1
|
Elshami M, Dwikat MF, Al-Slaibi I, Alser M, Albandak ME, Ayyad M, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Nemer RMA, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study. BMC Cancer 2024; 24:590. [PMID: 38750448 PMCID: PMC11094844 DOI: 10.1186/s12885-024-12357-9] [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] [Received: 01/10/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population. METHODS A nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted 'high' awareness, while the remaining two tertiles denoted 'low' awareness. RESULTS The final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07-1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71-3.58). CONCLUSION A high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.
Collapse
Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside, Cleveland, OH, 7100, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammad Fuad Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| |
Collapse
|
2
|
Naseri N, Taleghani F, Hashemi MS, Najimi A. Designing a virtual breast cancer prevention program for Iranian women: A study protocol. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:93. [PMID: 38726097 PMCID: PMC11081432 DOI: 10.4103/jehp.jehp_263_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/30/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND The growing number of breast cancer patients in Iran, following the lower referrals of women to screening centers after the outbreak of the COVID-19, suggests the need for designing virtual educational interventions to teach self-care methods to women. The aim of this study is to design a virtual training program for the prevention of breast cancer in women based on the steps of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) educational design model. MATERIALS AND METHODS This developmental study will be conducted based on the steps of the ADDIE model. In the first step (analysis), a qualitative study, literature review, and a panel of experts will be conducted to analyze the situation (learners, content, platforms, and media for the electronic presentation of the program). In the design step, the learning objectives, educational strategies, and the way of program's implementation and evaluation will be specified. In the third step, not only are the content, storyboard, and educational program developed, but the pilot study is also conducted and formative assessment is performed. In the fourth step, the program will be provided to the audience and will be implemented as a preliminary program. In the final step, the final virtual education program for the prevention of breast cancer in women will be presented based on the results of the evaluation. CONCLUSIONS Using a comprehensive and systematic educational design model can be a step toward making changes and encouraging innovations in breast cancer prevention education programs in women based on virtual education. Given the existing needs and conditions, this program can promote cancer preventive behaviors as much as possible, reduce the costs imposed on the family and healthcare systems, and lower the complications and mortality rate caused by the delayed diagnosis of the disease.
Collapse
Affiliation(s)
- Nayereh Naseri
- Ph.D. Student of Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Nursing, Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Fariba Taleghani
- Professor of Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Sadat Hashemi
- Assistant Professor of Nursing, Nursing and Midwifery Care Research Center, Department of Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Najimi
- Associate Professor of Health Education and Promotion, Department of Medical Education, Medical Education Research Center, Education Development Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
3
|
Faryabi R, Daneshi S, Davarani ER, Yusefi AR, Arabpour M, Ezoji K, Movahed E, Daneshi-Maskooni M, Hussaini SM. The assessment of risk factors and risk perception status of breast cancer in Northern Iran. BMC Womens Health 2023; 23:268. [PMID: 37194061 PMCID: PMC10189944 DOI: 10.1186/s12905-023-02422-z] [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] [Received: 09/01/2022] [Accepted: 05/09/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common malignancy in women. Identifying and avoiding the preventable risk factors of BC reduces its occurrence effectively. So, this study aimed to assess BC's risk factors and risk perception status in Babol, Northern Iran. METHODS This cross-sectional study was conducted on 400 women aged 18 to 70 in Babol, Northern Iran. According to the eligibility criteria, the selected participants completed the demographic characteristics and researcher-made valid and reliable questionnaires. The statistical software was SPSS20. RESULTS The significant risk factors related to BC were old age (60 years old and more) (30.2%), obesity (25.8%), history of radiation (10%), and familial history of BC (9.5%), respectively (P < 0.05). Suspected symptoms of BC were observed in 78 (19.5%) women, including indentations in 27 (6.75%), redness in 15 (3.75%), pain in 16 (4%), and enlargement of lymph nodes in 20 (5%). The BC risk perception score was 107.72±13.22. CONCLUSION Most participants had at least one risk factor for BC. It is essential to implement intervention programs to control obesity and BC screening programs in obese and overweight women to prevent BC and its complications. Further studies are needed.
Collapse
Affiliation(s)
- Reza Faryabi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Salman Daneshi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Esmat Rezabeigi Davarani
- Health in Disasters and Emergencies Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Reza Yusefi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Mahdieh Arabpour
- School of Medicine, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Khadijeh Ezoji
- Social Determinants of Health Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Movahed
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | | | | |
Collapse
|
4
|
Participation in breast cancer screening and its influence on other cancer screening invitations: study in women aged 56 years old in four French departments. Eur J Cancer Prev 2023; 32:238-245. [PMID: 36779309 DOI: 10.1097/cej.0000000000000777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Today, women 50 years of age are offered three types of cancer screening in France. However, participation is not optimal. The aim was to describe (1) participation in organised breast cancer screening (OS) of women aged 56 years old, and the influence of this participation on colorectal and cervical cancer screening, (2) the reasons for non-participation in breast cancer OS, and (3) the reasons for screening before age 50. METHODS A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1-2 and 0). We described the quantitative responses and grouped the qualitative responses thematically. RESULTS A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening. CONCLUSION There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.
Collapse
|
5
|
Kumar K, Mohammadnezhad M. "Once you get cancer you die. There is no way to get saved from cancer." A qualitative exploration of patients' perceptions towards cancer in Fiji. PLoS One 2022; 17:e0277970. [PMID: 36525441 PMCID: PMC9757585 DOI: 10.1371/journal.pone.0277970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Understanding patients' perspective to get an insight into cancer, and how best the public health systems can battle with this disease is the way forward in this current world. This study aimed to explore patients' knowledge about common cancers, barriers to assessing cancer information and cancer preventative approaches in Fiji. METHODS The study used a qualitative method approach that was conducted among patients who attended Special Outpatients (SOPD) at the four selected health centres in Lautoka Subdivision, Fiji from 1st March to 30th April 2021. A semi-structured open-ended questionnaire was used to guide in-depth interviews. These audio recordings were transcribed and analysed using thematic analysis. All interview transcripts were read and similar words and phrases were assigned numbers which were grouped together to identify themes and sub themes. RESULTS Twenty-eight patients took part in the in-depth interview and the responses were grouped into four themes including; cancer knowledge, diagnosis of cancer in a close friend/family, barriers of communication and optimizing cancer awareness. Patients' awareness about common cancers and cancer risk factors was low. Many barriers for cancer screening were highlighted including stigmatization, fear, worry, death, lack of information, herbal medicine use, lack of resources and delay in diagnosis. Awareness strategies highlighted by participants included community outreach programs, house to house visits, opportunistic screening, engagement of community health care workers and the concept of a cancer hub centre. CONCLUSION It is evident that there is a range of views from patients towards cancer and it is important to understand these perceptions to better guide public health interventions concerning cancer. This puts more focus on the need to invest more in information, education, and communication material for public campaigns that target a variety of people for a wider reach.
Collapse
Affiliation(s)
- Kaushal Kumar
- Fiji Ministry of Health and Medical Services, Lautoka Hospital, Lautoka, Fiji Islands
| | - Masoud Mohammadnezhad
- School of Nursing and Healthcare Leadership, University of Bradford, Bradford, United Kingdom
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Nakhon Pathom, Thailand
- * E-mail:
| |
Collapse
|
6
|
Abstract
Background: By 2040, the predicted global cancer burden is expected to be more than 27 million new cancer cases per year. Understanding primary health care workers’ (HCWs) perception on cancer can highlight new ways in which cancer advocacy can be increased. This study aimed to explore the perceptions of primary HCWs in Lautoka, Fiji, towards common cancers with focus on knowledge, risk perceptions, barriers and preventive approaches. Methods: The study used a qualitative method approach. The study was conducted among primary HCWs at four purposively selected health centres in Lautoka Subdivision, Fiji, from 1 March 2021 to 1 April 2021. Focus group discussions (FGDs) were conducted with primary HCWs. A semi-structured open-ended questionnaire was used to collect data, and the FGDs were audio-recorded. These audio recordings were transcribed and analysed using thematic analysis. Results: The responses from the four FGDs with six primary HCWs in each group emerged four major themes. These themes were cancer knowledge, health professional training, barriers and challenges and awareness strategies. Primary HCWs were not fully aware about common cancers and were not confident to discuss about cancer with their patients which is an important role of primary HCWs in cancer management. This lack of knowledge was attributed to less training received in primary care setting. Barriers to accessing cancer screening included misconceptions about cancer, negative attitudes from patients, stigmatization, lack of resources at health facility and less informed health staff. Community outreach programmes, opportunistic screening, community HCWs and the concept of a cancer hub centre were awareness strategies highlighted by primary HCWs. Conclusions: Lack of knowledge about common cancers among primary HCWs is a concern that is depicted well in this study. This low knowledge was attributed to lack of training on cancers received by primary HCWs. Guidelines on cancer screening and diagnosis can be developed by the health ministry to assist primary HCWs in detecting patients at pre-cancerous stage.
Collapse
|
7
|
Keshavarzi A, Asadi S, Asadollahi A, Mohammadkhah F, Khani Jeihooni A. Tendency to Breast Cancer Screening Among Rural Women in Southern Iran: A Structural Equation Modeling (SEM) Analysis of Theory of Planned Behavior. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2022; 16:11782234221121001. [PMID: 36091183 PMCID: PMC9452820 DOI: 10.1177/11782234221121001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran. Methods: This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/df were evaluated. The significance level in all tests was considered 0.05. Results: The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model. Conclusions: The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.
