Health promoting behavior and influencing factors in Iranian breast cancer survivors

Latent classes of health-promoting lifestyle in breast cancer patients undergoing chemotherapy in China: A cross-sectional survey

AIM

To identify the latent classes of a health-promoting lifestyle and examine the associations of latent class profile with individual characteristics of breast cancer undergoing chemotherapy in China in order to provide some insights and recommendations for targeted and individualized health education of health-promoting lifestyle.

DESIGN

A descriptive cross-sectional survey design was used for this work.

METHODS

A total of 197 patients with breast cancer undergoing chemotherapy recruited from the Breast Cancer Outpatient Chemotherapy Clinic of a Grade 3A hospital were surveyed. Health-promoting lifestyle was measured using the Health Promotion Lifestyle Profile-II: Chinese Version Short (HPLP-IICR). Latent class analysis was used to examine respondents' health-promoting lifestyle patterns. Associations between the latent class membership and individual characteristics were examined using multinomial logistic regression.

RESULTS

Four latent classes were identified: Class 1-Good Nutrition and Poor Physical Activity, Class 2-Poor Health Responsibility and Nutrition, Class 3-Active Health-Promoting Lifestyle, and Class 4-Medium Spiritual Growth and Poor Other Dimensions. Younger respondents and respondents with a higher score in anxiety and depression were more likely to be classified in Class 4 rather than Class 1 or 3. Respondents with low exercise self-efficacy were more likely to be classified in Class 4 than the others. Respondents in Class 4 had more chemotherapy symptom severity and interference, and cases of menopause were fewer in Class 4 rather than Class 3. Those in Class 4 were more likely to have been diagnosed with cancer within 3 months than those in Class 1.

The associations between social support, self-regulatory fatigue, and health-promoting behaviors among people with type 2 diabetes mellitus: a cross-sectional survey

Background

The prevalence of diabetes in China is increasing annually, posing a serious public health challenge. Health-promoting behaviors are crucial for enhancing the quality of life in individuals with type 2 diabetes. However, the relationship between self-regulatory fatigue in type 2 diabetes, social support, and health-promoting behaviors remains unclear.

Objective

This study aimed to explore the interconnections among social support, self-regulatory fatigue, and health-promoting behaviors, as well as to examine the mediating role of self-regulatory fatigue in patients with type 2 diabetes mellitus.

Methods

A cross-sectional design was employed using the Self-Regulatory Fatigue Scale (SRF-S), the Social Support Rating Scale (SSRS), and the Health Promotion Scale for People with Diabetes Mellitus (T2DHPS). These scales assessed social support, self-regulatory fatigue, and health-promoting behaviors in 316 patients with type 2 diabetes mellitus, exploring the relationships among these variables. SPSS and AMOS were used for statistical analysis to investigate the mediating effects.

Results

Social support in type 2 diabetes mellitus positively predicted health-promoting behaviors (β = 0.401, p < 0.001). The regression coefficients of self-regulatory fatigue in patients with type 2 diabetes mellitus social support (β = -0.502, p < 0.001), and health-promoting behaviors (β = -0.331, p < 0.001), both exhibiting significant differences. Self-regulatory fatigue mediated the relationship between social support and health-promoting behaviors in these patients, with a mediation effect of 0.166, consisting of 29.28% of the total effect.

Conclusion

A significant interplay exists among social support, self-regulatory fatigue, and health-promoting behaviors in patients with type 2 diabetes mellitus. The findings suggest that self-regulatory fatigue mediates the relationship between social support and health-promoting behaviors. Healthcare professionals should focus on enhancing patients' social support to mitigate self-regulatory fatigue and improve health behaviors.

The Impact of Educational Intervention Based on Pender's Health Promotion Model on Healthy Lifestyle in Women of Reproductive Age in Iran

Background

Lifestyle is one of the most important factors affecting women's health. Women's quality of life and health depends on their health-promoting behaviors and lifestyles. The aim of this study was to determine the impact of an educational intervention based on Pender model on healthy lifestyle in women of reproductive age in Iran.

