Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer

AIM: The aim of this qualitative study was to describe from the perspective of 10 women (aged 39-69 years), their experience of living with breast cancer. BACKGROUND: Although there is increasing research into a variety of aspects associated with breast cancer, there is a continuing need for research to increase nurses' understanding of how women experience living with newly diagnosed breast cancer. DESIGN/METHODS: Following ethical approval, open-ended interviews were analysed, using methods influenced by Grounded Theory. Verifiability and empirical grounding of the theory was established through use of the constant comparative method. FINDINGS: Existential issues arose as an important aspect of living with newly diagnosed breast cancer. The will to live emerged as the central theme. All energy was channelled into a tenacious fight for life. Furthermore, results revealed other aspects in the women's awareness of living with breast cancer, such as their experiences in relation to emotional reactions, bodily physical changes, their female identity, meaningful activities and their social network. CONCLUSIONS: An understanding of how women experience their new and changed life situation is important to the support nurses give in the process of healing. Nurses need this knowledge to be better able to assist women and their families in their development of coping strategies.     

Coping with breast cancer in newly diagnosed Iranian women

AIM: This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. BACKGROUND: Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed breast cancer increasing each year, there is no information on how Iranian women cope with breast cancer when compared with women of other cultures. METHOD: In this qualitative study, 19 women with newly diagnosed breast cancer were interviewed during the period May-September 2004 about coping with their disease. Interviews were analysed using a content analysis method. FINDINGS: The main themes emerging from this qualitative study included coping using a religious approach (acceptance of disease as God's will; spiritual fighting), thinking about the disease (positive thinking: positive suggestion, hope, intentional forgetfulness; negative thinking: hopelessness, fear, impaired body image), accepting the fact of the disease (active acceptance; passive acceptance), social and cultural factors and finally finding support from significant others. CONCLUSION: Understanding how Iranian women cope with diagnosis of breast cancer is important to nurses involved in the process of healing. The majority of strategies used by Iranian women were positive, and religious faith played a major role in this. The findings of the study can be used to design a nursing approach to improve successful coping in Iranian women suffering from breast cancer, and can provide nurses and other healthcare professionals with deeper understanding of these women as they face this diagnosis.     

The information needs of women newly diagnosed with breast cancer

Nurses can play a key role in patient education, including providing patients with useful and approrate information Rather than focusing on the process of education or information giving by nurses, this study places emphasis on the content of that information by taking the patients'perspective and asking the patients themselves what particular types of information are perceived as important at a specific point in time The aim of the study was to explore what particular types of information were important to women newly diagnosed with breast cancer, to enable nurses and other health care professionals to utilize their time as effectively as possible and provide a high-quality service to individuals in their care Women with breast cancer (a mean of 2 5 weeks from diagnosis) were interviewed and asked to compare items of information The items of information were presented m pairs and the women stated a preference for one item in that pan- Thirty-six pairs were presented in total The analysis involved the use of a Thurstone scaling model, which allowed rank ordermgs, or profiles of information needs, to be developed, reflecting the perceived importance of each item Information about the likelihood of cure, the spread of the disease and treatment options were perceived as the most important items of information at the tune of diagnosis Other information needs, in order of descending priority, included information about the risk to family, side-effects     

住院乳腺癌患者心理痛苦及其相关因素调查

目的调查住院乳腺癌患者心理痛苦发生状况并探索其相关因素。方法采用描述性研究,通过目的抽样法抽取住院乳腺癌患者320例,采用一般资料问卷和心理痛苦管理筛查工具进行问卷调查。结果 48.13%的住院乳腺癌患者心理痛苦评分≥4分;心理痛苦相关因素有6项,即与丈夫沟通差、疲乏、保险/经济、便秘是危险因素,年龄和病程是保护性因素。结论医护人员应当关注乳腺癌患者引起心理痛苦的相关因素,并制订具有针对性的干预措施。     

An environmental intervention to restore attention in women with newly diagnosed breast cancer

Earlier research indicated that attentional fatigue with reduced capacity to direct attention in women treated for breast cancer may be ameliorated by a theoretically based intervention involving regular exposure to the natural environment. This study tested the efficacy of a natural environment intervention aimed at restoring attention in 157 women with newly diagnosed breast cancer. Capacity to direct attention was assessed with a brief battery of objective measures at two time points: approximately 17 days before surgery (time 1) and 19 days after surgery (time 2). A randomly assigned intervention protocol was initiated after the first assessment and before any treatment. The intervention comprised a home-based program involving 120 minutes of exposure to the natural environment per week. The intervention group (n = 83) showed greater recovery of capacity to direct attention from the pretreatment (time 1) to the preadjuvant therapy period (time 2), as compared with the nonintervention group (n = 74). A significant effect of the natural environment intervention was observed even after control was used for the effects of age, education, attention scores at time 1, other health problems, symptom distress, and extent of surgery. The findings suggest therapeutic benefits for capacity to direct attention from early intervention aimed at restoring attention in women with newly diagnosed breast cancer.     