Collapse
Affiliation(s)
- Ameneh Keshavarzi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeedeh Asadi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abdolrahim Asadollahi
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
8
|
Almuhtaseb MIA, Alby F, Zucchermaglio C, Fatigante M. Social support for breast cancer patients in the occupied Palestinian territory. PLoS One 2021; 16:e0252608. [PMID: 34143797 PMCID: PMC8213135 DOI: 10.1371/journal.pone.0252608] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
Previous research indicates that social support is beneficial to cancer patients in adjusting to the stress of the disease. Drawing on a qualitative content analysis of 36 semi-structured interviews, this article explores sources and types of social support in Arab-Palestinian women with breast cancer. Results show that members of the immediate family, husbands in particular, are reported to be the most supportive social sources. Given the limitations that characterize access to cancer care in the occupied Palestinian territory (OPT) and the collectivistic values of the society, women with breast cancer seem to rely mainly on their husbands to handle emotional, functional and informational needs. Emotional support includes the provision of care, trust, reassurance, and companionship. Functional support includes the practical assistance that the cancer patients receive in terms of financial support, attendance during treatment or help with domestic chores and childcare. Accessing appropriate informational support can be quite challenging in the OPT since available information is not always reliable. The family plays a key role in mediating communication with doctors. Contact with breast cancer patients and survivors is also a source of supporting information, with however a possible negative impact in terms of emotional coping. In this context, the immediate family becomes a fundamental resource for coping and a relational space that mediates connections with others, including doctors, acting as a "proxy" between the patient and the social environment. Findings are discussed in light of the historical and sociocultural context of the OPT.
Collapse
Affiliation(s)
- Mona I. A. Almuhtaseb
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, Rome, Italy
| | - Francesca Alby
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, Rome, Italy
- * E-mail:
| | - Cristina Zucchermaglio
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, Rome, Italy
| | - Marilena Fatigante
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, Rome, Italy
| |
Collapse
|
9
|
Choridah L, Icanervilia AV, de Wit MJM, van Asselt ADI, Kurniawan WT, Fahmi YI, Rengganis AA. Knowledge and Acceptance Towards Mammography as Breast Cancer Screening Tool Among Yogyakarta Women and Health Care Providers (Mammography Screening in Indonesia). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:532-537. [PMID: 31776894 PMCID: PMC8099792 DOI: 10.1007/s13187-019-01659-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Annual mammography remains the gold standard of asymptomatic breast cancer screening for women starting at the age of 40. However, Indonesia has not designated mammography as its national screening program. To help policymakers decide whether mammography should be introduced into a national program, it is important to comprehensively understand the knowledge and acceptance of both consumers and providers. A total of 25 subjects including a range of women and health care professionals (HCPs) in Yogyakarta Province were recruited using purposive, maximum variation sampling and then interviewed in-depth. The interviews were recorded and all data were taken and transcribed from the audio recording, which were subsequently translated to English and analyzed thematically. Almost all of Yogyakarta women had heard about the term of mammography. However, only few of them have let themselves be screened, mainly because of their perceived lack of urgency to screen for asymptomatic breast cancer. Another important reason was the high cost of mammography. Meanwhile, several HCPs believed that breast cancer has not been a priority for the government and hence the government limited mammography screening's access and excluded it from the national insurance coverage. Most women in Yogyakarta have a good understanding about breast cancer screening, but their acceptance of mammography as a breast cancer screening tool is significantly influenced by high cost, limited access, and lack of urgency.
Collapse
Affiliation(s)
- Lina Choridah
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Ajeng Viska Icanervilia
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia.
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands.
| | | | - Antoinette D I van Asselt
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
| | - Wahyu Tri Kurniawan
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Yusnia Irchami Fahmi
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Anggraeni Ayu Rengganis
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia
| |
Collapse
|
10
|
Mutebi M, Anderson BO, Duggan C, Adebamowo C, Agarwal G, Ali Z, Bird P, Bourque JM, DeBoer R, Gebrim LH, Masetti R, Masood S, Menon M, Nakigudde G, Ng'ang'a A, Niyonzima N, Rositch AF, Unger-Saldaña K, Villarreal-Garza C, Dvaladze A, El Saghir NS, Gralow JR, Eniu A. Breast cancer treatment: A phased approach to implementation. Cancer 2021; 126 Suppl 10:2365-2378. [PMID: 32348571 DOI: 10.1002/cncr.32910] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/14/2022]
Abstract
Optimal treatment outcomes for breast cancer are dependent on a timely diagnosis followed by an organized, multidisciplinary approach to care. However, in many low- and middle-income countries, effective care management pathways can be difficult to follow because of financial constraints, a lack of resources, an insufficiently trained workforce, and/or poor infrastructure. On the basis of prior work by the Breast Health Global Initiative, this article proposes a phased implementation strategy for developing sustainable approaches to enhancing patient care in limited-resource settings by creating roadmaps that are individualized and adapted to the baseline environment. This strategy proposes that, after a situational analysis, implementation phases begin with bolstering palliative care capacity, especially in settings where a late-stage diagnosis is common. This is followed by strengthening the patient pathway, with consideration given to a dynamic balance between centralization of services into centers of excellence to achieve better quality and decentralization of services to increase patient access. The use of resource checklists ensures that comprehensive therapy or palliative care can be delivered safely and effectively. Episodic or continuous monitoring with established process and quality metrics facilitates ongoing assessment, which should drive continual process improvements. A series of case studies provides a snapshot of country experiences with enhancing patient care, including the implementation of national cancer control plans in Kenya, palliative care in Romania, the introduction of a 1-stop clinic for diagnosis in Brazil, the surgical management of breast cancer in India, and the establishment of a women's cancer center in Ghana.
Collapse
Affiliation(s)
- Miriam Mutebi
- Breast Surgical Oncology, Aga Khan University Hospital, Nairobi, Kenya
| | - Benjamin O Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Section of Surgical Oncology, Department of Surgery, University of Washington, Seattle, Washington
| | - Catherine Duggan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Clement Adebamowo
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland.,Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.,Center for Bioethics and Research, Ibadan, Nigeria
| | - Gaurav Agarwal
- Endocrine and Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Zipporah Ali
- Kenya Hospices and Palliative Care Association, Nairobi, Kenya
| | | | - Jean-Marc Bourque
- Department of Radiation Oncology, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Rebecca DeBoer
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Luiz Henrique Gebrim
- Department of Mastology, Federal University of São Paulo, São Paulo, Brazil.,Centro de Referência da Saúde da Mulher, São Paulo, Brazil
| | - Riccardo Masetti
- Department of Women and Child Health, Catholic University, Rome, Italy
| | - Shahla Masood
- University of Florida Health Jacksonville Breast Center, Jacksonville, Florida
| | - Manoj Menon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Anne Ng'ang'a
- National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Nixon Niyonzima
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Uganda Cancer Institute, Kampala, Uganda
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Karla Unger-Saldaña
- Epidemiology Unit, Instituto Nacional de Cancerología - México, Mexico City, Mexico
| | - Cynthia Villarreal-Garza
- Tecnologico de Monterrey, Centro de Cancer de Mama, Hospital Zambrano Hellion, Monterrey, Mexico
| | - Allison Dvaladze
- Section of Surgical Oncology, Department of Surgery, University of Washington, Seattle, Washington
| | | | - Julie R Gralow
- Section of Surgical Oncology, Department of Surgery, University of Washington, Seattle, Washington
| | - Alexandru Eniu
- Hopital Riviera Chablais, Vaud-Valais, Rennaz, Switzerland
| |
Collapse
|
11
|
Momenimovahed Z, Tiznobaik A, Taheri S, Hassanipour S, Salehiniya H. A review of barriers and facilitators to mammography in Asian women. Ecancermedicalscience 2020; 14:1146. [PMID: 33343705 PMCID: PMC7738271 DOI: 10.3332/ecancer.2020.1146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Indexed: 11/29/2022] Open
Abstract
Aim Breast cancer is the most common cancer among women in Asia and one of the major health problems in most countries in the region. Despite extensive advances in treatment, early diagnosis is one of the main methods for increasing the survival rate. It is necessary to evaluate the barriers and facilitators of screening in different societies. This study was conducted to identify the barriers and facilitators of mammography in Asia. Materials and methods To identify the barriers and facilitators of mammography in Asia, a comprehensive search was carried out in databases such as Medline, Web of Science Core Collection and Scopus using keywords, including breast cancer, screening, mammography, barriers, facilitators and the names of each Asian country, as well as a combination of these keywords were used to help the search. Full-text, English language and original articles were included in this study. Results In total, 71 articles were entered into the study. The findings of this study revealed various barriers to mammography in Asian women, including knowledge, sociodemographic factors, cost and insurance, cultural factors, belief, attitude and feeling, fear, pain and embarrassment, self-efficacy, religious, psychological factors, time constraint, fatalism, professional recommendations, communication, social support and access. Also, knowledge, attitude and belief, perceived risk, professional and social factors were found to be facilitators of mammography. Conclusion Knowing the barriers and facilitators to access mammography is the first step in the development of a successful screening program. Awareness and various personal, professional and social factors have emerged as the major barriers to access to mammography in most Asian countries.
