Empowerment Needs of Women With Breast Cancer: A Qualitative Study (original) (raw)
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Nursing Open, 2021
Breast cancer is the most prevalent cancer among females globally. According to statistics, there were ~2.1 million new breast cancer cases and ~63,000 breast cancer deaths in 2018 (Bray et al., 2018). Female breast cancer is also the most commonly diagnosed cancer worldwide, with 2.26 million cases having been diagnosed in 2020 (Ferlay et al., 2021). With the development of medical treatment, the 10-year survival rates among breast cancer now exceeds 90%, which has contributed to a statistically significant number of breast cancer survivors (Akechi et al., 2018). The National Coalition for Cancer Survivorship of the United States regards cancer survivors as those who have undergone treatment after being diagnosed with cancer or those considered to be fully cured (Lee & Park, 2020). However, some reports about cancer survivors as those who have finished conventional therapy, such as surgery, radiotherapy and chemotherapy but includes those who have entered the follow-up period or the endocrine treatment period (Mao & Sun, 2015). In this study, we use this latter definition. Modalities of treatments for breast cancer include surgery, chemotherapy, radiation, targeted therapy and hormone therapy (Wu & Zhao, 2020). After cancer treatment, some complications may persist for years, such as persistent pain (Juhl et al., 2016), breast cancer-related lymphedema (Ferguson et al., 2016), and sleep disturbance (Singer et al., 2018). Among breast cancer survivors, the
Research Square (Research Square), 2022
Background. "Ariadne's thread" is a psycho-educational intervention designed by the Clinical Psychology Unit of an Italian Comprehensive Cancer Center and aimed at promoting empowerment in patients with metastatic breast cancer. It consists of 8 online meetings led by a psycho-oncologist where informational parts discussed by all the doctors that care these patients alternate with moments of stress management. Aim. This case study aims to investigate: 1) the feasibility of the "Ariadne's thread" intervention; 2) the satisfaction and perception of e cacy of the pilot intervention by the participants. Method. We used a mixed method in which 1) it was detected: the number of acceptance to the intervention both of patients and professionals, the number of help requests by patients and the number of requests of date changing by the professionals; 2) semi-structured interviews to the professionals who participated at the intervention were conducted; 3) 2 focus groups with the patients were conducted and a questionnaire was submitted to each of them. Results. The intervention is sustainable for the organisation, professionals and patients point of view. In particular, the patients declare the perception of e cacy in many aspects: improvement of the relation with the doctors, acceptance of their illness, learning of a relaxing technique, possibility to look at the world with trust and hope, etc. The questionnaires show an improvement of empowerment and the satisfaction with the intervention. Conclusion. Even though other research are needed, the results are promising. majority of women with MBC that today live in Italy (about 37.000) have shown a recurrence of the disease after a treatment for an initial form of breast cancer (1). The clinical progression pattern of MBC is heterogeneous and patients can experience acute and stable phases at different time points (2). In Italy 30% of women with MBC is alive after 5 years from diagnosis. However, statistics change according to the number and the location of metastasis, to the molecular subtypes of cancer, to the age, to the presence of potential genetic mutations, to the course of treatment. The range of survival varies from less of a year to over 20 years (3). For this reason, the women with MBC will likely experience continuous uncertainty about their health and longevity (4). The treatment aims to extend survival, control symptoms and improve or maintain the patient's quality of life (QoL). Treatment often continues until the cancer starts growing again or until secondary effects become unacceptable. If this happens, other drugs might be tried (5). Anxiety, depression, loneliness, uncertainty about the future and a pervasive sense of limited time are common in these patients (6)(4)(7) (4). Recently, the literature has focused on the unmet needs of women with MBC, although contributions are still few. Research agrees that there is a lack of health information, especially in relation to treatments and prognosis; patients ask for psychological support, especially in groups; physical needs related to daily life also emerge (8)(9)(10)(11)(12)(4). A recent study conducted whit MBC women at the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan (INT) (8) identi ed the following unmet needs: 1) the need for clinical recognition, because this phase of the disease-even more than in the earlier stages-implies greater vulnerability, limitations in daily life, frequency of exams and duration of therapy; 2) the need for more attention by healthcare professionals: i.e. improving coordination between professionals, improving the quality and quantity of information, using empathy, not seeing the person only as a patient, being careful when communicating the diagnosis; 3) the need for more and better services to be available at the hospital: i.e. decreasing waiting times, creating recreational facilities, having a space for children, having a coordinating gure, doing all the exams in the hospital, possibility of having a psychological support and a social service, possibility of peer and group support meetings; 4) the need for speci c public health policies: i.e. support in knowledge of labor rights, more research into BMC. Not only the number of studies on the needs of MBC patients is limited, but also structured interventions that meet such needs are unknown. In the literature there are psychological (i.e. psychological support, psychotherapy, etc.), expressive (i.e. writing) or relaxing (i.e. yoga, mindfulness) interventions for patients with MBC (13)(14)(15). Although effective, nevertheless they only partially meet the multiplicity and complexity of the needs expressed by the patients.
