Changed Body Image as Perceived by Jordanian Women Undergoing Breast Cancer Treatment

Background: Breast cancer is the most common cancer affecting women worldwide. The purpose of this study wasto generate an understanding of women’s perceptions of changes to their body image due to breast cancer treatment.Method: A phenomenological qualitative approach was taken and semi-structured interviews conducted with 20women who underwent breast cancer treatment at a public hospital in Jordan. Results: Data were analyzed followingColaizzi’s methodology, yielding a core theme (“Broken things cannot be repaired”) and four subthemes: changesin physical wellbeing (“my body fall apart”), changes in emotional wellbeing (“broken heart”), changes in socialwellbeing (“broken future”), and coping strategies (“repairing what has been broken”). Religion and family supportwere major factors helping the women cope with their condition. Conclusion: Nurses and other healthcare providersneed to be aware of body image changes of women with breast cancer to initiate timely, and culturally sensitive nursingintervention and support. Therefore, nurses should support patients in finding their own sources of strength to facilitatetheir healing process.     

Coping Strategies and Experiences in Women with a Primary Breast Cancer Diagnosis

Background: Women with breast cancer experience problems in multiple aspects of their lives, but applying effective strategies can result in enhancing their quality of life and their psychosocial adaptation to the disease. However, there is little information about the strategies that women use to cope with complications associated with their experiences following a breast cancer diagnosis. Objectives: The aim of this study was to explore the experience of coping behavior and the main strategies that women use in dealing with a breast cancer diagnosis. Methods: This study was conducted according to a qualitative phenomenological design to investigate women’s experiences in living with breast cancer and the related complications and how they cope with these issues. Purposive sampling was used for recruiting participants with breast cancer, and data collection was conducted by semi-structured, in-depth interviews with 22 patients. The transcribed interviews were analyzed using Van Manen’s thematic approach. Results: The age range of the women was 32-68. Most were married and received adjuvant therapy (i.e., mastectomy surgery and chemo-radiation). Three dominant themes that emerged from the interviews were emotional turmoil, avoidance, and logical efforts. Conclusion: The findings highlight the importance of addressing psycho-oncology intervention programs to address the unmet pyscho-social and palliative care needs of patients suffering from breast cancer.     

Social Perceptions of Breast Cancer by Women Still Undergoing or Having Completed Therapy: a Qualitative Study

Background: Diagnosis and treatment of breast cancer is a crisis situation which effects women’s lives physically, socially and spiritually. Investigating women’s perceptions of this disease is crucially important for treatment decisions. We therefore determined social perceptions and interpretations of women diagnosed with breast cancer during therapy and in the post-treatment period. Materials and Methods: In the study, focus group and in-depth interviews were made with women still undergoing or having completed breast cancer treatment. Some 25 women were included in the research. Content analysis was used in the analysis of the qualitative data obtained after the focus group and in-depth interviews. Results: Some of the women demonstrated positive perceptions towards accepting the disease, whereas others had emotions such as rebellion and anger. The loss of a breast is important with different interpretations. Conclusions: Women’s acceptance or rebellion against the disease varies within their social interpretations after the treatment, as at the stage of diagnosis/treatment. All stages of breast cancer negatively affect the social life of the affected individual as much as her body. Nurses assume crucial roles in coping with these negative effects. Thus, it is necessary to know, and sociologically interpret, what is indicated by the information on what the negative effects concerning the disease are and how they are interpreted.     