Collapse
Affiliation(s)
| | | | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| |
Collapse
|
12
|
Predicting Factors of Mammography Adherence among Iranian Women Based on Transtheoretical Model. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2020. [DOI: 10.52547/jgbfnm.17.2.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
13
|
Khani Jeihooni A, Darvishi N, Harsini PA. The Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Screening in Iranian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:264-273. [PMID: 30604386 DOI: 10.1007/s13187-018-1460-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mammography is the most special screening method for early diagnosis of breast cancer. The purpose of present research is investigating the effect of educational intervention based on theory of planned behavior on mammography screening of women in Fasa city, Fars province, Iran. In this quasi-experimental study, 400 subjects (200 subjects for experimental group and 200 subjects for control group) were selected in 2017-2018. Educational intervention for the experimental group included 8 educational sessions. A questionnaire used for evaluating demographic information and constructs of theory of planned behavior (knowledge, perceived behavioral control, subjective norms, and attitude) investigated mammography performance of women before and 6 months after intervention. Data were analyzed by using SPSS 22 through chi-square test, McNemar's test, and Wilcoxon-Mann-Whitney test at significance level of P < 0.05. The average age of subjects was 45.52 ± 6.76 years in the experimental group and 45.12 ± 6.64 years in the control group. Six months after intervention, the experimental group showed significant increase in knowledge, perceived behavioral control, subjective norms, and attitude compared to the control group and 174 people (78%) of the experimental group had intention for doing mammography and 148 people (74%) of the experimental group performed mammography. Also, 6 months after educational intervention, 38 people (19%) of the control group had intention for performing mammography and 14 people (7%) of the control group performed mammography.
Collapse
Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran.
- Fasa Ibn Sina square, Fasa University of Medical Sciences, Fasa, P.Code:7461686688, Iran.
| | - Niloofar Darvishi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
14
|
Azamjah N, Soltan-Zadeh Y, Zayeri F. Global Trend of Breast Cancer Mortality Rate: A 25-Year Study. Asian Pac J Cancer Prev 2019; 20:2015-2020. [PMID: 31350959 PMCID: PMC6745227 DOI: 10.31557/apjcp.2019.20.7.2015] [Citation(s) in RCA: 289] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Indexed: 12/12/2022] Open
Abstract
Background: breast cancer is the most common cause of cancer death for women worldwide. In the past two decades, published epidemiological reports in different parts of the world show significant increase in breast cancer mortality rate. The aim of this study was to determine the 25-year trend of breast cancer mortality rate in 7 super regions defined by the Health Metrics and Evaluation (IHME), i.e. Sub-Saharan Africa, North Africa and Middle East, South Asia, Southeast Asia and East Asia and Oceania, Latin America and Caribbean, Central Europe and Eastern Europe and Central Asia, High-income. Methods: Our study population consisted of 195 world countries in the IHME pre-defined seven super regions. The age-standardized mortality rates from 1990 to 2015 were extracted from the IHME site. The reference life table for calculating mortality rates was constructed based on the lowest estimated age-specific mortality rates from all locations with populations over 5 million in the 2015 iteration of GBD. To determine the trend of breast cancer mortality rate, a generalized linear mixed model was fitted separately for each IHME region and super region. Results: Statistical analysis showed a significant increase for breast cancer mortality rate in all super regions, except for High-income super region. For total world countries, the mean breast cancer mortality rate was 13.77 per 100,000 in 1990 and the overall slope of mortality rate was 0.7 per 100,000 from 1990 to 2015. The results showed that Latin America and Caribbean the highest increasing trend of breast cancer mortality rate during the years 1990 to 2015 (1.48 per 100,000). Conclusion: In general, our finding showed a significant increase in breast cancer mortality rate in the world during the past 25 years, which could be due to increase in incidence and prevalence of this cancer. Low this increasing trend is an alarm for health policy makers in all countries, especially in developing countries and low-income regions which experienced sharp slopes of breast cancer mortality rate.
Collapse
Affiliation(s)
- Nasrindokht Azamjah
- Department of Administrative Science, Faculty of Shariaty, Tehran Branch, Technical and Vocational University (TVU), Tehran, Iran
| | - Yasaman Soltan-Zadeh
- Department of Information Studies, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Farid Zayeri
- Proteomics Research Center and Department of Biostatistics, Faculty of paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Lagarde JBB, Laurino MY, San Juan MD, Cauyan JML, Tumulak MAJR, Ventura ER. Risk perception and screening behavior of Filipino women at risk for breast cancer: implications for cancer genetic counseling. J Community Genet 2019; 10:281-289. [PMID: 30259342 PMCID: PMC6435779 DOI: 10.1007/s12687-018-0391-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/17/2018] [Indexed: 12/11/2022] Open
Abstract
The burden and experiences that come with a breast cancer diagnosis in a family impact how women perceive personal cancer risk and pursue preventive strategies and/or early detection screening. Hence, this study sought to understand how Filipino women incorporate their experiences living with a sister diagnosed with early-onset breast cancer to their personal perceived risk and screening behavior. Guided by phenomenological approach of inquiry, a face-to-face, semi-structured interview was conducted with 12 purposively sampled women with a female sibling diagnosed with breast cancer before age 50. Transcripts were analyzed using thematic analysis. Results revealed that the respondents tend to compare themselves with their sister when constructing views of personal cancer vulnerability. The subjective risk is also shaped by their beliefs regarding cancer causation such as personalistic causes, personal theory of inheritance, and locus of control. Their sisters' cancer diagnoses serve as a motivation for them to perform breast self-examination. However, clinical breast examination and screening mammography are underutilized due to perceived barriers such as difficulty allotting time to medical consultation, fear, and lack of finances. Overall, cancer risk perception and screening behavior are important factors that must be addressed during cancer genetic counseling consultations. Better understanding of these factors will aid in the formulation of an effective management plan for at-risk women.
Collapse
Affiliation(s)
- John Benedict B Lagarde
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
| | - Mercy Y Laurino
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Michael D San Juan
- Section of Medical Oncology, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jaclyn Marie L Cauyan
- College of Education, University of the Philippines Diliman, Quezon City, Philippines
| | - Ma-Am Joy R Tumulak
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Elizabeth R Ventura
- College of Social Sciences and Philosophy, University of the Philippines Diliman, Quezon City, Philippines
| |
Collapse
|
16
|
Karimi SE, Rafiey H, Sajjadi H, Nosrati Nejad F. Identifying the Social Determinants of Breast Health Behavior: a Qualitative Content Analysis. Asian Pac J Cancer Prev 2018; 19:1867-1877. [PMID: 30049199 PMCID: PMC6165651 DOI: 10.22034/apjcp.2018.19.7.1867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/08/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Prevention, early diagnosis and reduction of mortality caused by breast cancer are the priorities of the world health systems. The aim of this study was to identify the social factors that affect the women’s breast health behavior based on the social determinants model of the World Health Organization (WHO). Materials and Method: This qualitative study was conducted and analyzed using content analysis approach. The data were collected from 32 participants by semi-structured interviews and focused group discussion. The participants comprised of breast surgeons, radiologists, health care providers and women over 35 years of age in Tehran who were selected through purposeful sampling. The interviews continued until data saturation was reached. Results: Based on the experiences of the participants, three themes were obtained from the data that shaped the women’s breast health behavior, including 1) the context of health policy, 2) socioeconomic status, and 3) cultural, psychological, and behavioral factors. Conclusion: A better understanding of social determinants related to breast health behavior can be effective in designing and applying of appropriate theories and models of education and intervention, so that, by early diagnosis of breast cancer and timely treatment of patients, the disease complications and mortality would be reduced.
Collapse
Affiliation(s)
- Salah Eddin Karimi
- Social welfare management department, University of social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | | | | |
Collapse
|
17
|
Pahlevan Sharif S, Abaeian V, Khanekharab J. Attitudes toward mammography: questionnaire psychometric properties. Int J Health Care Qual Assur 2018; 31:391-399. [PMID: 29865960 DOI: 10.1108/ijhcqa-02-2017-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to evaluate the Persian version of the Attitude toward Breast Cancer Screening Procedures Scale (ABCSPS) among Iranian women. Design/methodology/approach In this methodological study, 1,000 Iranian women completed a demographic questionnaire and the 14-item Persian ABCSPS. The scale's construct validity was evaluated using exploratory and confirmatory factor analysis. Internal consistency and reliability were assessed using Cronbach's α and McDonald's coefficient ω. Findings The exploratory factor analysis revealed a two-factor solution accounting for 55.1 percent of the variance. The two-factor measurement model had a good fit with all factor loadings greater than 0.5, which were statistically significant. The results showed good reliability and internally consistency ( α=0.767 and 0.872; ω =0.979 and 0.997). Moreover, model structure was invariant across different income groups. Originality/value The Persian ABCSPS translation demonstrated good validity and reliability among Iranian women. The results also showed that the scale had a multidimensional structure. Regarding proper psychometric properties, the validated scale can be used in future studies as a reliable and relevant breast cancer screening attitude measure.
