My Wife Has Breast Cancer: The Lived Experience of Arab Men

ObjectivesBreast cancer is a leading cause of mortality and morbidity among women in Middle Eastern countries. In Bahrain, breast cancer is the second-leading cause of death and first among women. Prior research has shown that Middle Eastern women will often delay seeking treatment for breast cancer and subsequently hide the diagnosis from friends and family. As a result, women rely heavily on their spouses for support and care. There is limited research on spouses’ experience of breast cancer, especially in the Middle East. This study explored the lived experience of Arab men following their wives’ diagnosis and treatment for breast cancer in Bahrain.Data SourcesData from semi-structured interviews with Arab men (n = 6) were analyzed using the interpretative phenomenological approach (IPA). Participants’ wives had completed their treatment 3 to 6 months prior to the interviews.ConclusionThree main themes emerged: Perceptions of breast cancer diagnosis and treatment, coping strategies, and impact on quality of life. Findings revealed that Arab men in Bahrain relied on family and friends for support and drew on religious beliefs to give them hope so they could better support their wives. Findings also highlighted the unique culturally related coping strategies used by Arab men. This study highlights the specific needs of Arab men following their wives’ diagnosis and treatment for breast cancer. Faith and beliefs were overwhelmingly a foundation for coping and support. Therefore, this must be considered within the health care service to improve support strategies for Arab patients and their spouses in treatment and care plans encompassing a holistic interprofessional, multidisciplinary, and communicative approaches including the need for culturally sensitive care pathways that are cognizant of the care needs through help-seeking and information-sharing throughout the illness. Nurses should provide the education and encourage open communication among the couple and their family.Implications for Nursing PracticeFindings can be used by nurses and other health care professionals to provide better support and holistic care to Arab women with breast cancer and their spouses.     

Communicating good care: A qualitative study of what people with urological cancer value in interactions with health care providers

PurposeCommunication with health care providers is important to help meet cancer patients' information and support needs. It can significantly affect the extent to which patients feel cared for, respected and involved, and it can influence a range of cancer care processes and outcomes. This paper presents findings from a study which explored urological cancer patients' experiences of care, focussing on insights into what they appeared to value in their interactions with health care providers and why.MethodIn-depth interviews were undertaken with 20 men and 6 women with different types of urological cancer at a range of times since diagnosis. Interviews were audio-recorded, transcribed and thematically analysed using an established interpretive approach.ResultsPatients valued being treated as someone who mattered and was worthy of care; being recognised and responded to as an individual; and experiencing support for autonomy/agency. Reasons for their valuations related to the implications of communicative interactions for the ways patients thought health professionals related to them ‘as persons’. Our findings highlight the value of relational aspects of communication for: indicating to patients what clinicians think of their worth; facilitating individualised care; and enabling patients to contribute to their own care.ConclusionsEfforts to improve health care provider-patient communication should attend not only to the transfer of information about the condition and its management but to the range of features of interactions that can signal to people how health care providers relate to them as persons.     

Life experiences of women with breast cancer in south western Turkey: A qualitative study

PurposeThis qualitative study explores the experience of women living with breast cancer.MethodsThe study was conducted among eight women with ongoing breast cancer chemotherapy treatment, which occurred in an ambulatory unit. The data were collected using semi-structured and in-depth individual interviews. All interviews were tape-recorded, and the results were obtained by analysing the content of the recorded data.ResultsThree major themes related to the experiences of women living with breast cancer were identified. They are as follows: (1) needs (the need for spouse and family support, the need to worship, and the need to receive and share information), (2) living with losses (loss of the breast and of one’s hair), and (3) changes (changes in one’s normal life, change in self-perception, changes in the perception of the value of health, and a greater appreciation for life).ConclusionsThis study was conducted to increase awareness concerning women’s perceptions of their care and various needs during breast cancer treatment. The results of this study challenge health care providers and educators to be more aware of the difficulties that women face when living with breast cancer.     

Living into old age with the consequences of breast cancer

Purpose of the researchBreast cancer survival rates are improving with over 60% likely to live 20 years. As 30% diagnoses occur in women over 70 the prevalence of breast cancer survivors living into older age is increasing. The specific needs and experiences of this group have rarely been addressed. This study aimed to explore older women's experience of living with breast cancer alongside other health conditions, and to identify their information and support needs and preferences.Methods and sampleData were collected from 28 semi-structured qualitative interviews and 2 focus groups (n = 14), with breast cancer survivors aged 70–90, and were analysed using thematic analysis.Key resultsThese older breast cancer survivors experienced a range of long-term physical problems resulting from treatment, including poor cosmetic results and poor shoulder movements, and bras and prostheses were often unsuitable. Many were keen to preserve their body image ideal irrespective of age. Reconstruction was rarely discussed, but all would have liked this option. Older women wanted to be treated as individuals rather than uniformly as older people, with their personal physical and social needs (including co-morbidities) taken into account. They expressed a preference for information direct from health professionals.ConclusionsMany breast cancer survivors will live into advanced old age with permanent physical and emotional consequences of their treatment. Holistic and personalized assessment of needs becomes increasingly important with age, particularly with comorbidity. Effective rehabilitative care is important to reduce the impact of breast cancer into old age.     

Symptom Clusters Predictive of Quality of Life Among Jordanian Women with Breast Cancer

ObjectivesThis study was conducted to explore symptom clusters among women with breast cancer in Jordan.Data SourcesA cross-sectional survey of 516 women with breast cancer who were recruited from three hospitals.ConclusionThis study demonstrated that women with breast cancer experienced several symptoms at the same time. These symptoms tend to cluster in five main groups, and patients experiencing the psychological, nausea and vomiting, and pain clusters are expected to have a lower mean score of quality of life.Implications for Nursing PracticeNurses need to assess and manage symptoms as clusters to improve the quality of life of women with breast cancer. Symptoms clusters should guide symptoms management practice and be given a priority equal to the active treatment of cancer. Symptoms management and cancer treatment should be started simultaneously.     