Methods

This randomized controlled trial study was carried out in women of reproductive age in Iran, from August to December 2019. The samples were divided into experimental (n = 120) and control (n = 120) groups. 6 training sessions were provided for the experimental group. The questionnaire consisted of several items including socio-demographic characteristics, health-promoting lifestyle profile-II (HPLP-II), self-efficacy, social support and constructs of Pender's health promotion model. SPSS-18 software has been applied for statistical analysis.

Results

The mean age of the experimental group was 31.88±7.624 years and for the control group was 30.33±6.89 years. There was no statistically significant relationship between demographic variables such as marital status, education, employment status, age and body mass index with lifestyle in women. Lifestyle in women had a statistically significant relationship with the structure prior health-related behavior (p < 0.001). The score of women in structures of prior health-related behavior, perceived benefits, commitment to action, and social support increased after educational intervention (p < 0.001).

Conclusion

Findings showed that educational intervention based on Pender health promotion model has increased the score of healthy lifestyle in women. Therefore, planning and performing educational interventions to improve health promotion behaviors based on this model is essential.

Social Disparities in Post-diagnosis Health Behaviors of Iranian Breast Cancer Survivors: The Mediating Role of Psychosocial Factors as Potential Buffering Agents

Background: Breast cancer (BC) is surging as a public health issue in Iran and engagement in positive health behaviors improves the odds of survival and reduces the risk of concomitant comorbidities in BC survivors. Objectives: The primary purpose of this study was to investigate the impact of socioeconomic inequalities on leisure-time physical activity (LTPA) and fruit and vegetable (F & V) consumption among Iranian BC survivors. Another objective of this study was to examine the role of psychosocial factors, such as stress, self-efficacy, and social support as mediators between socioeconomic status (SES) and these health behaviors. Few studies have investigated social disparities in the health behaviors of cancer survivors. Likewise, the mediating role of psychosocial factors in the SES-health behavior gradient has rarely been explored in the cancer context. Psychosocial factors might have positive implications for socioeconomically disadvantaged survivors. Methods: Cross-sectional data were obtained from 196 patients with BC by a telephone-administrated questionnaire. The Behavioral Risk Factor Surveillance System (BRFSS) 2013 was partially employed to measure exercise and F & V consumption. Cross-sectional analyses (correlation and logistic regression) were conducted to assess the relationship between SES, psychosocial factors, and health behaviors (P < 0.05). Results: Regarding LTPA and F & V consumption, more than half of the survivors complied with the recommended levels, consecutively. Both education and family income exhibited a positive association with LTPA and F & V consumption. Furthermore, self-efficacy and social support showed a positive relationship with LTPA and F & V consumption. Conclusions: The SES impacted health behaviors directly and via intermediary psychosocial factors. The results can inform future studies and interventions; psychosocial factors could buffer the effects of social inequalities on health behaviors. A key policy priority should, therefore, be planning and implementing psychosocial empowerment interventions to promote exercise and a healthy diet among impoverished cancer survivors.

Depression and its correlation with social support and health-promoting lifestyles among Chinese university students: a cross-sectional study

OBJECTIVES

To investigate the prevalence of depression in college students and determine how social support and healthy lifestyle factors are associated with depression in this population.

DESIGN

A cross-sectional design.

SETTING

A comprehensive university in Changsha, Hunan, South China. The study was conducted from May to June 2019.

PARTICIPANTS

A total of 541 students at the comprehensive university.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Zung Self-Rating Depression Scale, Social Support Rating Scale and Health-Promoting Lifestyle Profile-II (HPLP-II) were used to evaluate depression, social support and lifestyles, respectively, and analyse the mutual relationships among them.