Collapse
Affiliation(s)
| | - Vahideh Abaeian
- Taylor's Business School, Taylor's University , Subang Jaya, Malaysia
| | - Jasmine Khanekharab
- Graduate School of Business, Universiti Tun Abdul Razak , Kuala Lumpur, Malaysia
| |
Collapse
|
18
|
Suwankhong D, Liamputtong P. Early Detection of Breast Cancer and Barrier to Screening Programmes amongst Thai Migrant Women in Australia: A Qualitative Study. Asian Pac J Cancer Prev 2018; 19:1089-1097. [PMID: 29699369 PMCID: PMC6031773 DOI: 10.22034/apjcp.2018.19.4.1089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Breast cancer screening programme is seen as the best practice to detect breast cancer early. However, there are circumstances that can prevent immigrant women from attending screening programmes. Little is known about Thai migrants and the barriers to their seeking breast cancer screening when living in a new homeland. This paper aimed to discuss the barriers to attending screening services among Thai migrant women living in Australia. Methods: This study adopted qualitative approach. Semi-structured in-depth interviewing and drawing methods were employed as data collection technique with 25 Thai migrant women who had not experienced breast cancer and were living in Metropolitan Melbourne, Australia. Thematic analysis method was employed to analyse the data. Results: Basing on the Health Belief Model, most Thai migrant women did not perceive that they were at risk of breast cancer. Despite seeing a breast cancer screening programme as important, the women rarely paid attention to breast cancer screening and used the mammography services provided by the Australian health care system. The barriers included the location of the services, unfamiliar patterns of health care provision, and language difficulties. Conclusions: There are many barriers that that they encountered in Australia that prevent Thai migrant women living in Melbourne Australia to pay attention to mammographic screening service provided by Australia health system. Our findings suggest that health services and interventions need to be designed more sensitive to the needs and socio-cultural context of migrant women in general and Thai migrant women in particular.
Collapse
Affiliation(s)
- Dusanee Suwankhong
- Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung, Thailand.
| | | |
Collapse
|
19
|
Abstract
BACKGROUND Breast cancer has become the most common cancer among Yazdi women in Iran. Thus, it is necessary to encourage these women to participate in breast health-seeking behaviors. In this regard, husbands can play an effective role. OBJECTIVE The aim of this study was to explore women's perceptions about the effect of their husband's role on breast health-seeking protection motivation. METHODS This study used a directed qualitative content analysis approach based on the Protection Motivation Theory. Participants were selected using purposive sampling; in-depth semistructured interviews with 14 Yazdi women were completed. RESULTS One major category named "motivator role of husband" emerged from the analysis. The following subcategories underlying this category were "indifference and a lack of support as long as the women can continue with expected duties," "what women want for support," "facilitating and restrictive factors of husband's supportive role," "public health education needed," and "husband's agreement with preventive actions." CONCLUSIONS Voluntary participation in breast health-seeking behaviors is a culturally sensitive topic. The qualitative methodology allowed this sensitive topic and its different aspects to be explored. The findings indicated that the major source of support for women was their husband's behavior toward breast health-seeking actions. Family cohesion and love among couples were identified as strong determinant factors pertaining to husband's supportive behaviors. IMPLICATIONS FOR PRACTICE The study findings provided deeper understanding about the effective factors related to a husband's role in motivating a wife to practice breast cancer prevention. These new findings are relevant for health educators and practitioners to develop culturally based interventions.
Collapse
|
20
|
Nouri Sanchuli H, Rahnama M, Shahdadi H, Poudineh Moghaddam M. From Love and Fidelity to Infidelity- Individual Experiences of Women with Breast Cancer Regarding Relationships with Their Spouses. Asian Pac J Cancer Prev 2017; 18:2861-2866. [PMID: 29072437 PMCID: PMC5747415 DOI: 10.22034/apjcp.2017.18.10.2861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background and Objective: Breast cancer and its treatment processes not only involve the patients but also their spouses and can impact on mutual relationships. Spouses of women with breast cancer may experience devastating consequences of the disease in their marital and sexual relationships. Therefore, in the present study we aimed to investigate individual experiences of women with breast cancer in their relationships with their spouses. Materials and Methods: This was a qualitative study with a conventional approach to content analysis. A purposive sampling method was used to select 12 patients with breast cancer visiting the Chemotherapy Clinic in Zabol in 2016. Semi-structured interviews were employed for data collection. Data trustworthiness was checked and data were analyzed based on the steps proposed by Graneheim and Lundman. Ethical issues were considered. Results: Three main categories and ten sub-categories were extracted. The three main categories were surrounded by misery, from emotional to practical companionship and influencebeing imposed upon someone else. Conclusion: The findings showed paradoxical experiences of the women under study ranging from love and fidelity to infidelity. This indicates that some spouses do not adequately support for their sick wives. Therefore, health professionals should provide support, guidance and training for couples, including sex therapy and counseling services, so that spouses can better support their wives.
Collapse
Affiliation(s)
- Hajar Nouri Sanchuli
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.
| | | | | | | |
Collapse
|
21
|
Yılmaz M, Sayın Y, Cengiz HÖ. The Effects of Training on Knowledge and Beliefs About Breast Cancer and Early Diagnosis Methods Among Women. Eur J Breast Health 2017; 13:175-182. [PMID: 29082374 PMCID: PMC5648273 DOI: 10.5152/tjbh.2017.3255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/04/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Breast cancer (BC) is the most common female malignancy in the world and Turkey. Its prevalence and mortality are surprisingly increasing at a rapid rate. The objective of this study was to determine the effectiveness of training sessions on women's knowledge of relevant risk factors of BC and screening methods, screening behaviors and health beliefs among of healthy women in Turkey. MATERIALS AND METHODS In this study, in order to establish the efficiency of BC training, a semi-empirical single group pre-test & post-test research model was used. The data were collected by using a self-administered questionnaire and by using the Turkish version of Champion's health belief model scale (CHBMS). The pre-test was performed before the training and after one week of the training, post-test was performed with a questionnaire having the same content. RESULTS In total, 244 women participated in the study. The average age of the women was 39.44 (SD=1.06) years. The mean total knowledge score increased significantly (p<.001) from 9.05 in the pre-test to 16.53 in the post-test. The results showed that both mean knowledge scores and CHBMS subscales scores of the women were increased significantly (p<.001) from the pre-test to the post-test. In multiple linear regression analysis, BC screening knowledge of women with susceptibility, benefit, self-efficacy and health motivation subscales of CHBMS, breast self-examination (BSE) practice and self-efficacy were also significant in the post-test; in the pre- and post-tests, a significant relationship among the level of education of women, susceptibility and seriousness was found (p<.001). CONCLUSION The study showed that the training program had profound effects on BC knowledge, screening behaviors and health beliefs of women.
Collapse
Affiliation(s)
- Meryem Yılmaz
- Division of Nursing, Department of Surgical Disease Nursing, Cumhuriyet University School of Health Sciences, Sivas, Turkey
| | - Yazile Sayın
- Division of Nursing, Department of Surgical Disease Nursing, Bezmialem Vakıf University School of Health Sciences, İstanbul, Turkey
| | - Hatice Öner Cengiz
- Department of Surgical Nursing, Ankara University School of Health Sciences, Ankara, Turkey
| |
Collapse
|
22
|
Savabi-Esfahani M, Taleghani F, Noroozi M, Tabatabaeian M. Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination. Asian Pac J Cancer Prev 2017; 18:2501-2505. [PMID: 28952284 PMCID: PMC5720657 DOI: 10.22034/apjcp.2017.18.9.2501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE). Methods: A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach’s alpha. The women were followed up regarding performance of BSE one month later. Results: Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were the most important information sources for breast cancer and screening. There were significant differences between mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE. Conclusion: It appears that application of a role playing method by providers improves women’s knowledge and behavior with respect to breast cancer screening.
Collapse
Affiliation(s)
- Mitra Savabi-Esfahani
- Department of Midwifery and Reproductive Health, Nursing & Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | |
Collapse
|
23
|
Bowser D, Marqusee H, El Koussa M, Atun R. Health system barriers and enablers to early access to breast cancer screening, detection, and diagnosis: a global analysis applied to the MENA region. Public Health 2017; 152:58-74. [PMID: 28843410 DOI: 10.1016/j.puhe.2017.07.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/11/2017] [Accepted: 07/19/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify barriers and enablers that impact access to early screening, detection, and diagnosis of breast cancer both globally and more specifically in the Middle East and North Africa (MENA) region (with a specific focus on Egypt, Jordan, Oman, Saudi Arabia, United Arab Emirates [UAE], and Kuwait) with a specific focus on the health system. STUDY DESIGN A systematic review of literature. METHODS We conducted a systematic reviewing using the PRISMA methodology. We searched PubMed, Global Index Medicus, and EMBASE for studies on 'breast cancer', 'breast neoplasm,' or 'screening, early detection, and early diagnosis' as well as key words related to the following barriers: religion, culture, health literacy, lack of knowledge/awareness/understanding, attitudes, fatalism/fear, shame/embarrassment, and physician gender from January 1, 2000 until September 1, 2016. Two independent reviewers screened both titles and abstracts. The application of inclusion and exclusion criteria yielded a final list of articles. A conceptual framework was used to guide the thematic analysis and examine health system barriers and enablers to breast cancer screening at the broader macro health system level, at the health provider level, and the individual level. The analysis was conducted globally and in the MENA region. RESULTS A total of 11,936 references were identified through the initial search strategy, of which 55 were included in the final thematic analysis. The results found the following barriers and enablers to access to breast cancer screening at the health system level, the health provider level, and the individual level: health system structures such as health insurance and care coordination systems, costs, time concerns, provider characteristics including gender of the provider, quality of care issues, medical concerns, and fear. In addition, the following seven barriers and enablers were identified at the health system or provider level as significantly impacting screening for breast cancer: (1) access to insurance, (2) physician recommendation, (3) physician gender, (4) provider characteristics, (5) having a regular provider, (6) fear of the system or procedure, and (7) knowledge of the health system. More specifically, the largest increased odds for having a mammogram was from having insurance, having a physician recommendation, type of provider (mainly gynecologist), and having regular contact with a physician. Clinical breast examinations were increased by having insurance and having regular contact with a physician. The eight studies identified from the MENA region identified barriers to breast cancer screening related to service quality, fear of pain and of cancer itself, female versus male provider, having a physician recommend the screen, cost issues as well as time and convenience of the services. CONCLUSIONS There are a number of system changes that can be made to remove barriers to breast cancer screening. Some of these system changes apply directly to MENA countries. A larger health system assessment of a country is warranted to determine which health system changes should be made to most efficiently and effectively improve access to breast cancer screening.
