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The Decision-Making Journey of Malaysian Women with Early Breast Cancer: A Qualitative Study

  • Abdullah, Adina;Abdullah, Khatijah Lim;Yip, Cheng Har;Teo, Soo-Hwang;Taib, Nur Aishah;Ng, Chirk Jenn
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7143-7147
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    • 2013
  • Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.

Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

  • Ugwumba, Fred O;Ekwueme, Osa Eloka C;Okoh, Agharighom D
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4999-5003
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    • 2016
  • The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.

A Study of Burden and Social Support in Mothers of Handicapped Children (장애아 어머니의 부담감과 사회적지지에 관한 연구)

  • Jun, Hoa-Yun;Kwon, Hye-Jeoung;Kim, Sang-Jin
    • Journal of Korean Physical Therapy Science
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    • v.4 no.2
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    • pp.439-452
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    • 1997
  • Mothers of handicapped children experience many problems and difficulties related to the child's prolonged dependency and demands for special care. Social support can be identified as stress-relieving factor, social support is considered to decrease the amount of negativeness in an individual or family. This study attempted to identify the level of burden and social support in mothers of children who are handicapped, and to determine whether social support is an effective strategy for burden relief in these mothers. The method used in the study was a correlational descriptive survey using a questionnaire. The subjects for the study were 42 mothers who have the handicapped children, between two to twelve years of age, being treated at S General Welfare House for Handicapped and S Rehabilitation Center in Seoul. The data were collected during 1 month from March 20 to April 20, 1996. The instruments used for this study was a structured questionnaire which was the Burden scale developed by Suh Mihae and Oh Kasil(1993) and the PRQ(Personal Resource Questionnaire) scale developed by Brandt & Weinert(1981). The collected data were analyzed using the SPSS computer program, yielding frequencies, percentiles, means, standard deviations, $x^{2}$-test, Pearson's correlation coefficienct, t-test and ANOVA. The results of this study are as follows ; 1)The range of age in the subjects was $29{\sim}44$ years, the range age in the handicapped children was $2{\sim}12$ years. 2) The mean score of burden, for the mothers of the handicapped children was 2.75(standard deviation was 0.47) of a possible total of 5. 3) The mean score of social support, for the mothers of the handicapped children was 4.99 (standard deviation was 0.59) of a possible total of 7. 4) There was an negative correlations hip between burden level and the social support, but there was no statistically significant correlationship between burden level and the social support(r = -.2252, p = .076) 5) In the general characteristics influencing on the burden level was significantly related with the sex(t = - 2.87, p = .007) and the degree of child's handicap level(F = 11.8680, p = .000l). In the general characteristics influencing on the social support was significantly related with the family(husband) support(F = 3.5199, p = .0240). There were significant differences in the mother's levels of burden depending upon the severity of child's handicap. In other words, the degree of mother's burden was directly proportionate to the degree of child's handicap level. There were significant differences in the mother's levels of social support depending upon the family(husband) support. In conclusion, on the basis of the results of this study, there was no statistically significant correlationship between burden level and the social support. Above results suggest that strategies for the intervention programs in diminishing the mother's burden and reinforcing the social support.

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A Study on the Oxidative Transformation of Quinone Compound using Nanostructured Black-birnessite (나노구조의 블랙-버네사이트를 이용한 퀴논계 화합물의 산화-변환 연구)

  • Harn, Yoon-I;Choi, Chan-Kyu;Shin, Hyun-Sang
    • Journal of Korean Society of Environmental Engineers
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    • v.32 no.6
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    • pp.547-554
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    • 2010
  • In this study, new manganese oxide (i.e., black-birnessite) particles with nanostructures were prepared and its physico-chemical properties and oxidative-transformation efficiency on 1,4-naphthoquinine(1,4-NPQ) in the presence of reactive mediator was investigated. The results were also compared with that of the manganese oxide (i.e., brown-birnessite) particles synthesized by classical McKenzie method. Analysis of XRD and SEM data show that the particles are a single phase corresponding to a birnessite-based manganese oxide with cotton ball-like shapes containing nanofibers. In batch experiments, removals of 1,4-NPQ by the black-birnessite follows pseudo-first-order kinetics and the rate constant values obtained are greater about 2.3 times than that of the brown-birnessite in spite of its lower surface area (41.0 vs 19.80 $m^2/g$). The results can be explained by the higher crystallinity and nano structured features of the back-birnessite particles, which give higher reactivity for the removals of the quinone compound. HPLC analysis of the reaction products confirmed that the balck-birnessites removed 1,4-NPQ through cross-coupling reaction in the presence of catechol as a reactive mediator.