Basic & Clinical Cancer Research, 2016
Introduction : One of the unmet needs in close association with the quality of life in women with breast cancer is the need for communication; therefore, the aim of the ongoing research is to elucidate the communication needs of patients with breast cancer. Methods : The present study is a Qualitative Content Analysis covering a cohort of people including 20 patients, physicians and nurses who were selected from amongst clients and staff of Shohadaye Tajrish and Taleghani hospitals affiliated to the Shahid Beheshti University of Medical Sciences. Purposive sampling was conducted and continued until data saturation. Semi-structured interviews were used for data collection. All the interviews were recorded and transcribed into typed text. Analysis of data was done simultaneously applying content analysis as outlined and developed by Graneheim & Lundman (2004) using the software MAXQDA. The data trustworthiness was evaluated using the criteria developed by Lincoln & Guba. Results : wo ...
Breast cancer is one of the most common cancers and chemotherapy in Iran, followed by the most significant impact on the quality of life of patients and family members. Therefore, they need the knowledge, understanding and abilities rather than factors influencing the quality of their lives. This study was to determine the effects of family empowerment model-based on the scale of life for women with breast cancer undergoing chemotherapy quality performance was done. A quasi-experimental study is an applied research.The selection of 70 women with breast cancer undergoing chemotherapy in both intervention and control groups was done through purposive sampling. The research tools included demographic questionnaire, questionnaire information about the disease and treatment and quality of life are two standard questionnaires(QLQ-C30,QLQ-Br23). Family-centered empowerment model in the intervention group and post-test one month after the intervention examined. The results showed that the implementation of family-centered empowerment improving the general performance scales (physical, role, cognitive, emotional and social) for patients in the intervention group (P <0.05). The specific function of scales in the two groups after the intervention in terms of body image, sexual performance and sexual pleasure, there was no significant difference (P> 0.05) but after coming back attitude was improved in the intervention group. The results showed that the implementation of the empowerment family-centered on the promotion of general and specific functional scale (with the exception of the aspects of body image, sexual function and sexual pleasure) quality of life for women with breast cancer undergoing chemotherapy was effective.
Empowerment from patient’s and caregiver’s perspective in cancer care
Health Psychology Open, 2018
The caregivers’ perceptions of the patients’ health condition may be biased and induce them to perceive higher needs than patients actually disclose. Our aim was to assess if the level of knowledge and awareness about cancer disease and treatment, and patient participation and assistance differs between caregivers and patients. A descriptive, cross-sectional study was conducted across five countries (Italy, United Kingdom, Spain, France and Germany) on a total of 510 participants who directly (patient) or indirectly (caregiver) faced a cancer diagnosis. Investigating this divergence could help to identify possible difficulties in patient–caregiver relationship, eventually improving patient empowerment.
