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Soleymani Moghadam M, Parvizifard A, Foroughi A, Ahmadi SM, Farshchian N. An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial. J Cancer Res Clin Oncol 2024; 150:128. [PMID: 38485807 PMCID: PMC10940429 DOI: 10.1007/s00432-024-05655-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/18/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person's life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women. PURPOSE This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer. METHOD A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest-posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26. RESULTS The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05). CONCLUSION MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study's results. Trial registration (IRCT20160103025817N6). 2022-04-06.
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Affiliation(s)
| | - Aliakbar Parvizifard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Aliakbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mojtaba Ahmadi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Farshchian
- Department of Radiation Oncology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Sarkar S. How patriarchy and conservatism fuel deadly hesitancy among women with breast cancer. BMJ 2024; 384:2563. [PMID: 38167613 DOI: 10.1136/bmj.p2563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
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Bigdeli Shamloo MB, Shamsi A, Elahi N. Find Meaning and Help: The Lived Experiences and Support Needs of Iranian Muslim Husbands of Women Undergoing Mastectomy From Diagnosis to the End of Life. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231211627. [PMID: 37902105 DOI: 10.1177/00302228231211627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The husbands of women undergoing mastectomy have been introduced as the patient's primary caregivers. This research was conducted to investigate the lived experiences of Iranian Muslim husbands of women undergoing mastectomy. In this phenomenological research, 18 participants were interviewed, and Van Menan's method of interpretation was used to interpret the data. 8 themes were extracted from the data analysis: physical problems, living in the shadow of fear and discomfort, and destiny is not blameless, modified roles, marital coldness, imposing a financial burden, spiritual care, and support failure. It is concluded that the husbands of these patients need comprehensive support, and the current support is not enough.
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Affiliation(s)
| | - Aziz Shamsi
- Assistant Professor of Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Nasrin Elahi
- Department of Nursing, School of Nursing and Midwifery, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Shamloo MBB, Elahi N, Zaker MA, Zarea K, Zareian A. Role playing and interdependence among husbands of Iranian women after a mastectomy. Int J Palliat Nurs 2023; 29:360-369. [PMID: 37620141 DOI: 10.12968/ijpn.2023.29.8.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND Breast cancer is the most prevalent cancer among women. AIM To investigate the impact of breast cancer on the husbands of Iranian women. METHODS A content analysis based on a Callista-Roy adaptation model was conducted on 23 patients with breast cancer and their husbands and therapists. After asking questions about coping with cancer through telephone interviews, the following subcategories were obtained: role play and interdependence. Data analysis was completed via the Elo and Kyngas approach. RESULTS Data analysis led to the production of 51 initial codes from participants' experiences. The category role-playing included three further sub-categories: primary role, secondary role and tertiary role. Independence/dependence problems included seven sub-categories: personal beliefs, love and heartfelt attachment, organised support, non-organised support, support failure, economic problems and dependence problems/independence. CONCLUSIONS Husbands of women who have had a mastectomy have to take on new roles in their life in order to care for their wife. Also, despite the financial, spiritual, psychological, and medical support that they receive, husbands still felt that the support was insufficient.
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Affiliation(s)
| | - Nasrin Elahi
- Associate Professor of Nursing, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Marziyeh Asadi Zaker
- Associate Professor of Nursing, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Kourosh Zarea
- Associate Professor of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armin Zareian
- Associate Professor of Nursing Education, AJA University of Medical Sciences, Iran
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China.
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Sexuality after breast cancer, how to provide a global and contemporary approach. Bull Cancer 2023; 110:113-128. [PMID: 36336478 DOI: 10.1016/j.bulcan.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Patients' sexuality is one of the major and most neglected impact of breast cancer (BC) and its treatment. Even though research is ongoing on the subject, sexuality issues are rarely taken into account and efficiently dealt with in clinical practice. The objective is to review the impact of BC and its treatment on modern women sexuality. In the literature, a heterogeneous level of advancement is notable in the different publishing countries depending on the cultural background; some countries simply do not publish on the matter, others mainly discuss the male partners and practicians experience, and lastly, the most progressive countries have moved up to studying niches of patients such as sexual and gender minorities. A multidisciplinary approach, including pharmacologic and nonpharmacologic management, appears most efficient. There is a need for greater inclusion of partners and for providing a specific training to first-line health care providers. This review provides a general contemporary worldwide overview of the state of the art in sexuality issues in BC patients and survivors.
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Kianpour M, Taleghani F, Noroozi M, Savabi-Esfahani M, Boroumandfar Z, Changiz T, Ravankhah Z, Javanmard SH, Hashemi MS. Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol. Womens Midlife Health 2022; 8:7. [PMID: 35791001 PMCID: PMC9254568 DOI: 10.1186/s40695-022-00077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/15/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method. Methods The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved. Discussion Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach. Supplementary Information The online version contains supplementary material available at 10.1186/s40695-022-00077-8.
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Affiliation(s)
- Maryam Kianpour
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing Midwifery Care Research Center, Faculty of Nursing Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi-Esfahani
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Boroumandfar
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Changiz
- Department of Medical Education, Educational Development Center, Medical Education Research Canter, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Ravankhah
- Isfahan Cancer Registry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Department of Physiology, School of Medicine Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Sadat Hashemi
- Nursing and Midwifery Care Research Center Department of critical care, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
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The effectiveness of group problem-solving therapy on women's sexual function and satisfaction after mastectomy surgery. BMC Womens Health 2022; 22:50. [PMID: 35197028 PMCID: PMC8867677 DOI: 10.1186/s12905-022-01628-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Breast cancer is the second cause of death and the most common cancer in women worldwide, threatening different aspects of individual and mental health, quality of life, sexual function, and sexual satisfaction. This study aimed to determine the effectiveness of group counseling based on a problem-solving solution on women's sexual function and satisfaction after mastectomy surgery. Methods The present research was an open pilot study, with a pretest, a post-test, and a follow-up period. Of women referred to the Tehran Breast Cancer Institute, 32 were selected using convenience sampling. The group received eight 90-min sessions of problem-solving solution counseling. This approach is based on cognitive-behavioral therapy and can improve an individual's ability to cope with stressful life experiences. The data collection tool was FSFI and sexual satisfaction questionnaires, which were filled before the intervention (baseline), immediately after the intervention, and one month later (follow up). Data analysis was performed using SPSS 21 statistical software application at the certainty level of 95% (P < 0.05). Results The mean FSFI score increased from 18.37 ± 8.35 before the intervention to 20.88 ± 7.67 immediately after the intervention and 22.95 ± 5.79 one month later (P < 0.0001). Also, the mean sexual satisfaction score was 65.27 ± 5.98, 68.08 ± 5.61, and 70.46 ± 5.35 before the intervention, immediately after the intervention, and one month later, respectively (P < 0.05). The results also showed that although the two components of sexual function and satisfaction were statistically significant after sexual counseling, this improvement was not clinically progressive. The mean sexual function and satisfaction score was still low after sexual counseling. Conclusions It was observed that sexual function and satisfaction were improving among the patients after the intervention. Thus, sexual health counseling sessions are recommended for breast cancer patients.
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