Optimization of Synthesis Condition for Nanoscale Zero Valent Iron Immobilization on Granular Activated Carbon (영가철이 고정된 입상활성탄 제조를 위한 최적 합성조건 도출)

  • Hwang, Yuhoon;Mines, Paul D.;Lee, Wontae;Andersen, Henrik R.
    • Journal of Korean Society of Environmental Engineers
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    • v.38 no.9
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    • pp.521-527
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    • 2016
  • Nanoscale zero valent iron (nZVI) has been intensively studied for the treatment of a plethora of pollutants through reductive reaction, however, the nano size should be of concern when nZVI is considered for water treatment, due to difficulties in recovery. The loss of nZVI causes not only economical loss, but also potential risk to human health and environment. Thus, the immobilization onto coarse or structured support is essential. In this study, two representative processes for nZVI immobilization on granular activated carbon (GAC) were evaluated, and optimized conditions for synthesizing Fe/GAC composite were suggested. Both total iron content and $Fe_0$ content can be significantly affected by preparation processes, therefore, it was important to avoid oxidation during preparation to achieve higher reduction capacity. Synthesis conditions such as reduction time and existence of intermediate drying step were investigated to improve $Fe_0$ content of Fe/GAC composites. The optimal condition was two hours of $NaBH_4$ reduction without intermediate drying process. The prepared Fe/GAC composite showed synergistic effect of the adsorption capability of the GAC and the degradation capability of the nZVI, which make this composite a very effective material for environmental remediation.

Development Mechanism of Circulation Current and Oceanographic Characteristics in Yeongil Bay (영일만 순환류 발생구조와 해황 특성)

  • Yoon, Han-Sam;Lee, In-Cheol
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.8 no.3
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    • pp.140-147
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    • 2005
  • We investigated the interactions between coastal waters of the Yeongil Bay, Korea, and oceanic waters of the Eastern Sea, as wet 1 as the development mechanism of vertical circulation currents in the bay. The oceanic waters of the bay have an average water temperature of $12.2{\sim}18.4^{\circ}C$ and salinity of $33.32{\sim}34.43$ PSU. Results of spectral analysis have shown that the period of revolution between oceanic and coastal waters is about 0.84-0.91 years in the surface waters and 1.84 years in the bottom layer. The wind direction in the bay shifts between SW and NE, with the main wind direction being SW during the winter period, and water mass movement is influenced by such seasonal variations in wind direction. Vertical circulation currents in the bay are structured by two phenomena: the surface riverine outflow layer from the Hyeong-san River into the open sea and the bottom oceanic inflow layer with high-temperature and salinity into the bay. These phenomena start the spring when the water mass is stable and become stronger in the summer when the surface cold water develops over a 10-day period. Consequently, tidal currents have little influence in the bay; rather, these vertical and horizontal circulation currents play an important role in the transport of the pollutant load from the inner bay to the open sea.

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Various Factors giving Impacts On the Satisfaction level of spectacle Wearers (안경원 이용자의 만족에 영향을 미치는 요인)

  • Ju, Kyung-Bok
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.1
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    • pp.181-186
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    • 2000
  • This study has been implemented to identify the level of satisfaction of the Glass spectacle wearers on various services being given by optical shop workers and help them to provide services of higher quality to the spectacle wearers. The objectives of this study are the spectacle wearers who visited to the 5 Designated optical shops located in Seoul area. All the data has been collected for the 2 months period (Oct. 1 through Dec. 1. 1999.) By using structured, self-described research form. All the collected data were 250 copies in total but evaluated 222 copies only as we excluded 28 copies which has uncertain reply/contents. Major results are as follows: 1. The proportions of objectives by sex was male 54.1%, female 45.9% and by Academic career was University graduates 35.1%, High school graduates 32.4%. 2. The factors impects on the satisfaction level of spectacle wearers were the Employee's service and the status of frame. 3. the factors impacts on the intention for revisit the optical shops were facility status, the responsiveness on wearer s opinion and the employee s services. The factors impect the wearers to build up intention to recommend the visited optical Shops to the 3rd costomer were employee s services, the status of frames, the facility Status and the price level they paid. Considering the results of this study above mentioned, in order to raise up the satisfaction level of glass spectacle wearers, it s thought that the employee (optician) of optical shops have to well acquainted fluent knowledge on the glass spectacles and detailed to the spectacle wearers in a gentle manner and let them build up the reliabily.

