic is more than twice as high as that in Western countries. It is therefore necessary to identify the risk factors for breast cancer incidence by age and economic activity participation status. Women aged 30 to 59-whether breast cancer patients or those in the control group and having no breast cancer-were appraised from the sample cohort database. The data were analyzed using the statistical software R36.2. To identify the factors affecting breast cancer incidence, the degree of association was determined with HR and 95% CI by means of cox regression analysis. As for the socio-demographic variables, the older the individual, the higher the risk of breast cancer incidence becomes. As for the economic activity variables, those who were dependents (unemployed) and who had higher income (medium and high) were at higher risk of breast cancer incidence, which was statistically significant. The income-adjusted HR (model 1) for breast cancer development associated with the economic activity was 1.452 (95% CI, 1.19-1.77). The body mass index and alcohol intake-adjusted HR (model 2) was 1.431 (95% CI, 1.18-1.74). One needs to pay attention to policy plans regarding women's quality of life, as well as to the risk of breast cancer incidence by their economic activity. In other words, policies need to give post care, instead of focus on early detection and cancer treatment.
Purpose: This study was conducted to determine risk of developing of breast cancer among Turkish women. Materials and Methods: Using a descriptive and cross-sectional approach, data were collected from 231 women. Breast cancer risk was calculated using the National Cancer Institute's on-line verson of called as the Breast Cancer Risk Assessment Tool or the Gail Risk Assesment Tool. Results: The average age of women was $45.0{\pm}8.06$ years. It was revealed that 6.1% of participants reported having first degree relatives who had had breast cancer, with only four women having more than one first-degree relative affected (1.7%). The mean five-year breast cancer risk for all women was $0.88{\pm}0.91%$, and 7.4% of women had a five-year breast cancer risk >1.66% in this study. Mean lifetime breast cancer risk up to age 90 years was $9.3{\pm}5.2%$. Conclusions: The breast cancer risk assessment tool can help in the clinical management of patient seeking advice concerning screening and prevention. Healthcare providers in Turkey can use this approach to estimate an individual's probability of developing breast cancer.
Purpose: To date most research related to patients with breast cancer has discriminately investigated the status within or after the treatment although the patients demand holistic nursing care from the time of diagnosis. Thus, the purpose of this study was to investigate the trajectory of breast cancer diagnosis and patients' experiences in the pre-treatment period. Method: This qualitative study used qualitative thematic analysis. Nineteen Korean women who were diagnosed with breast cancer within the last 6 month participated in the study. Individualized interviews were conducted with each participant in a cancer center in K city. The interviews were tape-recorded, transcribed, and analyzed using the thematic analysis process. Results: The overriding theme was "the scattered life in an unforeseen swirl", which illustrates the participants' unexpected crisis with confusion and emotional distress. Two subthemes included "falling into an unavoidable journey", and "staggering in a muddle with urgency". The categories were "unexpected probability", "nagging nodularity", "ominous presentiment", "emotional upheaval", "bad thought intrusion", and "a sense of urgency". Conclusion: Patients in the pre-treatment period encountered utter emotional distress and a sense of urgency after being diagnosed breast cancer. Strategies to develop nursing care for patients in this period and nursing implications are discussed.
Donnelly, Tam Truong;Al Khater, Al-Hareth;Al-Bader, Salha Bujassoum;Al Kuwari, Mohammed Ghaith;Malik, Mariam;Al-Meer, Nabila;Singh, Rajvir;Fung, Tak
Asian Pacific Journal of Cancer Prevention
/
제15권23호
/
pp.10157-10164
/
2015
Background: Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. Materials and Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. Results: While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. Conclusions: The low levels of participation rates in BCS among Arab women in this study indicate a strong need to increase awareness of the importance of breast cancer screening in Qatari women. Without this awareness, compliance with the most recent breast cancer screening recommendations in Qatar will remain low. An increased effort to implement mass media and public health campaigns regarding the impact of breast cancer on women's health and the benefits of early detection of breast cancer must be coupled with an enhanced participation of health care providers in delivering this message to Qatar population.
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