Collapse
Affiliation(s)
- D Bowser
- Brandeis University, Heller School for Social Policy and Management, 415 South Street, Waltham, MA, USA.
| | - H Marqusee
- Brandeis University, Heller School for Social Policy and Management, 415 South Street, Waltham, MA, USA
| | - M El Koussa
- Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave., Boston, MA, USA
| | - R Atun
- Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave., Boston, MA, USA
| |
Collapse
|
24
|
Islam RM, Billah B, Hossain MN, Oldroyd J. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review. Asian Pac J Cancer Prev 2017; 18:1751-1763. [PMID: 28749101 PMCID: PMC5648375 DOI: 10.22034/apjcp.2017.18.7.1751] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs.
Collapse
Affiliation(s)
- Rakibul M Islam
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
| | | | | | | |
Collapse
|
25
|
Moshki M, Shahgheibi S, Taymoori P, Moradi A, Roshani D, Holt CL. Psychometric properties of the mammography self-efficacy and fear of breast cancer scales in Iranian women. BMC Public Health 2017; 17:534. [PMID: 28569149 PMCID: PMC5452424 DOI: 10.1186/s12889-017-4404-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 05/09/2017] [Indexed: 11/30/2022] Open
Abstract
Background Research investigating mammography screening has often reported low mammography self-efficacy and breast cancer fear contribute to underutilization of mammography. This study aimed to examine the reliability and validity of Champion’s Mammography Self-efficacy Scale (CMSS) and Champion’s Breast Cancer Fear Scale (CBCFS) in a sample of Iranian women. Methods The adapted instruments were administered to a community sample of 482 women aged 40 years or older. They inhibited in Sanandaj, Iran. Cronbach’s α coefficients, item-total, and test-retest correlations were used to assess the reliability of the scales. Confirmatory factor analysis was applied to assess construct validity. Results The α coefficients for the Farsi 14-item CMSS and 8-item BCFS were .87 and.95, respectively. In terms of the CMSS confirmatory factor analysis, the proportion of x2/df was 2.4, Comparative Fit Index (CFI) = 0.93, Tucker Lewis Index (TLI) = 0.96 providing a strong fit to the data induced by two-factor model. With regard to CBCFS, x2/df was 86.33, CFI =0.99, and TLI =0.99 supporting one-factor model. Conclusion The CMSS and CBCFS exhibited strong initial psychometric properties; therefore, they are recommended to understand women’s breast cancer screening behaviors better.
Collapse
Affiliation(s)
- Mahdi Moshki
- Department of Public Health, School of Health Sciences; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shole Shahgheibi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Moradi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Deam Roshani
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Cheryl L Holt
- Department of Behavioral and Community Health, Center for Health Behavior Research, University of Maryland School of Public Health, Maryland, USA
| |
Collapse
|
26
|
Badihian S, Choi EK, Kim IR, Parnia A, Manouchehri N, Badihian N, Tanha JM, Guallar E, Cho J. Attitudes Toward Cancer and Cancer Patients in an Urban Iranian Population. Oncologist 2017; 22:944-950. [PMID: 28559414 DOI: 10.1634/theoncologist.2017-0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/18/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Because of the significant incidence and mortality of cancer in Iran, a Comprehensive National Cancer Control Program for the prevention and early detection of cancer was launched in 2007. However, cancer awareness and screening rates in Iran did not improve. This study aimed to evaluate public attitudes toward cancer and cancer patients in Iran. MATERIALS AND METHODS We conducted a cross-sectional survey among 953 non-institutionalized individuals in Isfahan, Iran, from November 2014 to February 2015. We collected data on attitudes toward cancer in three domains (impossibility of recovery, cancer stereotypes, and discrimination), as well as questions on willingness to disclose a cancer diagnosis. RESULTS Among all participants, 33.9% agreed that it is very difficult to regain one's health after a cancer diagnosis, 17.4% felt uncomfortable with a cancer patient, and 26.9% said that they would avoid marrying people whose family members had cancer. While 88.9% of study participants said that cancer patients deserve to be protected in society, 53.3% and 48.4% of participants agreed that they would not disclose a cancer diagnosis to neighbors and coworkers, respectively. CONCLUSION Negative attitudes with respect to impossibility of recovery and discrimination toward cancer and cancer patients were common among urban Iranians. Most people would not disclose a cancer diagnosis to others in spite of advancements in cancer diagnosis and treatment, reflecting unfavorable attitudes toward cancer and cancer patients in society. Successful implementation of cancer awareness and prevention programs in Iran may require social changes based on adequate information on cancer and cancer patients. IMPLICATIONS FOR PRACTICE Public attitudes toward cancer and cancer patients are an important factor affecting cancer control programs as well as quality of life and recovery of cancer patients. The issue has not been studied in Iran and the surrounding countries in the Middle East. This is the first report presented on the subject. These findings can be used by health policy makers, health managers, and clinicians for better practice.
Collapse
Affiliation(s)
- Shervin Badihian
- Students' Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Eun-Kyung Choi
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Im-Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Aidin Parnia
- Center of Excellence in Teaching and Learning Clinical Skills, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Navid Manouchehri
- Students' Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negin Badihian
- Faculty of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Jila M Tanha
- Department of Patient Education, The Learning Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eliseo Guallar
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute of Health Sciences and Technology SAIHST, Sungkyunkwan University, Seoul, Korea
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Juhee Cho
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Sungkyunkwan University, Seoul, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute of Health Sciences and Technology SAIHST, Sungkyunkwan University, Seoul, Korea
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
27
|
Alianmoghaddam N, Khoshnood K, Benn C, Kennedy HP, Lamyian M. Breast Cancer, Breastfeeding, and Mastectomy: A Call for More Research. J Hum Lact 2017; 33:454-457. [PMID: 27881730 DOI: 10.1177/0890334416678822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Kaveh Khoshnood
- 2 School of Public Health, Yale University, New Haven, CT, USA
| | - Cheryl Benn
- 1 School of Public Health, Massey University, Palmerston North, New Zealand
| | | | - Minoor Lamyian
- 4 Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
28
|
Polat P, Ersin F. The Effect of Breast Cancer Fear Levels of Female Seasonal Agricultural Laborers on Early-Diagnosis Behaviors and Perceptions of Breast Cancer. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:166-175. [PMID: 28253134 DOI: 10.1080/19371918.2015.1137525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to determine the effect of breast cancer fear levels of female seasonal agricultural laborers between ages 40 and 60 on breast cancer early-diagnosis behaviors and perceptions. This is a cross-sectional study. The data of the study were collected between February and September 2014 in Şanlıurfa, Turkey. A sample of the study group consisted of 350 women. The data were assessed by using SPSS 16.0 statistics package software. Descriptive statistics, t test, chi-square, and correlation analysis were used to analyze the data. Considering that breast cancer fear levels are effective on the breast cancer early-diagnosis behaviors and health beliefs, it can be recommended for the health care staff to carry out initiative works to reduce the fear levels.
Collapse
Affiliation(s)
- Perihan Polat
- a Adıyaman Üniversity, Adıyaman Education Research Hospital , Adıyaman , Turkey
| | - Fatma Ersin
- b Department of Community Health Nursing , Harran University School of Nursing , Şanlıurfa , Turkey
| |
Collapse
|
29
|
Hwang JJ, Donnelly TT, Ewashen C, McKiel E, Raffin S, Kinch J. Sociocultural Influences on Arab Women's Participation in Breast Cancer Screening in Qatar. QUALITATIVE HEALTH RESEARCH 2017; 27:714-726. [PMID: 26631675 DOI: 10.1177/1049732315619373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Breast cancer, the most common cancer among Arab women in Qatar, significantly affects the morbidity and mortality of Arab women largely because of low participation rates in breast cancer screening. We used a critical ethnographic approach to uncover and describe factors that influence Arab women's breast cancer screening practices. We conducted semistructured interviews with 15 health care practitioners in Qatar. Through thematic analysis of the data, we found three major factors influencing breast cancer screening practices: (a) beliefs, attitudes, and practices regarding women's bodies, health, and illness; (b) religious beliefs and a culturally sensitive health care structure; and (c) culturally specific gender relations and roles. Arab women's health practices cannot be understood in isolation from the sociocultural environment. The problem of low rates of breast cancer screening practices and supportive interventions must be addressed within the context and not be limited to the individual.