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The Influence of Parenting Attitudes and Parenting Efficacy on Educational Needs of Married Immigrant Women with Adolescent Children (사춘기 자녀를 둔 결혼이주여성의 부모교육 요구도에 양육태도와 양육효능감이 미치는 영향력)

  • Lim, Hyun-Suk
    • The Journal of the Korea Contents Association
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    • v.17 no.12
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    • pp.202-214
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    • 2017
  • This study figured out the influence of parenting attitudes and parenting efficacy on parents educational needs. Accordingly, it is for the purpose of being tried to establish a basic data for educational programs and intervention strategy to promote parenting attitudes and parenting efficacy for marriage immigration women. This is a study on descriptive correlation among 130 marriage immigration women with adolescent children. As the results of this study, parenting attitudes and parenting efficacy showed to be affected on the parents educational needs and had positive correlation(r=.248, p<.01). Receptive parenting attitudes and autonomous ones in the parenting attitudes had also positive correlation(r=.192, p<.05). It showed that the higher the excessive expectant parenting attitudes are, the higher the educational needs of social instruction are, and the higher the receptive parenting attitudes are, the higher the educational needs to understand growth development are. Also it showed that the lower the parenting efficacy is, the higher the social instruction and the educational need on growth for parents themselves are. The parents educational needs were high in the educational needs on learning, career instruction and education of effective communication. Based on the results above, this study hoped to develop structured education program develop for marriage immigration women and have more education opportunities for enhancing receptive parenting attitudes, autonomous ones and parenting efficacy.

The Multilevel Analysis for Factors effecting on the Health-related Quality of Life in Dental Technicians (치과기공사의 건강관련 삶의 질에 영향을 미치는 요인에 대한 다수준분석 연구)

  • Lee, Tae-Yong;Kim, Won-Soo;Lee, Hye-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3625-3634
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    • 2014
  • This study was conducted to provide the basic data for the prevention and management of health risk of dental technicians by proposing the necessary data in the management of the health related quality of life of dental technicians. The subjects of the survey were 141 dental technicians working in 30 dental technical laboratories and corresponding companies in Daejeon area. A structured self-entry type questionnaire survey was implemented by measuring the work environment from December 20, 2011 to January 31, 2012 at the same time. The total score of health index showed a significant difference according to the working hours and smoking state as the a factor of the individual level, the physical health index showed a significant difference according to the smoking state and the exercise habits as the factor of the individual level. The mental health index showed a significant difference according to the working hours and smoking state as the factor of the individual level. The significant variable did not appear in the predictor of the group level. In conclusion, the quality of life of dental technicians in relation to health appeared to have a larger effect on the factor of the individual level than the factor of the group level.

Analysis of the Influence of Hopelessness, Psychosocial Stress and Depression on Suicide Ideation Among Middle School Students Using the Structural Equation Model (구조방정식모형을 이용한 중학생의 절망감, 사회심리적스트레스 및 우울이 자살생각에 미치는 영향 분석)

  • Bae, Sang-Yun;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3685-3695
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    • 2014
  • This study was performed to determine the suicide ideation and its association with hopelessness, psychosocial stress and depression among some middle school students. The survey was administered to 975 middle school students in Gyeongin area during the period, May $1^{st}$ to June $30^{th}$, 2013. Structured self-administered questionnaires were delivered and collected without the respondents' personal information. As a result, concerning the correlation of depression with various factors, the level of suicide ideation was positively correlated with hopelessness, psychosocial stress and depression. Multiple linear regression analysis showed that the factors influencing the suicide ideation included sex distinction, experience of alcohol drinking, hobbies and leisure life, subjective health status, grade, school violence experience, hopelessness, psychosocial stress and depression. An analysis of the covariance structure, hopelessness (BHOP) was more influential on the suicide ideation than psychosocial stress (PWI) and depression (CES-D). The study found that higher hopelessness, severe distress and higher depression tends to increase the suicide ideation.