Factors Affecting Women’s Participation in Breast Cancer Screening in Turkey

Background: Breast cancer is the most frequent cancer type in Turkey and the rest of the world. Regular mammography screening leads to a significant decrease in breast cancer mortality rates. The aim of this study is to analyze the factors that affect Turkish women’s participation in screening. Methods: This qualitative research design is grounded in a phenomenological approach. Fifteen women were selected using a purposive sampling method and participated in in-depth interviews. Interview data was analyzed using thematic content analysis. Results: The breast has a special meaning for participants which is heavily associated with feminity. Breast cancer causes fear because of its potential to undermine women’s sense of feminity. Women’s knowledge about the screening services and the mammography procedure is insufficient with only one third of women obtaining information about screening from healthcare workers. Individual and social factors that affect women’s participation in screening are women’s roles in the family, knowledge and awareness of breast cancer and screening, fear of cancer, anxiety about getting a mammogram, need for spouse-family support, and concerns for privacy. Organizational factors that affect participation are accessibility of breast cancer screening services, guidance given by and communication with healthcare professionals. Conclusion: Women should be better informed about breast cancer and screening services by healthcare professionals. Accessibility of mammography screening should be increased by expanding mobile services. National and institutional policies should be implemented to overcome women’s anxiety and socio-cultural barriers to increase participation in screening.     

Explaining Perceived Priorities in Women with Breast Cancer: A Qualitative Study

Objective: Cancer is a stressful event in life, and the dreadful impact and problems created for patients and families by cancer negatively affect their quality of life. Therefore, regarding the increasing number of cancer patients and the nature of this disease, the need to recognize and understand the priorities and problems of patients after the diagnosis of cancer is of high importance. This study was designed and implemented with the aim of identifying the perceived priorities of women with breast cancer. Methods: This study is a qualitative research of content analysis type. To collect data, purposeful sampling and deep semi-structured individual interviews were used. The subjects were women with breast cancer who visited the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz, and the data were saturated after 15 interviews. The four criteria presented by Lincken and Guba were used to evaluate the validity and reliability. To analyze the qualitative data, conventional qualitative data analysis and MAXQDA10 software were used. Two themes were obtained in the assessment of interviews and analysis of data: 1) Supportive relief; 2) Therapeutic support. Results: Some of the participants highlighted the role of social and family support in coping with the disease, and considered social communication and continued support in the form of empathic relationship as a turning point in their lives. The absence of a fertility specialist in the cancer treatment system was the main complaint of most participants. The results showed that receiving support from family and the healthcare system is the most important perceived priorities in breast cancer patients. Conclusion: The results of this study show the importance of social support as a perceived priority in breast cancer patients to improve their quality of life. Development and reinforcement of the supportive network seem to be essential to provide the best possible help to these patients.     

Predictors of psychological distress,sexual dysfunction and physical functioning among women with upper extremity lymphedema related to breast cancer

Sixty-nine women presenting for rehabilitation treatment for upper extremity lymphedema (UEL) were assessed by physical examination and validated self-report assessment instruments measuring demographics, psychological distress, sexual functioning, social support, coping style, pain and functional status. Statistical analyses revealed that women with UEL had high levels of psychological distress, and high levels of sexual, functional and social dysfunction. There were no linear relationships between severity of UEL and levels of distress. Women with UEL in their dominant hand, however, had more distress and less overall sexual satisfaction than those with UEL in their non-dominant limb. Women with pain of any intensity were the most distressed, and had the most significant difficulties in psychological and physical functioning. Women with pain also perceived significantly less interpersonal support than those without pain. Virtually none were receiving pain treatment. An avoidant coping style and low perceived social support were significant correlates of psychological distress. UEL poses significant functional, social and sexual functioning problems in women following breast cancer treatment. An assessment of pain, as well as social support and coping, might help identify those in need of consultation by psychiatry and pain specialists. Patients may also benefit from psychological support and sexual therapy in addition to physical rehabilitation. A psycho-educational and support group within the clinic may prevent the worsening of UEL through the adoption of preventive strategies, maximizing compliance with rehabilitative efforts, augmenting better coping methods through group support, decreasing isolation that accompanies the condition, and facilitating the identification of patients in need of formal consultation.     