Collapse
Affiliation(s)
| | | | | | | | | | - Janice Kinch
- 1 University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
30
|
Effects of a Randomized Controlled Trial to Increase Repeat Mammography Screening in Iranian Women. Cancer Nurs 2017; 33:309-15. [PMID: 25122130 DOI: 10.1097/ncc.0000000000000185] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although mammography use has increased in developed countries, regular screening in developing countries including Iran remains low. Multiple frameworks, including the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), have been used to understand screening practices among Iranians. The HBM includes intrapersonal constructs such as perceptions of breast cancer and mammography. The TPB includes interpersonal and environmental constructs, such as perceived control and subjective norms. OBJECTIVES The current study had 2 objectives: (1) to examine changes in the HBM and TPB constructs and repeat mammography screening in women receiving either intervention and women in the control group and (2) to compare changes in the HBM and TPB constructs and repeat mammography screening across the 2 interventions. METHODS One hundred eight-four women from 3 randomly selected health centers in Sanandaj, Iran, participated. Eligibility criteria were being 50 years or older, having received a mammogram in the past 2 to 3 years, and no intention to obtain a mammogram within the next year. RESULTS The TPB and HBM participants exhibited greater changes in the HBM and TPB constructs and were more likely to have a mammogram relative to control participants. The TPB and HBM participants exhibited comparable changes in constructs and repeat mammography. CONCLUSION Findings suggest both interventions equally improved mammography screening. Additional studies are furthermore warranted to address nonadherent Iranian women's needs in line with these conceptual models. IMPLICATIONS FOR PRACTICE Use of the HBM and TPB constructs in clinical practice may be helpful to promote continued screening among this population.
Collapse
|
31
|
Abstract
Similar to other Middle Eastern countries, breast cancer is the most common cancer among women in Qatar with increasing incidence and mortality rates. High mortality rates of breast cancer in the Middle Eastern countries are primarily due to delayed diagnosis of the disease. Thus screening and early detection of breast cancer are important in reducing cancer morbidity and mortality. With the aim of updating knowledge on existing interventions and developing effective intervention programs to promote breast cancer screening in Arabic populations in Qatar, this review addresses the question: What interventions are effective in increasing breast cancer knowledge and breast cancer screening rates in Arabic populations in Arabic countries and North America? Systematic literature review was performed to answer the proposed question. As the result of the search, six research studies were identified and appraised. From the findings, we infer several insights: (a) a language-appropriate and culturally sensitive educational program is the most important component of a successful intervention regardless of the study setting, (b) multi-level interventions that target both women, men, health care professionals, and/or larger health care system are more likely to be successful than single educational interventions or public awareness campaigns, and (c) more vigorous, personal and cognitive interventions that address psychosocial factors are likely to be more effective than less personal and informative interventions. This review has important implications for health care providers, intervention planners, and researchers.
Collapse
Affiliation(s)
- Tam Truong Donnelly
- University of Calgary-Qatar, Doha, Qatar
- Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB Canada
| | - Jasmine Hwang
- Faculty of Nursing, University of Calgary, 23 Edgeland Close NW, Calgary, AB Canada
| |
Collapse
|
32
|
Dey S, Sharma S, Mishra A, Krishnan S, Govil J, Dhillon PK. Breast Cancer Awareness and Prevention Behavior Among Women of Delhi, India: Identifying Barriers to Early Detection. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2016; 10:147-156. [PMID: 27789957 PMCID: PMC5074580 DOI: 10.4137/bcbcr.s40358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Globally, breast cancer (BC) has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC. METHODS A total of 20 focus group discussions (FGDs) were conducted during May 2013–March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted of an average of ~10 women (aged ≥18–70 years) who came to participate in a BC awareness workshop. All FGDs were audio taped and transcribed verbatim. The transcripts were inductively analyzed using ATLAS.ti. Based on emerged codes and categories, thematic analysis was done, and theory was developed using the grounded theory approach. RESULTS Data were analyzed in three major themes: i) knowledge and perception about BC; ii) barriers faced by women in the early presentation of BC; and iii) healthcare-seeking behavior. The findings revealed that shyness, fear, and posteriority were the major behavioral barriers in the early presentation of BC. Erroneously, pain was considered as an initial symptom of BC by most women. Financial constraint was also mentioned as a cause for delay in accessing treatment. Social stigma that breast problems reflect bad character of women also contributed in hiding BC symptoms. CONCLUSIONS Lack of BC awareness was prevalent, especially in low socioeconomic class. Women’s ambivalence in prioritizing their own health and social and behavioral hurdles should be addressed by BC awareness campaigns appropriately suited for various levels of social class.
Collapse
Affiliation(s)
- Subhojit Dey
- Associate Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Surabhi Sharma
- Senior Research Assistant, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Arti Mishra
- Program Coordinator, State Health Resource Centre, Raipur, Chattisgarh, India
| | - Suneeta Krishnan
- Country Director, Research Triangle Institute Global Pvt. Limited, Shakarpur, New Delhi, India
| | - Jyotsna Govil
- Honorary Secretary, Indian Cancer Society, Siri Fort, New Delhi, India
| | - Preet K Dhillon
- Epidemiologist, Senior Scientific Officer, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| |
Collapse
|
33
|
Hashemi-Ghasemabadi M, Taleghani F, Kohan S, Yousefy A. Living under a cloud of threat: the experience of Iranian female caregivers with a first-degree relative with breast cancer. Psychooncology 2016; 26:625-631. [PMID: 27328629 DOI: 10.1002/pon.4198] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 06/09/2016] [Accepted: 06/18/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUNDS Breast cancer is a global threat to all women, especially those having close relatives with breast cancer. Women who were caregivers to relatives with breast cancer are more vulnerable to stress caused by the perception of heightened risk of cancer. Because health measures and breast health are affected by cultural beliefs and social status, information about breast cancer should consider the cultural beliefs and values of the society. OBJECTIVES This study explored the experiences of Iranian women who were caregivers to relatives with breast cancer. METHODS In this qualitative content analysis study, 21 female caregivers of breast cancer patients were chosen by purposive sampling. Data were collected through interviews and analyzed using content analysis. RESULTS Data analysis developed 3 categories: perception of the concept of risk, changing views about femininity, and management of perceived threat. Perception of the risk of breast cancer increased in caregivers, and they tried to manage the perceived threat. They considered the breast to be an important part of women's lives, and breast cancer in relatives changed their view of femininity. CONCLUSION Understanding the experiences of breast cancer family caregivers in different cultures can help in planning, counseling, and effective intervention.
Collapse
Affiliation(s)
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education Research Center, Department of Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
34
|
Lamyian M. Improving early detection behavior in women at risk of breast cancer: persuasion-based health monitoring model. Climacteric 2016; 19:409-10. [DOI: 10.1080/13697137.2016.1193138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Lamyian
- Associate Professor, Tarbiat Modares University, Iran, and Visiting Scholar, School of Public Health, Yale University
| |
Collapse
|
35
|
Khodayarian M, Mazloomi-Mahmoodabad SS, Lamyian M, Morowatisharifabad MA, Tavangar H. Response costs of mammography adherence: Iranian women's perceptions. Health Promot Perspect 2016; 6:85-91. [PMID: 27386423 PMCID: PMC4932227 DOI: 10.15171/hpp.2016.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background: Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. Methods: A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). Results: One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Conclusion: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women’s awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.
Collapse
Affiliation(s)
- Mahsa Khodayarian
- Department of Health Education & Promotion, Shahid Sadoughi University of Medical Sciences (International Campus), Yazd, Iran
| | | | - Minoor Lamyian
- Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Ali Morowatisharifabad
- Department of Health Education & Promotion, Shahid Sadoughi University of Medical Sciences (International Campus), Yazd, Iran
| | - Hossein Tavangar
- Department of Nursing & Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
36
|
Surbone A, Baider L. Are oncologists accountable only to patients or also to their families? An international perspective. Am Soc Clin Oncol Educ Book 2016:e15-9. [PMID: 24451822 DOI: 10.14694/edbook_am.2012.32.307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In most societies, health professionals traditionally carry responsibility only toward their patients. However, this is not the case in all cultures. In the contemporary practice of oncology in Western cultures, there is a shift toward assuming broader responsibility for patients with cancer' families during the illness course, the grieving stage, and in cancer prevention and genetic counseling. Traditional family, community, and religious values play a central role in determining people's perceptions and attitudes toward life and death as well as toward caregiving for a sick relative. The meaning of cancer illness within the family culture is thus influenced not only by each individual's values and beliefs but also by the family's makeup and dynamics, as well as their taboos and secrets. Global cancer care should therefore be directed at the family as a unit, while respecting patient autonomy and privacy. This reappraisal of our traditional understanding of physicians' duty as solely directed at the patient is reflected in the recent US trend toward a patient- and family-centered care approach. An additional challenge for oncology professionals is to integrate and tailor interventions toward the needs of both care recipients and caregivers and relate it to this dyad as the basic and enduring unit of care.
