Spiritual needs and their associated psychosocial factors among women with breast cancer: A cross-sectional study

AIMS

Guided by the biopsychosocial-spiritual model, this study aimed to evaluate the spiritual needs of Chinese women with breast cancer and explored factors associated with those spiritual needs.

DESIGN

This study has a cross-sectional design.

METHODS

This cross-sectional study involved 228 breast cancer patients in China, between May 2019 and July 2019. Data were collected using the general information form, the Spiritual Needs Scale, the Perceived Social Support Scale and the Hospital Anxiety and Depression Scale. Data were analysed by Spearman correlation analysis, univariate analysis and multiple linear regression, and a structural equation model (SEM) was constructed by maximum likelihood estimation.

RESULTS

There was a slightly higher average score for spiritual needs. Of the five dimensions of spiritual needs, those with the highest and lowest levels were 'meaning and purpose' and 'relationship with transcendence' respectively. Religion, time since confirmed diagnosis and education level were related to spiritual needs. The proposed model linking spiritual needs perceived social support, anxiety, and depression revealed a satisfactory fit to the data. Specifically, a higher level of social support predicted lower levels of anxiety and depression, which in turn predicted stronger spiritual needs.

CONCLUSIONS

The spiritual needs of breast cancer patients were associated with individual characteristics and psychosocial elements. Patients' spiritual needs should therefore be effectively evaluated, especially the needs of those who are not religious. Furthermore, comprehensive, needs-tailored interventions that incorporate spiritual, biological, psychological and social support should be formulated.

IMPACT

Nurses should become more aware of the spiritual needs of breast cancer patients, incorporate a spiritual focus into their care and develop comprehensive needs tailored to their characteristics as well as interventions based on biopsychosocial factors.

Psychometric Features of the Turkish Version of the Cancer Rehabilitation Evaluation System-Short Form for Patients with Cancer

BACKGROUND AND PURPOSE

The Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) is one of the first self-report measurement tools that addresses problems and rehabilitation needs of patients with cancer. This study aimed to examine the validity and reliability of the CARES-SF for Turkish-speaking patients with cancer.

METHODS

The Turkish version of the CARES-SF was administered to 300 patients with colorectal, lung, or breast cancer.

RESULTS

While the first six factors of the Turkish CARES-SF covered the same spectrum as the original scale's subscales, the present study suggests dividing the original psychosocial factors into two subscales: psychological and social (relatives and friends).

CONCLUSIONS

This preliminary inquiry on the Turkish CARES-SF confirmed the validity and reliability of the original scale except for the shifting of a few items between subsections.

Becoming a family caregiver of a patient living with cancer

BACKGROUND

There is insufficient information on how the burden of caregiving is affected when the family caregiver is a health professional. Studies are needed to investigate this issue.

AIMS

The purpose of this study was to reveal difficulties experienced by a nurse family caregiver offering care to a family member diagnosed with end-stage cancer and how she coped with these difficulties.

METHODS

This was an autoethnographic study.

FINDINGS

Findings were grouped under three headings: being both a researcher and a subject; effects of caregiving; and coping.

CONCLUSIONS

Offering care to a cancer patient has many physiological and psychological effects. If a family caregiver is a health professional, his/her caregiving burden can be even higher. Cultural values affect both life and coping ways of caregivers. It should be kept in mind that family caregivers need support from health professionals whatever their occupations are. Support to caregivers plays an important role in their coping.

The Effects of Cognitive-Behavioral Stress Management for Breast Cancer Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BACKGROUND

Treatment for breast cancer can be stressful for patients. Cognitive-behavioral stress management (CBSM) interventions aim to improve patients' skills in coping with stress and buffer against the negative effects of cancer.

OBJECTIVES

This meta-analysis aimed to demonstrate the impact of CBSM on breast cancer patients.