Self-efficacy, coping, and difficulties interacting with health care professionals among women living with breast cancer in rural communities

This study examined self-efficacy, coping, and social support in relation to difficulties interacting with physicians and nurses among women living with breast cancer. One hundred women living in rural, mountainous communities of northeastern California were recruited, with 89 providing complete data for this study. All women completed a battery of questionnaires that included the CARES--Medical Interaction Subscale and measures of self-efficacy, coping, satisfaction with social support, and demographic and medical characteristics. In a multiple regression analysis, difficulties interacting with medical professionals were found to be greater among women who were not married, who used more behavioral disengagement or less self-distraction to cope with breast cancer, and who reported less self-efficacy for affect regulation and for seeking and understanding medical information. Emotional venting and satisfaction with social support for dealing with cancer-related stress were not, however, significantly related to difficulties in interacting with the medical team. This model accounted for an adjusted value of 42% of the variance. Further research is needed to identify possible causal relationships related to these findings and to determine what interventions might be warranted to improve medical interactions for women with breast cancer living in rural areas.     

Coping with Hospice Work Stress

Abstract

In an effort to gain a better understanding of the psychosocial needs of African-American women with breast cancer, the authors conducted three forms of qualitative interviews: kcy-infbmiant interviews, focus-group interviews, and in-depth interviews. They found that most African-American women receive inadequate information and support to help them through the initial diagnosis and treatment phases of the breast cancer experience. Many women, particularly those with less education and lower incomes, had inadequate medical insurance, received uncoordinated and incomplete medical care, and experienced a poor patient-physician relationship. A primary source of support and coping for these women was their spiritual beliefs. Hie results of this qualitative study have been used to prepare a survey instrument that examines these issues in a larger sample of African-American women.     

Causes of Delay in Seeking Treatment in Patients with Breast Cancer in Iran: a Qualitative Content Analysis Study

Background: In the Middle East, including Iran, breast cancer is the most frequent malignancy among women.Without treatment, a malignant breast tumor advances in stage, diminishing a woman’s chances of survival. Inthis study we aimed to gain insight into the causes of delay in seeking treatment in patients with breast cancer.Methods: The participants in this qualitative, content analysis study were 10 women in whom a diagnosis ofbreast cancer in the stages of II b, III or IIV had been made. They were selected from patients of a major oncologyclinic in Kerman, Iran. Data were collected by means of semi-structured interviews that lasted between 20 to30 minutes. Sampling was discontinued when data saturation was achieved. Content analysis was conductedby classifying the data into themes and sub-themes. Results: The results of our study revealed several factorsthat interfered with patients’ professional consultation seeking and prompt treatment. These factors included;lack of knowledge, fear of being diagnosed with cancer, not seeing oneself at risk, mental preoccupation andwrong diagnosis by physicians. Conclusions: This study suggests that women and even physicians need furtherinformation about breast cancer symptoms. Women need encouragement to seek medical advice when theyencounter suspicious symptoms. Additionally, women may benefit from awareness of the pros of early detectionand reassurance about the improvements in the success of breast cancer treatment.     

Accept me for myself: African American women's issues after breast cancer.

PURPOSE/OBJECTIVES: To identify the personal issues and concerns of African American women who are breast cancer survivors. DESIGN: Exploratory. SETTING: Southeastern United States; urban community. SAMPLE: A total of 24 women were recruited from churches and the community; 16 women participated in focus groups. METHODS: Two focus group sessions were held in a community library. Audiotaped interviews were transcribed and analyzed for themes that described issues the women had to deal with after treatment for breast cancer. MAIN RESEARCH VARIABLE: Women's perceptions of the impact breast cancer had placed on their personal lives, including sexuality. FINDINGS: Five themes emerged-body appearance, social support, health activism, menopause, and learning to live with a chronic illness. CONCLUSIONS: African American women have concerns that are similar to, but different from, those of Caucasian women. Further research is needed to identify culturally appropriate care. IMPLICATIONS FOR NURSING PRACTICE: Assess the effects of treatment on women's personal lives. Know where women can purchase prostheses that match their skin tones. Refer minority women to support groups specifically designed for them.     

