Breast cancer: evaluation of the Common Journey Breast Cancer Support Group

Dissemination and implementation science frameworks and strategies to increase breast cancer screening for at-risk women in the United States: A scoping review

Dissemination and implementation science (D&I) can help bridge the gap between research and practice by addressing how to facilitate and maintain pre-existing evidence-based interventions (EBIs) in various contexts within different fields, including that of breast cancer screening and treatment. Yet, despite the availability of D&I frameworks and strategies, there is a lack of studies exploring knowledge transfer dissemination and implementation models, strategies, and frameworks in the setting of breast cancer care. There is a need for studies that create guidelines and roadmaps built on theoretical foundations of D&I research to scale up successful D&I of strategies, frameworks, and protocols proven to cater to the needs of all breast cancer patients when seeking screening and treatment services. The Arksey and O'Malley (2005) York methodology was used as guidance for this review: (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; (5) collating, summarizing, and reporting results. Most cited barriers (n = 46) sorted into the category of "Recruitment, Measurement, and Delivery Challenges." The predominant ERIC strategy, featured in a noteworthy 84% of studies, was "Tailor strategies" (#16), which belongs to the "Adapt and tailor to context: culture, language, data analysis, collection" domain. This study can guide researchers, physicians, and community workers in improving accessibility, affordability, and quality of breast cancer screening and adequate follow-up opportunities through D&I strategies and models improving the reach and sustainability of evidence-based programs in at-risk female populations.

Equine-Assisted Activities and Therapies: State-of-the-Art Review

The purpose of this paper is to explore what is known about equine-assisted activities and therapies based on Roy's adaptation model. Quality of life for vulnerable populations who engage with equine-assisted activities and therapies is considered the main concept here. This state-of-the-art review was conducted from four databases ranging from January 2019 to February 2020. Limited studies examined the effect of equine-assisted activities and therapies on cancer survivors, although preliminary data were promising. The rural context was not extensively examined. Thus, equine-assisted activities and therapies may enhance the quality of life through four adaptation modes.

An Implementation Process Evaluation Based on an Integrated Psychosocial Support Program of Colorectal Cancer Couples in China: A Pilot Study

Studies have shown that the qualitative process assessment of cancer couple-based psychosocial interventions is often ignored. This article aims to evaluate the implementation process of an integrated psychosocial program developed for colorectal cancer couples. Semi-structured qualitative interviews were conducted with eight colorectal cancer couple participants and two intervention facilitators. Normalization Process Theory was used to guide the data collection and analysis. Data analysis was conducted using a directed content analysis approach within a framework approach. Participants had a good understanding of the program significance. For most participants, the intervention duration was appropriate, and was well integrated into daily life. A lack of understanding of psychological nursing, and a lack of confidence in the use of online platforms and other personal factors, inhibited participants' experience of participating in the intervention. The facilitator's challenge in the implementation process was being flexible in dealing with situations occurring outside of the framework plan. Face-to-face and online psychological interventions require more flexibility, and participant cognition of psychosocial care was the key to the successful implementation of the intervention. Future research should consider raising participants' awareness of psychological care to better integrate this type of intervention into participants' daily lives and routine care.

The effect of an educational program based on Roy's adaptation model on the quality of life of patients suffering from heart failure: A clinical trial study

AIM

Heart failure is a progressive, debilitating disease with exacerbated physical and psychological symptoms that reduces the quality of life of patients. Nursing intervention based on nursing theories could help in the adaptation of patients to the disease and improving quality of life. The aim of this study was to determine the effect of an educational program based on Roy's adaptation model on the quality of life of patients with heart failure.

METHODS AND MATERIAL

In this randomized controlled trial, 76 patients with heart failure were allocated to either the intervention or control group through a blocked randomization method. The data were collected between May and October 2017. The intervention group received oral and written educational programs for 4 weeks. Minnesota quality-of-life questionnaire and Roy's adaptation model-based evaluation form was completed at the beginning of the trial, and 1 month after the completion of the study.

RESULTS

Intervention patients showed statistically significantly improved scores on the physiologic, role function, independence-interdependence dimensions and the total score of Roy's adaptation model over time compared with control patients (p < .05). The mean score of all of the three quality-of-life dimensions and total score of quality of life increased significantly (p < .05).

CONCLUSION

The study results help nursing staff detect the stimuli and the behaviors of patients with heart failure. Roy's adaptation model can be used as a standard practice to increase adaptation to the disease and improving quality of life.