METHODS

We searched PubMed, EMBASE, the Cochrane Database, ScienceDirect, MEDLINE, CENTRAL, CINAHL, and PsycNET for randomized controlled trials (RCTs) published up to November 21, 2017. We then performed a meta-analysis of RCTs that compared CBSM for patients with breast cancer with a 1-day psychoeducation seminar, wait-list controls, or standard care.

RESULTS

Eighteen RCTs with 2564 participants were ultimately included. The results showed that CBSM can increase Measure of Current Status relaxation scores, benefit finding, and positive affect and decrease serum cortisol, anxiety, depression, thought avoidance and intrusion, and negative mood. However, it appears to have no effect on stress or mood disturbance.

CONCLUSIONS

Cognitive-behavioral stress management appears to be beneficial for breast cancer patients. Further high-quality RCTs are needed to clarify if any other factors are influenced by CBSM intervention.

IMPLICATIONS FOR PRACTICE

Cognitive-behavioral stress management can help breast cancer patients develop skills to increase relaxation, benefit finding, and positive affect; CBSM may provide a buffer against the negative effects of cancer. Further, CBSM may help breast cancer patients replace negative thoughts, improve their thought processes and behaviors, and maintain social support using cognitive and interpersonal coping skills. Nurses should be aware of the benefits of CBSM in their day-to-day care of breast cancer patients.

Sexuality in Muslim Women With Gynecological Cancer

BACKGROUND

Sexuality is a multidimensional subject that can be negatively affected after a diagnosis of gynecological cancer.

OBJECTIVE

The aim of this study was to reveal what sexuality difficulties Muslim women with gynecological cancers experience and how they overcome them.

INTERVENTIONS/METHODS

A qualitative approach was used. Data were gathered through semistructured interviews and analyzed by using a content analysis method. Eighteen Muslim women with gynecological cancers participated in the study.

RESULTS

The study findings were grouped into 3 major categories: situations that make sexual life difficult, impact of cancer on sexual life, and coping.

CONCLUSIONS

Women with gynecological cancers experience sexual reluctance, orgasmic incapacity, lack of enjoyment of sexual intercourse, and decreased frequency of sexual intercourse. In individuals with cancer, social support is important to facilitate coping; however, some women do not receive sufficient support. Women who consider sexuality to be a taboo topic and feel shame about asking sexuality-related questions are not likely to seek or receive relevant information from health professionals.

IMPLICATIONS FOR PRACTICE

Health professionals should provide information to women diagnosed with gynecological cancers about changes that they are likely to experience in their bodies and possible difficulties in sexuality. These women should be encouraged to talk about their sexual problems, and religious and cultural differences should be reflected in their cancer care.

Comparison of Illness Concepts and Coping Strategies among Cancer Patients of Turkish and German Origin

BACKGROUND

The aim of this study was to compare illness concepts and coping strategies among native German cancer patients and those with a Turkish migration background.

METHODS

Guideline-based, semi-structured interviews were conducted with 11 German (♂: 8, ♀: 3) and 11 Turkish (♂: 2, ♀: 9) cancer patients. The transcripts were evaluated using a qualitative content analysis in accordance with Mayring.

RESULTS

We identified eight categories of illness concepts: stressful life events, environmental influences, the will of God, medical factors, fate, trauma, health behaviour, and psychological causes. German patients frequently attributed their illness to environmental influences, persistent stress, or medical factors, whereas Turkish patients blamed persistent stress, the will of God, or trauma. The last two categories are not found among German patients. We classified the coping strategies into 11 main categories: social support, activity, patient competence, fighting spirit/positive thinking, use of health services/alternative healing methods, lifestyle, emotional coping, cognitive coping, religious coping, spiritual coping, and culture-specific methods for patients of Turkish origin. For German patients, activities as well as social support played primary roles in coping. Turkish patients also often used social support. However, in contrast to the German patients, they are less active and use much more religious coping and culture-specific means. In addition, negative emotions occur more often when processing the illness than in the German patients.

CONCLUSION

Common illness representations and coping strategies could be found for Turkish and German patients, but also specific ones for the respective group. It is particularly noticeable that German patients attach more importance to medical factors and try more actively to cope with the illness. For Turkish patients, cultural and religious factors play an important role, which should also be considered in treatment.