Experiences and concerns about ‘returning to work’ for women breast cancer survivors: a literature review

Objective: To explore how female breast cancer patients experience work incapacity during the treatment and return‐to‐work phases and how interactions between patients and stakeholders affect this experience. Method: Database search for full text articles published between January 1995 and January 2008 that focused on employed female breast cancer patients, factors related to work incapacity, and returning to work. Only results based on self‐report data were included. Studies focusing on treatment, financial factors, rate of return, or absence were excluded. Results: Six articles met the inclusion criteria. Women with breast cancer receive varied reactions but little advice about returning to work. Women were primarily concerned with disclosing the diagnosis to their employer and to relatives. Uncertainties about physical appearance, ability to work, and possible job loss affected the women's decisions about working during the treatment phase. After treatment, most women wanted to regain their ‘normal life’, but concentration and arm or fatigue problems potentially interfered. Although supportive work environments were helpful, the individual needs of women differed. Employers and employees need to find a balance in defining accommodating work. Many women received favourable support, but some reported feeling discriminated against. Many women re‐evaluated the role of work in their lives after being confronted with breast cancer. Conclusion: Work adjustments could help women to keep their jobs during illness and recovery. To resolve women's concerns about returning to work, employers, physicians, and insurance institutions should consider increasing and improving communication with breast cancer patients and playing a more active and supportive role. Copyright © 2009 John Wiley & Sons, Ltd.     

The Lived Experience of Australian Women Living with Breast Cancer: A Meta-Synthesis

Background: Breast cancer is the second most common cancer among Australian women. In 2019, an estimated 19,000 women in Australia were diagnosed with breast cancer, with around 3,058 women dying from the disease in the same year. Although many qualitative studies published in Australia exist which examine breast cancer from various perspectives, only limited literature is available which addresses Australian women’s lived experience of breast cancer from diagnosis, treatment and beyond. Method: Meta-synthesis of qualitative studies. Participants who took part in either semi-structured interviews or surveys with open-ended questions were included. A thematic synthesis analysis approach was used. Results: Five themes and 13 sub themes emerged from the data analysis which illustrated the lived experience of Australian women diagnosed with breast cancer. Emotional burden and women’s response towards their breast cancer diagnosis were key themes. Experience of decision- making , social distress, symptoms beyond changes in their body, fertility considerations and their role as mothers were some of the challenges during their treatment. Women coped and adjusted with these challenges through the support of their family, and healthcare providers. Women developed greater empowerment by making their life choices after treatment. Life choices such as getting into a new relationship was challenging for single women. Conclusion: Although most women were emotionally supported following their diagnosis, there are still areas where women could be better supported such as when having to break the news of their breast cancer diagnosis to their children, provision of ongoing emotional support for caregivers of women with breast cancer, providing constant emotional and informational support at the point of diagnosis and during their treatment, tailoring treatments according to different stages of pregnancy, and discussion of fertility treatments in timely manner by healthcare professionals.     

Adherence to recommendations for clinical follow-up after benign breast biopsy

PURPOSE: Women who undergo a benign breast biopsy are at elevated risk for the subsequent development of breast cancer (BC). Therefore, appropriate clinical follow-up of a benign breast biopsy is important. The present study examines the extent and correlates of nonadherence with follow-up recommendations after a benign breast biopsy. METHODS: Women (n = 114) who had undergone a benign breast biopsy completed an initial telephone interview within 50 days of their biopsy (mean = 21 days). Additional telephone interviews were completed at 4 and 8 months post-biopsy. Measures of BC risk perception, general and BC-specific distress, BC-related attitudes and beliefs, social support, optimism, and informational coping style were completed. Specific recommendations for clinical follow-up and evidence of actual follow-up were obtained from medical records. RESULTS: Of 103 women given a specific recommendation for clinical follow-up, 34% were classified as nonadherent with follow-up recommendations. Logistic regression analyses indicated that nonadherent women were characterized by younger age, recommendations for follow-up by clinical breast examination alone, greater confidence in their ability to perform breast self-examination properly, higher perceived personal risk for BC, and greater BC-specific distress. CONCLUSION: Despite the importance of appropriate clinical follow-up of a benign breast biopsy, about one-third of women did not adhere to recommended follow-up. Risk factors for nonadherence suggest potential avenues for interventions to enhance participation in appropriate clinical follow-up.     