Implementation of a prechemotherapy educational intervention for women newly diagnosed with breast cancer

Women newly diagnosed with breast cancer often are misled by false information regarding treatments and side effects. Web sites can be filled with graphic stories and false information about chemotherapy. Research has examined how patients handle the side effects of chemotherapy physically and emotionally during treatment. No standardized prechemotherapy intervention has been developed to assist patients with breast cancer preparing for chemotherapy. A 30-minute educational intervention provided by nurses before the start of chemotherapy may assist women in increasing their knowledge of chemotherapy treatment, enhancing their ability to manage side effects and improving their coping strategies.     

老年癌症患者心理困扰的现况调查

目的 调查老年癌症患者心理困扰的检出率及其所表现的具体问题,并分析不同人口学特征患者心理困扰的差异.方法 本研究为横断面描述性研究.便利抽样选取某大学两所附属三级甲等医院普外科和肿瘤科的153例老年癌症患者,应用美国综合癌症网络推荐并经汉化的心理困扰筛查工具中的困扰温度计及问题列表,进行心理困扰现况调查(得分≥4分为“有临床意义的心理困扰”);用自编一般情况调查表收集患者的人口学特征.结果 有43.8％(67/153)的老年癌症患者心理困扰得分达到有临床意义的界定水平;问题列表具体表现的4个维度方面得分差异有统计学意义(P＜0.001),情绪问题维度的平均得分最高,其次为实际问题、生理问题、家庭问题;用于统计分析的34个条目中,回答“是”表示存在相应问题的前5位条目分别是:担心(73.9％)、低落(55.6％)、疼痛(54.2％)、经济问题(52.3％)、害怕(49.7％);不同人口学特征(包括婚姻状况、文化程度、家庭月平均收入)的老年癌症患者心理困扰得分之间差异有统计学意义(P＜0.05).结论 本研究提示老年癌症患者心理困扰问题较为普遍,应引起医务工作者的重视.     

Living with newly diagnosed breast cancer--the meaning of existential issues. A qualitative study of 10 women with newly diagnosed breast cancer, based on grounded theory.

This study aimed to describe how 10 Norwegian women diagnosed with breast cancer experienced living with the disease. A qualitative method was used, including open-ended in-depth interviews based on principles in Grounded Theory. Data revealed that existential awareness was a central phenomenon in the women's experience. This central finding created the basis for the core category in data: the will to live. This core category includes existential aspects such as different levels of life expectations, the fight against death, life related to the future, religious beliefs and doubts, and increased awareness of values in life. Knowledge and an understanding of how women experience being diagnosed with cancer are prerequisites for supporting the women in a process of normalization. This study has shown that the existential aspects connected with the core category, the will to live, are a central issue in recovery and survival. The study suggests that health professionals, by increasing their awareness of existential aspects connected with the will to live, can assist women and their families in developing coping strategies.     

Hope as experienced in women newly diagnosed with gynaecological cancer

AimThis article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer.MethodFifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24–87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer.ResultsHope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others.ConclusionThe findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.     

Psychological distress among abused minority women with sexually transmitted diseases

PURPOSE: To describe psychological distress among abused minority women with sexually transmitted diseases (STDs) and to identify needs for psychotherapeutic intervention for reduction in abuse, sexual risk behavior and STD. DATA SOURCES: A controlled randomized trial of the effects of a behavioral intervention on STD recurrence. Eligibility was limited to English speaking Mexican-American and African-American women with a current non-viral STD confirmed by laboratory testing (gonorrhea, chlamydia, syphilis or trichomonas). All eligible women who could be contacted were recruited from public-health clinics in San Antonio. T-tests, Chi square and correlation were used to analyze the data. CONCLUSIONS: Women with STD and a history of abuse reported more symptoms of current psychological distress than nonabused women. This psychological distress was present in all dimensions of the SCL-90-R, including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Increased current psychological distress and correlation was found not only for women with reports of sexual abuse but also forms of physical or psychological abuse. The majority of abuse was reportedly experienced during a relationship with a boyfriend or friend/acquaintance. IMPLICATIONS FOR PRACTICE: Abused women with STD may benefit from the identification and assessment of abuse history and psychological distress so that appropriate psychological treatment can accompany medical treatment. The prevalence of woman abuse within a population of women with STD mandates the inclusion of violence in STD prevention programs.     