Review of Roy Adaptation Model-Based Qualitative Research

The aim of this paper is to examine the role of qualitative research in the development of the Roy adaptation model. An exploration of the findings from qualitative research using Roy's adaptation model from 1995 to 2005 is compared with the findings and recommendations from a previous review over a 25-year period (1970-1995). The usefulness of qualitative methods in furthering nursing theory is highlighted. Findings from both reviews support the assumptions of the model while generating new information and demonstrating the valuable place of qualitative research in promoting nursing science.

Social support and quality of life among Chinese breast cancer survivors: findings from a mixed methods study

BACKGROUND

Social support has been identified as a significant factor positively influencing quality of life (QOL) in breast cancer survivors. However, less is known about whether and how social support remains important among cancer survivors over the course of the survivorship trajectory.

AIM

To explore social support and its relationship with QOL in breast cancer survivors in China.

METHODS

This was a sequential mixed methods study. In Phase I, 100 breast cancer survivors were surveyed using standardized questionnaires. A multivariate regression analysis was performed to examine the relationship between social support and QOL after controlling for annual household income and length of survivorship. In Phase II, individual in-depth interviews were conducted to understand social support experience from 29 survivors selected from Phase I. Interview data were transcribed and analyzed using qualitative content analysis.

RESULTS

Survivors reported a median support network size of 2.2 persons (interquartile range = 1.2-3.8) and a median support satisfaction score of 5.5 (interquartile range = 5-6). While support satisfaction was found to be associated with QOL, no association was found between support network size and QOL. Interview findings revealed that close family members and peer survivors constituted the major source of breast cancer survivors' support, especially in emotional and informational support aspects. Cultural factors played a role in the perception and utilization of support of the breast cancer survivors.

CONCLUSIONS

This study has indicated that support satisfaction is more critical than support network size in influencing various aspects of survivors' QOL through the underlying different types of situation-specific support.

Self-advocacy and cancer: a concept analysis

AIM

To report an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts, and to unify understanding of the concept in cancer research and practice.

BACKGROUND

Cancer survivors are increasingly required to assume an active role in their health care. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors' ability to engage and manage their care throughout all stages of cancer survivorship.

DESIGN

Walker and Avant's eight-step process of conducting a concept analysis was used.

DATA SOURCES

PubMed, PsycINFO, and CINAHL databases were searched for articles, reviews, editorials, and grey literature directly addressing self-advocacy.

REVIEW METHODS

A broad inquiry into the literature from 1960 to 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept's application and intricacies.

RESULTS

Antecedents to self-advocacy include particular personal characteristics, learned skills, and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors' goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control, and adaptation to a life with cancer.

CONCLUSIONS

Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors' needs and goals.

Living with breast cancer, a Lebanese experience

AIM

The purpose of this qualitative phenomenological study is to provide in-depth understanding of the experience of Lebanese women living with breast cancer.

BACKGROUND

Breast cancer is the most frequently diagnosed cancer in women worldwide. In Lebanon, a country of 4 million people, breast cancer is as well the most widespread type of cancer among Lebanese women. The meaning of cancer diagnosis, the meaning of childbearing and femininity all have cultural bases in Lebanon. The international literature lacks information on how Lebanese women live with breast cancer when compared with women of other cultures.

METHOD

The study followed purposeful sampling and saturation principles in which 10 participants with a mean age of 51.3 years were chosen based on their actual knowledge of the phenomenon, and their readiness to share that knowledge. Data were collected between December 2007 and May 2008. All interviews were audio-taped and transcribed verbatim. Data were analyzed based on the Utrecht School of Phenomenology.

FINDINGS

Four major core themes describing the participants' lived experience emerged from the interviews: Living with losses; living with guilt feeling; living with fears and uncertainty; Living with the need to know and to share that knowledge.

CONCLUSION

The experience of Lebanese women with breast cancer revealed distinctive themes not reported by other women from other cultures. The results of this study challenge health care providers and educators to be aware of the difficulties that Lebanese women are facing when they are living with breast cancer.

A study on the efficacy of body-mind-spirit group therapy for patients with breast cancer

AIMS AND OBJECTIVES

This study aims to understand the effects of culturally enriched body-mind-spirit group therapy on anxiety, depression and holistic well-being among women with breast cancer and to examine patients' views on what aspects of group therapy worked to enhance their health.

DESIGN

The study was designed using multiple methods, which consisted of a randomised controlled trial and a focus group interview.

METHODS

A total of 16 subjects in the control group received the standard care of a physician's treatment at the outpatient department. In addition to standard care, 12 subjects in the experimental group received 10 sessions of weekly body-mind-spirit group therapy for 180 minutes each. This therapy integrates concepts and practices of traditional Chinese medicine and Western medicine (e.g. positive psychology and forgiveness therapy). The subjects in the experimental group were invited to participate in a focus group interview regarding their perceptions of the change mechanisms that occurred in group therapy.

