Evaluating the self-assessed support needs of women with breast cancer

Evaluating the self‐assessed support needs of women with breast cancer Aims of the study. The first aim of the study was to identify the self‐assessed support needs of women with breast cancer at various points of illness and, secondly, to establish if these needs formed clusters which could provide the basis for developing a standardized scale of needs for use by breast care teams in the evaluation of care. Background. It has been found that support given to women with breast cancer has a positive effect upon their reactions to the illness and may even prolong their survival. Given that breast cancer affects a large number of women it is obviously important that those affected receive, in addition to the best available medical treatment, the type of support that best meets their needs. This study aimed to provide information on the impact of breast cancer and the need for various types of support by examining women’s own assessment of their needs at different stages of their illness. Design and methods. A purposive sample of 12 women with a diagnosis of breast cancer was selected in one health authority in England, United Kingdom (UK). Women selected represented a wide age range (between 26 and 58), were married or in long‐term cohabiting relationships and were at different points on the illness trajectory. Women were invited to take part in a semi‐structured interview about their experiences of breast cancer. The data from these interviews were analysed using the software package Qualitative Solutions and Research, Nonnumerical Data Indexing, Searching and Theorizing (QSR*NUDIST). Following this content analysis, a questionnaire was formulated which divided statements into seven categories: diagnosis, treatment, support, femininity and body image, family and friends, information and after care, to be rated on a Likert scale ranging from ‘of no importance’ to ‘extremely important’. Questionnaire data were analysed by means of a one‐way analysis of variance (for three independent variables) or t‐test for two independent variables. Results. The questionnaire was sent to 971 women and achieved a response rate of 50·4%. The mean score for statements of need reached the level of point 4 on the Likert scale (important) with three exceptions: having professional help with family problems and domestic upheaval, coping with feelings of anger and dealing with the question ‘why me?’ Conclusion. With the above three exceptions, women experienced a high level of need associated with a diagnosis of breast cancer. Studies of this kind should enable resources to be targeted to areas of highest need.     

Illness perceptions and mood states are associated with injury-related outcomes in athletes

Background.?Athletes have to cope adequately with the consequences of their injury in order to return into sports as soon as possible. Besides the physical characteristics of the injury, illness perceptions and emotional responses impact the behavioural responses to the injury.

Purpose.?To apply Leventhal's Common Sense Model as a theoretical framework in the field of sports medicine, pertaining to injured athletes.

Methods.?In a sample of 95 injured athletes participating in different sports, sociodemographic, injury and sport-related characteristics, the Illness Perception Questionnaire-Revised-Sports (IPQ-R-S) and the Profile Of Mood States were assessed.

Results.?Injured athletes' most experienced symptoms were pain (82%) and loss of strength (50%), associated with a high controllability; they see their injury as not chronic, with minor consequences for daily life and minor emotional consequences. Athletes with an injury of longer duration have minor psychological attributions, 28% suffer from fatigue, which is strongly related to a negative mood state.

Conclusions.?Illness perceptions and mood states are related to injury characteristics. Clinicians ought to incorporate patients' views about their injuries into their treatment in order to increase the concordance between patient's and clinician's perceptions, thereby increasing chances of a quick and uneventful recovery.     

Evaluating the Illness Perception Questionnaire on patients with chronic kidney disease in Sweden

Scand J Caring Sci; 2012; 26; 474–484 Evaluating the illness perception questionnaire on patients with chronic kidney disease in Sweden Background: The Revised Illness Perception Questionnaire (IPQ‐R) measures illness perception according to the Common Sense Model of Self‐Regulation. Illness perception relates to coping, health management, treatment outcomes and health‐related quality of life. IPQ‐R has been used in many contexts. However, there is yet no Swedish version evaluated for validity, reliability and usability in the context of a Swedish, adult population with Chronic Kidney Disease (CKD). Objectives: To evaluate usability and psychometric properties of a Swedish translation of IPQ‐R on a group of adults in different stages of CKD. Methods:  Usability evaluation was carried out through cognitive interviews and psychometrics was assessed by internal consistency, test‐retest, inter‐correlations, correlations to health‐related quality of life and coping and testing for concurrent validity. Results: Content validity was strongly supported, but an uncertainty assessing symptoms attributed to CKD was indicated. All dimensions showed internal consistency, except the treatment control dimension. The IPQ‐R showed good stability over time except the personal control dimension. Most IPQ‐R dimensions distinguished illness representations between groups of different disease stages and symptom burden. The most supported IPQ‐R dimensions for inter‐correlations and convergent validity were identity, timeline cyclical, consequences and emotional representations. Conclusions: The evaluation of the Swedish version of IPQ‐R on patients with CKD showed support for construct validity, except for the dimensions controllability, illness coherence and timeline, which were less supported. These dimensions should therefore be interpreted with care in CKD patients. There is a need to capture uncertainty regarding illness identity. IPQ‐R should be interpreted with care in earlier stages of CKD or if few symptoms are reported. IPQ‐R may be applicable and useful as a tool in nursing practice to support healthy behaviour as well as assessing clinical interventions in patients with CKD.     