The perceived social support by Iranian women with breast cancer: a qualitative study
Supportive Care in Cancer, 2021
Background: Social support has an importnat role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore this article aims at discovering and describing the dimensions of social support based on the lived experience of women suffering from breast cancer. Methods: In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 7 hospitals a liated to Urmia University of Medical Sciences. The data were collected through semistructured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim's and Lundman's (2004) approach, using MAXQDA software, version 10. Results: After completion of the analyzing process, 6 categories were appeared including "creating an empathic atmosphere by family and community", "creating a safe communication network for the patient", "adaption to disease", "giving meaning to life", "the feeling of satisfaction with the healthcare providers for ful lling their role", and "accepting the support and help of family and friends in ghting the disease". Conclusion: According to the ndings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in ghting the disease and feeling of recovery. The ndings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers and the community and even providing the required supportive care for this group of women.
A Preliminary Study of Perception and Coping Mechanism of Breast Cancer Patients in An Iranian City
The life expectancy of women in Iran has increased in recent decades. This trend is contemporary with a growing incidence of breast cancer among women. Casual observation has shown that organized and systematic coping support for women with breast cancer disease has expanded much less than the treatment technology; leaving surviving women in ambiguity and fear of unknown. The analysis of qualitative data from a preliminary study of women in one city confirms the limitation of support for coping with the disease and the aftermath of the technology based treatments. Except for a few educated women, the majority of the subjects studied in this research saw their situation as catastrophic and ambiguous. They relied on their religious belief and family support to cope with their situation, but had limited success due to their lack of knowledge about the natural order of the disease and consequences of treatment. While there is need for more comprehensive studies of coping strategies using representative sample of breast cancer patients across rural and urban areas of Iran, the findings from the present study calls for organized and systematic community based support system to help women faced with this disease, to cope.
International Journal of Cancer Management
Background: Determining the needs and challenges of women, who care for patients with cancer and providing appropriate strategies to empower them in the design and implementation of appropriate change programs pave the way for the promotion of these women's health and empowerment. Objectives: This study aims at identifying the needs and challenges of women and developing a program to empower women, who care for patients with cancer. Methods: The present study is based on a participatory action research approach and uses the Kemmis and McTaggart model. The participatory action research of this study will be in 4 phases of planning, action, observation, and reflection. In the planning phase, the needs and challenges of female caregivers are examined from the perspective of women and the health team and, then, women's empowerment strategies in providing home-based supportive and palliative care for patients with cancer are determined, using the results of the qualitative phase ...
Communicating Breast Cancer On-Line: Support and Empowerment on the Internet
Women & Health, 1997
Using participant-observation and discourse analysis, this study explores the communication occurring on the Breast Cancer List, an on-line discussion group which continues to grow in membership and activity. Issues discussed include the evolution of the List, who participates, what topics are discussed. Three major dimensions are identified: exchange of information, social support, and personal empowerment. Social support via computer is compared with face-to-face groups. Empowerment centers on enhanced decision-making and preparation for new illness-related experiences. The influence of gender is considered in terms of communicative style and limitations of access. It is concluded that the List fulfills the functions of a community, with future concerns about information control and the potential to enhance patient-provider understanding.
Women’s Views on Handling and Managing Their Breast Cancer in Pakistan: A Qualitative Study
Diseases, 2016
In this study, we examine and analyze the experiences of women and their perceptions on handling and managing their breast cancer. Seven women from Peshawar, Pakistan who had breast cancer and have been cured, were interviewed. Qualitative content analysis of their life stories was performed using a computerized software Atlas.ti. In the coding process, 128 codes were initially developed. These codes were then grouped into 12 categories, which were then further refined into 8 theoretically grounded categories: awareness and education about breast cancer, cultural barriers, early detection, quality of care and treatment, support, side effects, courage and learned to face challenges. The early views of participant's feelings about breast cancer are mostly similar to the general population in Pakistan. Before starting treatment, all participant were unaware of the treatment process and had fear in their mind. They were hesitant in starting their treatment and were worried. However, when they were cured, their attitudes toward breast cancer and even to their whole lives were changed. Comprehensive awareness programs in a culturally acceptable language and facilities for routine breast examinations should be easily accessible to all women in Pakistan in order to promote early detection. In order to eradicate cultural barriers, female staff who are trained to perform routine breast examinations, should be available in all facilities and treatment centers.