Resource use in women completing treatment for breast cancer

OBJECTIVE: To explore resources used by women completing treatment for breast cancer, how they learned about them, and the psychological factors that predicted their use. DESIGN: A questionnaire on resource use was administered as part of a randomized clinical trial which assessed subjects' psychosocial characteristics and tested the outcomes of a psychosocial intervention. SETTING: Women completing treatment for breast cancer were recruited from the oncology departments of three university-teaching hospitals in Montreal. A questionnaire gathered data on the resources used by the subjects, how they learned about them, and the role of the health care team in their decision-making. Emotional distress, dimensions of coping effort, a sense of control and optimism were also measured. RESULTS: Five categories of resources were explored; professional services, informal support networks, informational resources, support organizations and complementary therapies. Most women found out about the last two resources by themselves. Women who used cancer support organizations or complementary therapies scored high on the use of problem-solving coping and low on the use of escape/avoidance coping. In addition they were moderately optimistic, had a slightly lower sense of personal control and were somewhat more distressed than the non-users. The use of support organizations and complementary therapies appears to represent a thoughtful approach to dealing with the distress of cancer. The opinion of the oncologist regarding resource use was valued by nearly half of the sample.     

Evaluation of an internet support group for women with primary breast cancer

BACKGROUND: Women with breast carcinoma commonly experience psychologic distress following their diagnosis. Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives. Web-based breast cancer social support groups are widely used, but little is known of their effectiveness. Preliminary evidence suggests that women benefit from their participation in web-based support groups. METHODS: Seventy-two women with primary breast carcinoma were assigned randomly to a 12-week, web-based, social support group (Bosom Buddies). The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format. RESULTS: The results indicate that a web-based support group can be useful in reducing depression and cancer-related trauma, as well as perceived stress, among women with primary breast carcinoma. The effect sizes ranged from 0.38 to 0.54. Participants perceived a variety of benefits and high satisfaction from their participation in the intervention CONCLUSIONS: This study demonstrated that the web-based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer-related trauma measures. The effect size of the intervention was in the moderate range. Although web-based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed.     

The impact of cervical cancer and dysplasia: a qualitative, multiethnic study

STUDY PURPOSE: Cervical cancer (CCA) remains a health challenge nationally and globally. In the US, more than 12,000 women are diagnosed each year with invasive cervical cancer and more than 220,000 are living with a history of this diagnosis (ACS, 2003). This qualitative study aims to examine health related quality of life (HRQOL) from a culturally consistent framework. METHODS: Key-informant interviews (N = 23) and focus group interviews (N = 51) were conducted with a multiethnic sample of cervical cancer survivors (CCS) recruited from hospitals and clinics. ANALYSES AND RESULTS: Content and theme analyses were conducted. Findings indicate that cultural and family factors often promote coping and well-being, but may foster delay in care seeking and self-deprecation, particularly among Latina and Asian CCS. Faith in God was relied on for comfort, strength and healing by many survivors, especially the African Americans and Latinas. Overall, our participants reported moderate HRQOL. However, persistent concerns included treatment side-effects; difficulties accessing quality care; inadequate health insurance, barriers to good physician-patient relationship such as language and doctors' time constraints; insufficient knowledge about CCA due to limited information from medical staff; lack of control over treatments; social support, family well-being, functional and work issues; and sexuality and relationship concerns. Socioeconomic status, ethnicity, cultural beliefs and practices, age and family support dictated the level of cancer-related burden. CONCLUSION: Invasive CCA is primarily a cancer of women who are economically disenfranchised. Women with a CCA diagnosis are disproportionately challenged by lack of resources including quality, affordable health care and psychosocial services. CCS experience persistent medical, psychological, social, and relational concerns. Information concerning CCS is needed, particularly in Spanish, Vietnamese and Korean. There is an urgent need for further research to understand the risk factors, and the social and cultural mediators of cancer-related HRQOL for CCS.     