Coping with a possible breast cancer diagnosis: demographic factors and social support

AIM: This paper reports a study examining the relationships between demographic characteristics, social support, anxiety, coping and defence among women with possible breast cancer. BACKGROUND: Awaiting a possible breast cancer diagnosis is an anxiety-provoking situation that demands coping. Social support and demographic characteristics have been reported to influence coping and well-being, but the interconnection is insufficiently understood. DESIGN: A survey design was used, and self-administrated questionnaires were returned by a convenience sample of 117 women in Norway who had undergone breast biopsy. The data were collected from September 1998 to February 2000. INSTRUMENTS: The instruments consisted of: the Social Provisions Scale, State-Trait Anxiety Scale, Utrecht Coping List and Defence Mechanisms Inventory. In addition, data on age, level of education, employment, marital status, and household status were collected. RESULTS: Social support was positively related to instrumental-oriented coping and emotion-focused coping, unrelated to cognitive defence and defensive hostility. Educational level was positively related to instrumental-oriented coping. Educational level, employment and marital status were negatively related to cognitive defence. Educational level was the most important contributor to social support. Attachment and education were the most important contributors to instrumental-oriented coping, with education as the strongest predictor. CONCLUSION: Better coping was linked primarily to education, and secondly to attachment. Unemployment, low level of education and single/divorced/widowed status were related to greater use of cognitive defence. Women who used a defensive hostile style tended to receive poor social support. Nurses need to be aware of the influence of demographic characteristics on social support, coping and defence and to identify poor copers, as these patients are most in need of professional support.     

Coping with radiation therapy: Effects of a nursing intervention on coping ability for women with breast cancer

A randomized study was carried out to investigate whether a nursing intervention, using Orem's self-care theory as a framework, would affect the coping ability of women with breast cancer during and following radiation therapy. The intervention consisted of promoting of behaviours to support the patient to restore, maintain or increase their abilities to interact with the situation and adapt to the demands of radiation treatment. The control and experimental groups both consisted of 67 patients. The Wheel Questionnaire was used to evaluate the effect of the intervention. Our results showed that the intervention provided patients older than 59 years the ability to cope with the treatment (df = 2, F = 3.463, P = > 0.05). The present study supports the idea that individual interventions aimed at improving well-being helps patients. It also highlights the fact that individual approaches to improving well-being are needed. Such interventions should be directed to patients at risk for poor adjustment, such as those older than 50 years of age.     

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.     

男性乳腺癌的围手术期观察与护理

目的总结男性乳腺癌患者围手术期护理体会。方法回顾性分析1990年1月～2011年7月本院收治的9例男性乳腺癌患者的临床资料,并总结围手术期护理要点。结果本组9例乳癌根治术均获成功。发生术后出血和皮瓣坏死各1例。结论做好心理护理、负压引流管的护理、皮瓣护理和患侧上肢护理及功能锻炼等护理对保证男性乳腺癌的围手术期质量具有重要意义。     

乳腺癌术后康复路径的临床应用效果

[目的]探讨康复路径的临床应用效果。[方法]选择乳腺癌根治术病人60例随机分成观察组和对照组。对照组病人按常规进行诊疗、护理和健康教育指导,观察组除常规进行诊疗、护理和健康教育指导外,将制订好的康复路径表发给病人,根据康复路径表的内容指导病人进行康复。测评两组护理法在住院天数、功能锻炼达标率、康复知识知晓率与护理服务满意度方面的差异。[结果]观察组病人较对照组住院天数明显缩短,肢体功能锻炼达标率、康复知识知晓率与护理服务满意度明显提高。[结论]乳腺癌术后应用康复路径指导病人锻炼有利于病人肢体功能恢复。     

乳腺癌术后化疗的护理体会

目的总结80例乳腺癌改良根治术后Ⅲ-Ⅳ期患者的化疗护理。方法包括化疗前指导,化疗时注意事项,化疗后不良反应的观察与护理,以及出院患者康复指导。结果80例患者全部完成了化疗方案。结论全面细致的护理,有效地减轻了患者的心理负担及化疗中的痛苦,增强了患者治愈疾病的信心,进而顺利地完成全程化疗。