Collapse
Affiliation(s)
- Antonella Surbone
- From the Department of Medicine, New York University Medical School, New York, NY; and the Hebrew University Medical School, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel
| | - Lea Baider
- From the Department of Medicine, New York University Medical School, New York, NY; and the Hebrew University Medical School, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel
| |
Collapse
|
37
|
Khazaee-pool M, Majlessi F, Foroushani AR, Montazeri A, Nedjat S, Shojaeizadeh D, Tol A, Salimzadeh H. Perception of breast cancer screening among Iranian women without experience of mammography: a qualitative study. Asian Pac J Cancer Prev 2016; 15:3965-71. [PMID: 24935582 DOI: 10.7314/apjcp.2014.15.9.3965] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Iran, there are high rates of breast cancer. It is among the five most common cancers, the first among cancers diagnosed, and is the leading cause of cancer deaths among Iranian women. OBJECTIVES The purpose of this qualitative study was to explore perception of breast cancer screening among Iranian women who have never had a mammograph. MATERIALS AND METHODS The current study was part of a qualitative research conducted by means of content analysis method and purposive sampling of 16 women over the age of 30 years who had not undergone mammography using individual semi-structured interviews. Interviews were recorded and transcribed verbatim. The data were under continuous consideration and comparative analysis in order to achieve data saturation. RESULTS After codification of data, three concept categories were achieved including: i) low awareness, ii) worries, and iii) lack of motivation. CONCLUSIONS Although there is a tendency among Iranian women to participate in breast cancer screening, there is a powerful cultural belief that breasts are sexual organs that should not be discussed publicly. Due to the incidence of breast cancer in Iranian women, it is critical that breast awareness education be performed by health care experts to explore the concepts of breast cancer and breast cancer screening.
Collapse
Affiliation(s)
- Maryam Khazaee-pool
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran E-mail :
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Mermer G, Nazli A, Ceber E, Mermer G. Social Perceptions of Breast Cancer by Women Still Undergoing or Having Completed Therapy: a Qualitative Study. Asian Pac J Cancer Prev 2016; 17:503-10. [PMID: 26925635 DOI: 10.7314/apjcp.2016.17.2.503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Gulengul Mermer
- Ege University Faculty of Nursing, Public Health Nursing Department, Bornova, Izmir, Turkey E-mail :
| | | | | | | |
Collapse
|
39
|
Farhadifar F, Molina Y, Taymoori P, Akhavan S. Mediators of repeat mammography in two tailored interventions for Iranian women. BMC Public Health 2016; 16:149. [PMID: 26874508 PMCID: PMC4752754 DOI: 10.1186/s12889-016-2808-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 02/01/2016] [Indexed: 12/29/2022] Open
Abstract
Background Many theory-based interventions exist that incorporate theoretical constructs (e.g., self-efficacy, behavioral control) believed to increase the likelihood of mammography. Nonetheless, little work to date has examined if increased screening among women receiving such interventions occurs due to changes in these targeted constructs. The aim of this study is to address this gap in the literature in the context of two interventions for improving regular screening among Iranian women. Methods A sample of 176 women over 50 years old in Tehran, Iran were randomly allocated into one of these three conditions: 1) an intervention based on Health Belief Model (HBM); 2) an intervention based on an integration of the HBM and selected constructs from the TPB (TPB); and 3) a control group (CON). Questionnaires were administered before the intervention and after a 6-month follow-up. The Preacher and Hayes method of mediation was used in analytic models. Results Changes in susceptibility, self-efficacy, and perceived control appeared to mediate HBM-CON differences in screening. Barriers attenuated the mediating effect of self-efficacy. Changes in barriers and self-efficacy appeared to mediate TPB-CON differences in screening. Conclusion This study was successful in identifying which theory-based constructs appear to underlie the effectiveness of HBM- and TPB-based interventions. Specific constructs have been identified that should be targeted in clinical practice to increase mammography practices among Iranian women.
Collapse
Affiliation(s)
- Fariba Farhadifar
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yamile Molina
- Community Health Sciences, School Of Public Health, University of Illinois-Chicago, Chicago, USA
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Setareh Akhavan
- Tehran University of Medical Sciences, Imam Khomini Complex Hospital, Valiasr Hospital, Gynecology Oncology Ward, Tehran, Iran
| |
Collapse
|
40
|
Azami-Aghdash S, Ghojazadeh M, Sheyklo SG, Daemi A, Kolahdouzan K, Mohseni M, Moosavi A. Breast Cancer Screening Barriers from the Womans Perspective: a Meta-synthesis. Asian Pac J Cancer Prev 2016; 16:3463-71. [PMID: 25921163 DOI: 10.7314/apjcp.2015.16.8.3463] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the womans perspective. MATERIALS AND METHODS In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Programme (CASP) tool was used. RESULTS From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. CONCLUSIONS Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening.
Collapse
Affiliation(s)
- Saber Azami-Aghdash
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran E-mail : dr_ahmad_
| | | | | | | | | | | | | |
Collapse
|
41
|
Haghighi ST, Lamyian M, Granpaye L. Assessment of the level of health literacy among fertile Iranian women with breast cancer. Electron Physician 2015; 7:1359-64. [PMID: 26516442 PMCID: PMC4623795 DOI: 10.14661/1359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 09/11/2015] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Health literacy is one of the main determinants of health promotion. Regarding the influential role of the women in a society, enhancing their critical health literacy would be a prerequisite for the promotion of public health. The aims of this study were to determine the level of health literacy among fertile Iranian women with breast cancer and to determine the relationship between the health literacy level and socio demographic factors, such as age, educational level, occupation, age of marriage, duration of marriage, and several clinical factors, including taking psychiatric medication and the type of breast surgery among breast cancer patients. METHODS This cross-sectional study was conducted on 260 fertile patients with breast cancer from screening and monitoring centers and breast cancer clinics in Tehran from August 2014 to August 2015. Data were collected using socio demographic and clinical questionnaires developed by the researchers and the questionnaire for health literacy for Iranian adults (HELIA).The results were analyzed using SPSS-IBM version 20 and the Pearson product-moment correlation coefficient, along with Kido's correlation test. RESULTS The mean age of the participants was 43.32. Most of the participants (68.5%) had high school diplomas or lower school degrees (based on educational system in Iran). The mean score of health literacy was 75.73. The levels of health literacy among the different groups of participants were as follows: insufficient health literacy (6.9% of patients), barely enough health literacy (18.8% of patients), enough health literacy (38.8% of patients) and excellent health literacy (35.1% of patients). Also, significant relationships were found between the level of health literacy and the participants' age of marriage, duration of marriage, educational level, and occupation (p < 0.05). CONCLUSION This study showed that the level of health literacy was high among women with breast cancer. This indicates that their high level of health literacy might be used as a contributor to the promotion of the public health in terms of awareness about breast cancer.
Collapse
Affiliation(s)
- Soheila Tontab Haghighi
- M.Sc. of Midwifery, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Minoor Lamyian
- Ph.D. of Health Education, Associate Professor, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Loabat Granpaye
- Specialist of General Surgery, Assistant Professor, Department of General Surgery, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
42
|
Donnelly TT, Al Khater AH, Al Kuwari MG, Al-Bader SB, Abdulmalik M, Al-Meer N, Singh R, Fung T. Addressing Factors Associated with Arab Women's Socioeconomic Status May Reduce Breast Cancer Mortality: Report from a Well Resourced Middle Eastern Country. Asian Pac J Cancer Prev 2015; 16:6303-9. [PMID: 26434834 DOI: 10.7314/apjcp.2015.16.15.6303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Differences in socioeconomic status (SES) such as income levels may partly explain why breast cancer screening (BCS) disparities exist in countries where health care services are free or heavily subsidized. However, factors that contribute to such differences in SES among women living in well resourced Middle East countries are not fully understood. This quantitative study investigated factors that influence SES and BCS of Arab women. Understanding of such factors can be useful for the development of effective intervention strategies that aim to increase BCS uptake among Arab women. Using data from a cross-sectional survey among 1,063 Arabic-speaking women in Qatar, age 35+, additional data analysis was performed to determine the relationship between socioeconomic indicators such as income and other factors in relation to BCS activities. This study found that income is determined and influenced by education level, occupation, nationality, years of residence in the country, level of social activity, self-perceived health status, and living area. Financial stress, unemployment, and unfavorable social conditions may impede women's participation in BCS activities in well resourced Middle East countries.