Using a mixed methods research design to investigate complementary alternative medicine (CAM) use among women with breast cancer in Ireland

AimTo investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design.MethodsSemi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the ‘Use of Complementary and Alternative Therapies Survey’ questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31).ResultsOver half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results.ConclusionsSimilar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research.     

Common,important, and unmet needs of cancer outpatients

PurposeTo maximize patient well-being, health and social care should, whenever possible, address individual patient needs. The present study aims firstly, to identify prevalent, salient and unmet needs amongst cancer outpatients, and secondly, to explore socio-demographic and clinical influences on expressed need.MethodsOne-hundred and ten outpatients registered at a UK cancer treatment centre completed a self-report questionnaire measuring the presence, salience and degree to which 80 need items were met. Six broad cancer sites were represented: urology, colorectal, breast, gynaecology, haematology, and head and neck.ResultsThe mean number of needs reported was 27. The top five needs concerned the treatment, care and health information patients receive from healthcare professionals, all of which were rated as well met. Least met needs included receiving genetic information, information about lifestyle changes, help with worries about spread or recurrence, and parking near treatment centres. Salient needs showed greater variation across the sample and were often unmet, for example the need for genetic information, and the need for information about symptoms/indicators of recurrence. Gender (female), age (younger), having an informal caregiver, and cancer site all affected aspects of need; whereas time since diagnosis and type of treatment did not.ConclusionsAcknowledging these influences on patient need could help guide patient-centred support services with potential gains to patient satisfaction and well-being.     

Development of a Remote Monitoring Application to Improve Care and Support Patients in the First 30 Days Following Colorectal Cancer Surgery

ObjectiveTo design and develop a digital monitoring application to support and improve the care of patients in the first 30 post-operative days following colorectal cancer surgery.Data SourcesPatient interviews, health professional focus groups, patient co-creation activities, and health professional prioritization discussions.ConclusionThe structured and iterative co-design activities adopted in this study with key stakeholders, including patients and health professionals, lead to the development of a prototype application (app) to support patients at home during the first 30 days following surgery for colorectal cancer. A similar approach could be implemented to develop comparable apps for patients with other cancer diagnoses requiring different surgical procedures. Further research should focus on the continued development and testing of this app in relation to patient care and outcomes as well as the app's affect on nursing and other health services.Implications for Nursing PracticeClinical implementation of remote monitoring following discharge home after surgery for colorectal cancer gives patients the opportunity to report issues of concern to relevant health professionals. This could facilitate the early identification of concerning signs and symptoms, ensuring appropriate and timely interventions to minimize readmission rates. Patients’ experiences during the recovery period could also be improved through the provision of reliable and relevant online information. More specifically, health professionals could easily identify those patients requiring additional support to manage their recovery, for example, those with more severe symptoms or problems, facilitating the direction of appropriate health services to those most in need of their expertise.     

Workplace support after breast cancer treatment: recognition of vulnerability

Abstract

Background: Support from the workplace seems to be a key element in addressing the poor return-to-work (RTW) rate of employees with breast cancer. We aim to acquire an in-depth understanding of how Flemish employees experience their RTW after breast cancer and the support from the workplace. Method: Fourteen in-depth interviews of women who experienced breast cancer and returned to work (high school graduates, age range 42–55 years, mean age 48 at time of surgery) were analysed using the Qualitative Analysis Guide of Leuven (QUAGOL), based on a Grounded Theory approach. Results: The key experiences were feeling vulnerable, feeling able to work and need for support. Although little diversity in RTW experiences was found, the background of the vulnerability varied. Women experienced support (which could be emotional or practical) only as adequate if it addressed their specific vulnerability. Conclusions: Employees felt particularly vulnerable. Vulnerability is not the same as low-work ability and as such it should be added as theoretical concept in RTW research. Adequate workplace support addresses the specific vulnerability of an individual woman. Our study offers a nuanced insight into the RTW process of breast cancer survivors.

• Implications for Rehabilitation

• Upon actual return-to-work (RTW) after breast cancer treatment, women feel vulnerable but able to work and, hence, have a high need for workplace support.

• Support from the workplace during RTW after breast cancer treatment is experienced as adequate when it expresses genuine recognition of the individual woman’s vulnerability.

     

Experiences of women with a diagnosis of breast cancer: a clinical pathway approach.

The study presented in this paper formed the first part of a large survey of breast cancer patients in one health authority in England, UK looking at individual needs expressed by women with a diagnosis of breast cancer. The paper provides an account of the experiences of 12 women with a diagnosis of breast cancer. The women represent a wide age range and different stages of illness. The transcribed accounts of the women were analysed by means of Qualitative Solutions and Research, Non-Numerical Unstructured Data Indexing Searching and Theorising (QSR*NUDIST). The study examined the individual experiences of women with a diagnosis of breast cancer and its aftermath as they passed through different stages related to it. The women's experiences are presented within the conceptual framework of the clinical pathway and their accounts represent their journey along the pathway. Various significant points in this journey are portrayed representing the women's reactions to diagnosis, treatment, femininity and body image, support, family and friends, information and after care.     

Menopause as an issue for women with breast cancer

Menopause is beginning to be recognized as a survivorship issue for women with a diagnosis of breast cancer. This article presents an outline of the literature relating to natural menopause and its symptoms, moves on to discuss general management of menopausal symptoms, then reflects on the particular implications of breast cancer diagnosis and treatment. Finally, the role of nursing in restoring a holistic perspective to the subject of menopause generally, and to women with breast cancer specifically, is considered.