RESULTS

The results of analysis of covariance indicated that after a two-month trial, there was a similarity between the experimental and control groups in reducing the scores of Beck depression inventory and increasing the scores of body-mind-spirit well-being. However, subjects in the experimental group had a better reduction of the scores of state anxiety inventory than subjects in the control group. The qualitative analysis yielded eight domains: (i) imparting of information, (ii) interpersonal learning, (iii) catharsis, (iv) universality, (v) group cohesiveness, (vi) altruism, (vii) instillation of hope and (viii) existential factors. These domains illustrate how the therapeutic effects of group therapy worked to reduce patients' anxiety.

CONCLUSION

The culturally sensitive body-mind-spirit group therapy reduced anxiety among outpatients with breast cancer.

RELEVANCE TO CLINICAL PRACTICE

The involvement of mental health nurses in providing group therapy for cancer patients could enhance the quality of care in psycho-ontological nursing.

'Making the best of it': Chinese women's experiences of adjusting to breast cancer diagnosis and treatment

AIM

This paper is a report of a study to describe Chinese women's experiences of adjusting to breast cancer diagnosis and treatment.

BACKGROUND

Breast cancer is the most common cancer in women, and its diagnosis and treatment are pivotal life-changing events that prompt women to make immediate adjustments. Adjustment to breast cancer has been studied as a way of coping with a stressful event and adapting to chronic illness. Adequate adjustment through coping and adaptation leads to successful completion of treatment and improved quality of life.

METHOD

A descriptive phenomenological method was used, and 22 Chinese women were interviewed at a large cancer centre in Beijing, China, in 2004-2005.

FINDINGS

Facing breast cancer, Chinese women tried to 'make the best of it'. The essences of Chinese women's experiences were: facing the reality of cancer diagnosis, taking an active part in the cancer treatment, sustaining an optimistic spirit, sustaining physically, lessening the impact of cancer on others, and reflecting and moving on. Chinese women had similar perceptions of breast cancer to women in western countries as a fearful, stressful, life-threatening and life-changing event, and some of their intentions and actions were also similar to western women's coping strategies. However, their experiences of adjusting to breast cancer also reflected Chinese historical, social and cultural influences.

CONCLUSIONS

Our findings have implications for healthcare professionals also in countries with Chinese migrants, and could be used as a basis for information and emotional and social support interventions as these can be effective in promoting adjustment to breast cancer.

Systematic review of peer-support programs for people with cancer

OBJECTIVE

To identify models of peer support for cancer patients and systematically review evidence of their effectiveness in improving psychosocial adjustment.

METHODS

CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and PsychINFO databases were used to identify relevant literature published from 1980 to April 2007. Data on characteristics of the peer-support program, sample size, design, measures, and findings were extracted and papers were also rated with respect to research quality (categories 'poor', 'fair' or 'good').

RESULTS

Forty-three research papers that included data from at least 1 group were reviewed in detail, including 26 descriptive papers, 8 non-randomized comparative papers, and 10 papers reporting eight randomized controlled trials (RCTs). Five models of peer support were identified: one-on-one face-to-face, one-on-one telephone, group face-to-face, group telephone, and group Internet.

CONCLUSION

Papers indicated a high level of satisfaction with peer-support programs; however, evidence for psychosocial benefit was mixed.

PRACTICE IMPLICATIONS

One-on-one face-to-face and group Internet peer-support programs should be given priority when considering ways to offer peer support. Nevertheless, the other models discussed in this review should not be dismissed until further research is conducted with a wide range of cancer populations.

The role of hepatitis C support groups

Chronic hepatitis C infection has become the most common blood-borne pathogen in the United States, affecting an estimated 4 million Americans. The diagnosis of chronic hepatitis C carries with it threats to quality of life and life expectancy. Furthermore, the label of chronic hepatitis C encumbers the individual with concerns about contagiousness, social isolation, altered role function, stigmatization, loss of control, and the uncertainty and anxiety inherent in any chronic illness. These factors have a significant emotional effect on the affected individual and his or her family. Although biomedical research continues to seek new therapies for hepatitic C virus and methods of prevention and control, our health and social systems also must develop strategies to facilitate adjustment, provide education and caring, and enhance well-being. Abundant research supports the premise that social support facilitates patient well-being and contributes to health and health promotion through interpersonal interactions. Gastroenterology nurses are well positioned to facilitate improved outcomes in patients with chronic hepatitis C virus by initiating interventions designed to enhance existing sources of social support or to promote new ones. Development of psychosocial interventions, such as support groups, aimed at maintaining or fostering social support, may improve health outcomes and promote a higher health-related quality of life for persons living with chronic hepatitis C virus.