RESULTS

Among the 541 participants, 161 (29.8%) experienced depressive symptoms, and there were significant gender-related and academic discipline-related differences in self-rated depression. The average social support score was 38.06 (38.06±7.52). The average HPLP-II score was 71.09 (71.09±11.47). A monofactor analysis showed that depression was correlated with social support and a healthy lifestyle. As demonstrated by logistic regression analysis, being a woman (OR=2.613, 95% CI: 1.541 to 4.43), inadequate social support (OR=0.912, 95% CI: 0.877 to 0.948), poor nutrition (OR=0.87, 95% CI: 0.775 to 0.977) and lack of self-actualisation (OR=0.644, 95% CI: 0.572 to 0.724) were significantly correlated with depression.

CONCLUSIONS

Owing to the high prevalence of depression among Chinese university students, educational institutions must take measures such as providing compulsory mental health education courses and improving the psychological counselling services available to students.

Factors Influencing Health Promoting Behaviours in Women of Reproductive Age in Iran: Based on Pender's Health Promotion Model

INTRODUCTION:

Health promotion behaviours are considered as preventives of non-communicable diseases and key determinants of maintaining and improving the health status.

AIM:

This study aimed to investigate and identify effective factors on health-promoting behaviours based on Pender model in women of reproductive age from February to April 2017, in Savojbolagh, Iran.

METHODS:

This cross-sectional study is conducted on 240 women aged between 15 to 49 years in Savojbolagh, Iran, in 2017. The questionnaire consisted of several items, including socio-demographic characteristics, health-promoting lifestyle profile-II (HPLP-II), self-efficacy, social support and constructs of Pender’s health promotion model. SPSS-18 software has been applied for statistical analysis.

RESULTS:

The mean age of the women was 31.10 ± 7.29 years. Total HPLP-II score was 106.64 ± 11.93. The highest and the lowest mean in the subscales were belonged to nutrition and physical activity, respectively. According to the bivariate analysis, the total HPLP-II score is significantly related to prior health-related behaviour (p = 0.000). There was a statistically significant relationship between stress management and the variables including perceived benefits, perceived barriers, prior health-related behaviour, situational influences, commitment to a plan of action (p < 0.05). Also, health responsibility had a statistically significant relationship with self-efficacy (p < 0.05).

CONCLUSION:

According to our results, it can be inferred that there is a problem with the HPBs of women. Considering that health-promoting behaviours like physical activity had a low score, it is a necessity to plan and perform interventions for improving health promotion behaviours.

Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs

OBJECTIVES

Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival.

METHODS

The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.

RESULTS

The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.

CONCLUSIONS

Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.

Effects of a web-based expert support self-management program (WEST) for women with breast cancer: A randomized controlled trial

INTRODUCTION

This study was a randomized controlled trial that examined the effects of a web-based expert support self-management program (WEST) on metabolic syndrome risk factors and self-efficacy among Korean women with breast cancer.

METHODS

Participants were 60 women with breast cancer (30 participants each in both the experimental and control groups) who also had metabolic risk factors. WEST is based on the self-efficacy theory and is a self-health management program consisting of a web-based program, DIETEX (which entails keeping a health diary, identifying a lifestyle type, inputting personal health information), and expert support. WEST was provided to the experimental group once a week for 24 weeks. Metabolic syndrome risk factors and self-efficacy of the experimental and control groups were examined pre-intervention and at 12 and 24 weeks after intervention.

RESULTS

The decreases in body fat, body fat percentage, and waist circumference were greater in the experimental group than in the control group at 24 weeks (p = 0.019, p = 0.025, and p = 0.038, respectively).

DISCUSSION

The present study can provide basic data for the development and application of interventions for women with breast cancer in the future. Additionally, we propose that WEST be included in the treatment process to complement the intervention of medical personnel for improving metabolic risk factors in women with breast cancer.

Prevalence of depression in patients with cancer in Iran: a systematic review and meta-analysis

Introduction

It is generally accepted that depression, affecting the quality of life, is a serious and common complication in patients with cancer. Given that there is no integrated study on this topic in Iran, the present study sought to investigate the prevalence of depression in patients with cancer by a systematic review and meta-analysis.

Methods

To meet the study objectives, all English and Persian papers published from 2000 to January 2018 were systematically collected and the data were extracted for analysis.