Collapse
Affiliation(s)
- Tam Truong Donnelly
- Community Health Sciences, Nursing and Medicine, University of Calgary, Calgary, Canada E-mail :
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Khani Jeihooni A, Kashfi SM, Bahmandost M, Kashfi SH. The Survey of Factors Affecting Pap Smears Based on Health Belief Model in Health Centers in Fasa, Fars Province, Iran. WOMEN’S HEALTH BULLETIN 2015. [DOI: 10.17795/whb-25565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
44
|
Taymoori P, Berry T, Roshani D. Differences in health beliefs across stage of adoption of mammography in Iranian women. Cancer Nurs 2015; 37:208-17. [PMID: 23624601 DOI: 10.1097/ncc.0b013e31829194bc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. OBJECTIVES The aims of this study were to (a) examine the relationships between related beliefs and (b) to determine to what extent women in stages of mammography adoption differ in their agreement of individual perceived health beliefs. METHODS A sample of 686 Iranian women completed a questionnaire including selected constructs of the Health Belief Model and stages of mammography adoption. RESULTS Proportions of participants who were in the preadoption and adoption stages were 75% and 17.8%, respectively. Precontemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than did those in other adoption stages. In terms of specific items, women in the relapse and maintenance stages endorsed greatest agreement for the barrier items "not knowing how to get a mammogram" and "forget to schedule," respectively. Common barriers for women in preadoption stages were being painful, taking much time, and embarrassing. CONCLUSION Iranian women are less likely than other Asian women to be in the maintenance and action stages. Identifying the associations between perceived related beliefs items and stages of mammography adoption may provide detailed information to allow for future research and guide the development of interventions not only for Iranian women but also for similar cultural and immigrant groups that have been neglected to date in the breast cancer literature. IMPLICATIONS FOR PRACTICE Examining the interactions between perceived related beliefs items and other beliefs such as perceived control and self-efficacy to having a mammography is warranted.
Collapse
Affiliation(s)
- Parvaneh Taymoori
- Author Affiliations: Kurdistan Research Center for Social Determinants of Health, School of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Taymooi); Department of Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada (Dr Berry); and Kurdistan Research Center for Social Determinants of Health, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Roshani)
| | | | | |
Collapse
|
45
|
Jafari-Koshki T, Mansourian M, Mokarian F. Exploring factors related to metastasis free survival in breast cancer patients using Bayesian cure models. Asian Pac J Cancer Prev 2015; 15:9673-8. [PMID: 25520087 DOI: 10.7314/apjcp.2014.15.22.9673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is a fatal disease and the most frequently diagnosed cancer in women with an increasing pattern worldwide. The burden is mostly attributed to metastatic cancers that occur in one-third of patients and the treatments are palliative. It is of great interest to determine factors affecting time from cancer diagnosis to secondary metastasis. MATERIALS AND METHODS Cure rate models assume a Poisson distribution for the number of unobservable metastatic-component cells that are completely deleted from the non-metastasis patient body but some may remain and result in metastasis. Time to metastasis is defined as a function of the number of these cells and the time for each cell to develop a detectable sign of metastasis. Covariates are introduced to the model via the rate of metastatic-component cells. We used non-mixture cure rate models with Weibull and log-logistic distributions in a Bayesian setting to assess the relationship between metastasis free survival and covariates. RESULTS The median of metastasis free survival was 76.9 months. Various models showed that from covariates in the study, lymph node involvement ratio and being progesterone receptor positive were significant, with an adverse and a beneficial effect on metastasis free survival, respectively. The estimated fraction of patients cured from metastasis was almost 48%. The Weibull model had a slightly better performance than log-logistic. CONCLUSIONS Cure rate models are popular in survival studies and outperform other models under certain conditions. We explored the prognostic factors of metastatic breast cancer from a different viewpoint. In this study, metastasis sites were analyzed all together. Conducting similar studies in a larger sample of cancer patients as well as evaluating the prognostic value of covariates in metastasis to each site separately are recommended.
Collapse
Affiliation(s)
- Tohid Jafari-Koshki
- Department of Biostatistics, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran. E-mail :
| | | | | |
Collapse
|
46
|
Hassan N, Ho WK, Mariapun S, Teo SH. A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study. BMC Public Health 2015; 15:548. [PMID: 26065413 PMCID: PMC4465302 DOI: 10.1186/s12889-015-1892-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/29/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk. METHODS We conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening. RESULTS Although Malaysia comprises 54.5% Malay, 24.5% Chinese and 7.3% Indian, the majority of women in the MyMammo Study were Chinese (70.1%) and 99.2% had a <2% ten-year risk of breast cancer. The most commonly cited barriers were the perception of not being at risk and fear of painful mammography. We found that highly educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors. CONCLUSIONS Taken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.
Collapse
Affiliation(s)
- Norhashimah Hassan
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Weang Kee Ho
- Department of Applied Mathematics, Faculty of Engineering, University of Nottingham Malaysia Campus, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - Shivaani Mariapun
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Soo Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
| |
Collapse
|
47
|
Taymoori P, Moshki M, Roshani D. Facilitator psychological constructs for mammography screening among Iranian women. Asian Pac J Cancer Prev 2015; 15:7309-16. [PMID: 25227834 DOI: 10.7314/apjcp.2014.15.17.7309] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. MATERIALS AND METHODS A sample population of 184 women over 50 years old in Sanandaj, Iran, was selected for an experiment. Participants were randomly allocated into one of the three conditions: 1) an intervention based on the Health Belief Model (HBM) 2) an intervention based on an integration of the HBM and selected constructs from the Theory of Planned Behavior (TPB), and 3) a control group. Constructs were measured before the intervention, and after a 6-month follow-up. RESULTS Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Perceived susceptibility, severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. CONCLUSIONS This study was successful in establishing mediation in a sample of women. Our findings enrich the literature on mammography repeat, indicating key intervention factors, and relegating redundant ones in the Iranian populations. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted.
Collapse
Affiliation(s)
- Parvaneh Taymoori
- Kurdistan Environmental Health Research Center, School of Medicine, Kurdistan University of Medical Sciences, Kurdistan, Iran E-mail :
| | | | | |
Collapse
|
48
|
Donnelly TT, Al Khater AH, Al Kuwari MG, Al-Bader SB, Al-Meer N, Abdulmalik M, Singh R, Chaudhry S, Fung T. Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar? BMJ Open 2015; 5:e005596. [PMID: 25613951 PMCID: PMC4305075 DOI: 10.1136/bmjopen-2014-005596] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. SETTING A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses. RESULTS Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. CONCLUSIONS Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. RECOMMENDATIONS Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women.
Collapse
Affiliation(s)
| | | | | | | | - Nabila Al-Meer
- Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
| | - Mariam Abdulmalik
- Department of Primary Health Care, Qatar Supreme Council of Health, Doha, Qatar
| | - Rajvir Singh
- Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
| | | | - Tak Fung
- University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
49
|
Kobeissi L, Samari G, Telesca D, Esfandiari M, Galal O. The impact of breast cancer knowledge and attitudes on screening and early detection among an immigrant Iranian population in southern California. JOURNAL OF RELIGION AND HEALTH 2014; 53:1759-1769. [PMID: 24096382 PMCID: PMC3999292 DOI: 10.1007/s10943-013-9778-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Few studies explored factors influencing breast cancer screening and early detection behaviors among immigrant Iranian women residing in the USA. Using a cross-sectional survey, a convenience sample of 319 Iranian American women was selected to investigate the impact of breast cancer knowledge and attitude on screening. A self-administered questionnaire assessed breast cancer screening knowledge, attitude, and mammography use (ever, previous year, and future intention). 79 % of the women in the study reported ever receiving at least one mammogram and 74 % received a mammogram in the past year. Personal attitude had an independent significant effect on: mammography use in the last year, ever use of mammography, and future intention to screen. Knowledge and morality-induced attitude influenced screening behavior but not significantly. Interventions targeting breast cancer screening among immigrant Iranian women in the USA should focus on enhancing personal attitudes in order to influence actual screening behavior.
Collapse
Affiliation(s)
- L Kobeissi
- Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1250 N Martin Avenue, Tucson, AZ, 85724, USA,
| | | | | | | | | |
Collapse
|
50
|
Jafari-Koshki T, Schmid VJ, Mahaki B. Trends of breast cancer incidence in Iran during 2004-2008: a Bayesian space-time model. Asian Pac J Cancer Prev 2014; 15:1557-61. [PMID: 24641367 DOI: 10.7314/apjcp.2014.15.4.1557] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most frequently diagnosed cancer in women and estimating its relative risks and trends of incidence at the area-level is helpful for health policy makers. However, traditional methods of estimation which do not take spatial heterogeneity into account suffer from drawbacks and their results may be misleading, as the estimated maps of incidence vary dramatically in neighboring areas. Spatial methods have been proposed to overcome drawbacks of traditional methods by including spatial sources of variation in the model to produce smoother maps. MATERIALS AND METHODS In this study we analyzed the breast cancer data in Iran during 2004-2008. We used a method proposed to cover spatial and temporal effects simultaneously and their interactions to study trends of breast cancer incidence in Iran. RESULTS The results agree with previous studies but provide new information about two main issues regarding the trend of breast cancer in provinces of Iran. First, this model discovered provinces with high relative risks of breast cancer during the 5 years of the study. Second, new information was provided with respect to overall trend trends o. East-Azerbaijan, Golestan, North-Khorasan, and Khorasan-Razavi had the highest increases in rates of breast cancer incidence whilst Tehran, Isfahan, and Yazd had the highest incidence rates during 2004-2008. CONCLUSIONS Using spatial methods can provide more accurate and detailed information about the incidence or prevalence of a disease. These models can specify provinces with different health priorities in terms of needs for therapy and drugs or demands for efficient education, screening, and preventive policy into action.
Collapse
Affiliation(s)
- Tohid Jafari-Koshki
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran E-mail :
| | | | | |
Collapse
|