Perceptions of non-Western immigrant women on having breast cancer and their experiences with treatment-related changes in body weight and lifestyle: A qualitative study

BACKGROUND

The number of non-Western immigrants with breast cancer in the Netherlands has increased over the past decades and is expected to triple by 2030. Due to insufficient representation in clinical studies, it is unclear what the specific experiences and needs of these women are. Understanding how culture and religion affect these women's experience of breast cancer and how they deal with chemotherapy and treatment-related changes in body weight and lifestyle is crucial for health care professionals to be able to provide effective support.

METHODS

A qualitative study was conducted using semi-structured interviews with 28 immigrant women with a history of breast cancer treated with chemotherapy.

RESULTS

Women often associated breast cancer with taboo, death or bad luck. Religion offered these women guidance, strength and meaning to the disease, but also limited the women to openly talk about their disease. Women perceived lifestyle factors to have little influence on the development and treatment of cancer. After treatment, however, their thinking changed and these lifestyle factors became of paramount importance to them. They realised that they missed out on information about managing their own diet, exercise and body weight and were eager to share their experiences with other women in their culture with newly diagnosed breast cancer.

CONCLUSION

Women became aware during and after breast cancer treatment that it was difficult for them to actively deal with their illness under the influence of their culture and religion. Based on their own experiences and acquired knowledge, they would like to give advice to newly diagnosed women on how to deal with breast cancer within their own culture and religion. Their recommendations could be used by mosques, churches, support groups and health care professionals, to ensure interventions during breast cancer treatment meet their religious and cultural needs and thus improve their quality of life.

Role of stress, age and adjuvant therapy in the cognitive function of patients with breast cancer

According to data largely obtained from retrospective studies, it has been postulated that chemotherapy exerts an aggravating effect on the cognitive function of patients with breast cancer. Potential individual factors related to the effects of chemotherapy on cognitive function have been indicated, such as age-related cognitive dysfunction and stress. Elderly patients differ from non-elderly patients as regards higher cognitive related comorbidities, such as dementia, as well as regarding lower stress levels, indicating that 'chemobrain' may differentially affect these two age groups. The aim of this review was to discuss the effects of stress and chemotherapy on cognitive dysfunction and identify any potential age-related differences in patients with breast cancer treated with adjuvant chemotherapy. For this purpose, a systematic review of the literature was carried out on the PubMed, Scopus and Web of Science databases. The inclusion criteria were original articles published in peer-reviewed journals, elderly and non-elderly patients with breast cancer, reporting on stress and at least one cognitive parameter pre- and/or post-treatment. Eight studies met the preset criteria and were further analyzed. In total, the data of 1,253 women were included, of whom 800 patients with breast cancer were treated with surgery only, systemic treatment only, or both. Although all the studies included a non-elderly breast cancer patient subpopulation, only two of the studies included patients over 65 years of age. All studies indicated a statistically significant association of stress with various domains of cognitive dysfunction in patients, as shown by either self-completed questionnaires, neuropsychological testing or both. An age over 60 years was linked to fewer cognitive difficulties mediated by lower levels of stress. Thus, the evidence supports the association of stress with cognitive deficits in patients with breast cancer, regardless of the type of cancer-related treatment. Therefore, stress should be appropriately addressed. However, further research is required to investigate the association of stress with cognitive function in elderly patients with breast cancer.

Coping and quality of life in Turkish women living with ovarian cancer

BACKGROUND

This study investigated the utilization of both problem and emotion focused coping strategies and their association with aspects of quality of life among Turkish women with ovarian cancer undergoing chemotherapy.

MATERIALS AND METHODS

The convenience sample consisted of 228 patients in all disease stages. The data were collected using the brief COPE, QOL-Cancer patient tool, sociodemographic sheet, and medical variables were gathered from patients' medical charts.