Prevalence of emotional distress in newly diagnosed lung cancer patients

Goals of work

Distress is defined by the National Comprehensive Cancer Network as a multifactorial unpleasant emotional experience of a psychological, social, and/or spiritual nature that may interfere with the ability to cope effectively with cancer. We investigated the prevalence and associated symptoms of distress in newly diagnosed lung cancer patients.

Patients and methods

Between November 2005 and July 2007, 98 newly diagnosed lung cancer patients completed an assessment. The Distress Thermometer (DT) and Edmonton Symptom Assessment Scale (ESAS) were used as screening tools.

Main results

Fifty (51%) patients reported clinically significant distress (≥4) on the DT. Of those, 26 (52%) patients reported high levels of depression, nervousness, or both on ESAS. The remaining 24 (48%) patients had elevated levels of distress but no significant depression or nervousness. A correlation between the DT and the total ESAS score was observed (Pearson correlation?=?0.46). The ten items of the ESAS together explained 46% of the variability in DT scores. The depression and nervousness ESAS items were significant predictors of DT score (p?<?0.01 for both items). However, once the two psychosocial items, depression and nervousness, were removed from the total ESAS score, leaving only physical symptoms and the sleeplessness item, the predictive power of the model decreased to R²?=?0.12.

Conclusions

The prevalence of distress in lung cancer patients is high. The DT appears to discriminate between physical and emotional distress. This easily measured score may determine which patients require further intervention for emotional distress.     

Cardiopulmonary responses and adherence to exercise in women newly diagnosed with breast cancer undergoing adjuvant therapy

Cardiopulmonary responses to an 8-week moderate-intensity aerobic exercise intervention and adherence to exercise during and after intervention were assessed in 41 women newly diagnosed with breast cancer undergoing adjuvant therapy. The intervention was primarily aimed at minimizing deconditioning. Women were randomly assigned to the intervention or control group, completed graded exercise tests before and after intervention, and encouraged to continue their exercise postintervention. Over time, only the intervention group showed significant decreases in resting heart rate, resting systolic blood pressure (SBP), P <.05 each, and maximum SBP, P <.02, and an increase in VO2 peak, P <.001, although resting SBP was higher in the intervention group at both timepoints, P <.05. The adherence rate to 8-week exercise intervention was 78.3% with average weekly attendance of 2.4 sessions and 42.7 minutes (27.8 minutes within target heart rate) exercise per session. Overall physical activity levels over 16 weeks postintervention did not differ between 2 groups. However, the within-group analysis indicated that only the intervention group showed a significant increase in voluntary activity, P < .02, and energy expenditure, P < .02, and a decrease in sedentary activity, P < .02. These findings indicate that moderate-intensity aerobic exercise is beneficial in reducing deconditioning of cardiopulmonary responses in newly diagnosed breast cancer women undergoing adjuvant therapy.     

Breast cancer and experiences of social support. In-depth interviews of 10 women with newly diagnosed breast cancer

The present study aimed to describe how 10 Norwegian women with newly diagnosed breast cancer experienced living with the disease. A qualitative method based on principles in Grounded Theory was used. Data were collected through in-depth interviews. This paper explores the experience of social support as it evolves in women's relationships with others. Social support contains emotional, practical and informative dimensions. Here relationships are called interactions. Interaction can be divided into two groups. Interactions with close relatives and others the women know and have contact with. Interactions with organizations and institution staff. These interactions consist of social support and lack of social support. Health professionals can assist women and their families in this life-threatening situation, by increasing their awareness of social support issues.     

Role of continuing supportive cares in increasing social support and reducing perceived uncertainty among women with newly diagnosed breast cancer in Taiwan

The purpose of this study was to explore the roles of continuing supportive care in increasing the social support and reducing the perceived uncertainty among women newly diagnosed with breast cancer in Taiwan. A longitudinal, quasi-experimental design was used in this study. Sixty-one women younger than 60 years, newly diagnosed with breast cancer and undergoing surgery, were recruited from 2 urban teaching hospitals in northern Taiwan. The experimental group was provided with additional continuing supportive care for 3 months. Two instruments, including the Social Support Questionnaire and an uncertainty questionnaire, were administered to participants at 3 time points: presurgery within 2 weeks after diagnosis, 1 month after surgery, and 3 months after diagnosis. The experimental group reported significantly higher social support and lower disease uncertainty compared with the control group at 1 month after surgery and 3 months after diagnosis. With knowledge of the role that continuing-care intervention plays in social support and disease uncertainty, nurses and other healthcare professionals can continue to explore and strengthen strategies to enhance the coping ability of women with breast cancer in Taiwan.