Inequalities in breast cancer reconstructive surgery according to social and locational status in Western Australia.

AIMS: To study the effects of demographic, locational and social status and the possession of private health insurance in Western Australia on the likelihood of women receiving breast reconstructive surgery after surgery for breast cancer. METHODS: The WA Record Linkage Project was used to extract all hospital morbidity, cancer and death records of women with breast cancer in Western Australia from 1982 to 2001. Comparisons between those receiving and not receiving breast reconstructive surgery were made after adjustment for co-variates in Cox regression. RESULTS: Overall, 9.1% of women received breast reconstructive surgery after surgery for breast cancer. Women who were younger, with less co-morbidity and non-indigenous women were more likely to receive breast reconstructive surgery. Women in lower socio-economic groups were much significantly less likely to receive breast reconstructive surgery (RR 0.76; 95% CI 0.54-1.06). Women from rural areas were less likely to receive breast reconstructive surgery than those from metropolitan areas (RR 0.54; 95% CI 0.25-1.15) as were those treated in a rural hospital (RR 0.78; 95% CI 0.66-0.92). Treatment in a private hospital (RR 1.25; 95% CI 1.10-1.42) or with private health insurance (RR 1.25; 95% CI 1.08-1.39) independently increased the likelihood of breast reconstructive surgery. CONCLUSION: The rate of breast reconstructive surgery was lower than expected with several factors found to affect the rate; women from disadvantaged backgrounds were less likely to receive breast reconstructive surgery than those from more privileged groups.     

Examining the influence of coping with pain on depression, anxiety, and fatigue among women with breast cancer

Breast cancer treatment can have a profound influence on a woman's physical, psychological, social, and spiritual well-being. Anxiety, depression, anger, fatigue, and fear of recurrence are common responses to a diagnosis of breast cancer and undergoing breast cancer treatment. Women develop their own coping strategies for the pain and other effects of treatment. However, it is unclear whether there is a relationship between adaptation to pain and psychological distress during breast cancer treatment. Findings from the present study reveal that breast cancer patients who have better pain coping strategies also have lower levels of anxiety, fatigue and depression. These results suggest that pain coping interventions may reduce fatigue and psychological distress among women with breast cancer.     

Experiences of Spouses of Women with Breast Cancer: A Content Analysis

Introduction: In addition to the affected person, diagnosis and treatment of breast cancer also severely affects her husband. Therefore, it is worth paying attention to the needs of husbands of women with breast cancer. Therefore, the aim of the present study was to explain the experiences of spouses of women with breast cancer. Method: The present study was a qualitative study with conventional content analysis approach. Purposive sampling was carried out by selecting 6 spouses of women with breast cancer. Data were collected through semi-structured interview. The recorded interviews were transcribed verbatim. Content analysis was used to reduce and name the data, obtain analytical codes, and finally recognize the theme. Results: Data analysis resulted in the extraction of 4 categories of couples’ mental challenges, multifaceted romantic meditation, multifaceted traumas caused by the disease, dual energies (inductions) of relatives, and 12 subcategories. Conclusion: In spite of suffering from all the challenges and traumas, husbands of women with breast cancer have not left their wives alone and have done their best to improve their lives; so, we can raise ““Scarifying your life to save your wife’s life”” as an extract from the experience of spouses of women with breast cancer. Knowing and understanding this point by clinical staffs and policy makers can provide pave the way for planning to provide comprehensive support to these men.