RESULTS

Findings reveal that quality of life is moderately high for this group of cancer patients, despite some specific negative facets of the illness and treatment experience. Acceptance, emotional support and religion were the most frequently used problem-focused coping strategies and self-distraction, venting and behavioral disengagement were the most frequently used emotion-focused coping strategies reported by patients. Overall quality of life and, particularly, psychological and spiritual well- being scores of younger patients were lower. Patients reported using significantly more problem-focused coping than emotion-focused coping, and more problem-focused and less emotion-focused coping predicted greater quality of life. Problem-focused coping was related to patients' physical and spiritual well-being and emotion- focused coping was related inversely with psychological and social well-being.

CONCLUSIONS

Coping strategies are influential in patient quality of life and their psychosocial adaptation to ovarian cancer. Psycho-oncology support programs are needed to help patients to frequent use of problem-focused coping and reduce emotion- focused coping strategies to improve overall quality of life.

Un-met supportive care needs of Iranian breast cancer patients

BACKGROUND

Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors.

MATERIALS AND METHODS

A descriptive- correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality.

RESULTS

Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality.

CONCLUSIONS

The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

Symptom experiences and coping strategies among multi- ethnic solid tumor patients undergoing chemotherapy in Malaysia

BACKGROUND

This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital.

MATERIALS AND METHODS

Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies.

RESULTS

Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased.

CONCLUSIONS

These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psycho- oncology services provided are to be recommended.

Addressing Factors Associated with Arab Women's Socioeconomic Status May Reduce Breast Cancer Mortality: Report from a Well Resourced Middle Eastern Country

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.

Effect of perceived social support on psychosocial adjustment of Turkish patients with breast cancer

AIMS

To identify the psychosocial adjustment of Turkish patients with breast cancer and the effects of perceived social support on their adjustment.

MATERIALS AND METHODS

The sample comprised 100 volunteering patients diagnosed with breast cancer in the last six months reporting to the Outpatient Chemotherapy Unit at the Medical Faculty Hospital in northern Turkey. The data for the study were collected through the Descriptive Information Form, the Psychosocial Adjustment to Illness Scale-Self-reflection (PAIS-SR) and the Cancer-Specific Social Support Scale and analyzed via SPSS 16.0 for Windows. Descriptive statistics, Chi square test, ANOVA and correlation were used to evaluate data.

RESULTS

There was a negative significant correlation between mean scores in the sub-scales of the social support scale and the ones in the sub-scales of the psychosocial adjustment to illness scale (p<0.05). Similarly, there was a negative significant correlation between confidence support and health care orientation as well as adjustment to social environment. Likewise, emotional support was in a negative significant correlation with health care orientation, adjustment to domestic environment, extended family relationships and adjustment to social environment.

CONCLUSIONS

It was concluded that social support for patients with breast cancer had an influence on their psychosocial adjustment to illness. Holistic care should be given to breast cancer patients by oncology nurses especially in the first six months of treatment. It could be concluded that patients should be accompanied by their family/relatives in treatment and care following their diagnosis with breast cancer, that their family should be made more aware of the fact that the patient should be physically and psychologically supported, that patients with breast cancer should be provided with domiciliary care, and that they should be encouraged to participate in social support groups.

Experiences of Newly Diagnosed Breast Cancer Patients in Turkey

PURPOSE

The purpose of this qualitative study is to describe the experiences of women in Turkey during the diagnostic phase of breast cancer.

DESIGN

In the research, the phenomenological approach was used. The data were collected through semistructured in-depth interviews. The sample comprised nine breast cancer patients in the diagnostic phase.

RESULTS

The data were categorized into four themes: facing the breast cancer diagnosis, uncertainty, avoidance, and holding on to life. Women experience intense uncertainty about the disease, treatment, and social relationships and thus exhibit avoidance behavior.

IMPLICATIONS

Nurses should be aware of psychosocial difficulties suffered during the diagnostic phase and provide care for patients. It is important that nurses provide information about the diagnostic phase to women with breast cancer and encourage them to ask questions and express their feelings.