Results

There were 14 studies which were selected on the basis of the inclusion and exclusion criteria. A total number of 2831 patients with cancer had participated in the studies. The prevalence of depression among Iranian patients with cancer was 35% (95% CI 16% to 70%) based on random effects model. Among various types of cancer, the highest prevalence of depression appeared to patients suffering from breast cancer.

Conclusion

The prevalence of depression among patients with cancer in Iran was higher than the developed countries. As depression affects the quality of life of patients with cancer, the results can help policymakers and service providers in planning to reduce the prevalence of depression.

Family Intervention Based on the FOCUS Program Effects on Cancer Coping in Iranian Breast Cancer Patients: a Randomized Control Trial

Background:

Breast cancer affects patients’ lives. Many breast cancer patients have problems with coping and they need support from their families. Family involvement based on the FOCUS program is designed to support breast cancer survivors within their families. The aim of this study was to investigate the effect of family involvement based on the FOCUS program on coping in breast cancer patients undergoing chemotherapy in academic centers in Urmia in 2016.

Methods:

In this randomized controlled trial study, sixty breast cancer survivors were randomly assigned into intervention (N=30) and control (N=30) groups. The FOCUS program family-based intervention featured six sessions covering subject areas of family involvement, optimism, cancer coping, uncertainty reduction and symptom management. The instruments used were demographic and cancer coping questionnaires. Data were analyzed with SPSS 20 software.

Result:

The findings revealed a significant improvement in total cancer coping scores (t= -12/39, p<0.001), in all subscales including individual (t= -11/52, p<0.001), positive focus (t= -7/03, p<0.001), coping (t= -7/28, p<0.001), diversion (t= -11/76, p<0.001), planning (t=-4/91, p<0.001) and in interpersonal (t=-11/14, p<0.001). No significant changes were observed for the control group.

conclusion:

The results showed that family involvement based on the FOCUS program increases the ability to cope in breast cancer survivors.

Managerial Self-Efficacy for Chemotherapy-Related Symptoms and Related Risk Factors in Women with Breast Cancer

Background: Breast cancer is one of the most important diseases affecting physical, psychological and social health of women. This study aimed to determine managerial self-efficacy regarding chemotherapy-related symptoms and related risk factors in Iranian patients. Materials and methods: This descriptive-analytical cross-sectional study was conducted on 150 patients with breast cancer referred to medical centers of Urmia in 2016 with a convenience sampling method . The data collection instrument was the symptom-management self-efficacy scale-breast cancer (SMSES-BC) questionnaire whose validity and reliability was evaluated for the first time for Iranians. Data were analyzed using SPSS software version 20. Results: Most of the patients were in the age range of 41-49 years. Lowest scores were in the areas of emotional and interpersonal disorders and the highest scores in the area of managing chemotherapy-related symptoms. The mean score of self-efficacy chemotherapy-related symptoms was 168.0±25.4. There were significant relationships between age, education, economic status, marital status and life status and self-efficacy chemotherapy-related symptoms. In addition, a positive significant correlation for each of the subscales. Conclusion: It should be noted that interventional efforts for improving managerial self-efficacy of symptoms, especially management of interpersonal and emotional disorders in these patients are necessary.

Effects of Energy Conservation Strategies on Cancer Related Fatigue and Health Promotion Lifestyle in Breast CancerSurvivors: a Randomized Control Trial

Purpose:

Cancer-related fatigue is frequently experienced by patients during and after therapy. The present study was conducted to assess the impact of energy conservation strategies and health promotion in breast cancer survivors.

Methods:

A randomized controlled trial was carried out to compare the intervention effect (n=69.0) with controls (n=66.0) based on routine oncology ward care. The intervention was five weekly sessions for groups of 6-8 breast cancer survivors. Data on fatigue and health promotion lifestyle were obtained before and after completion the intervention and then 8 weeks later for analysis of variance (ANOVA) with repeated measures.

Results:

Our findings showed cancer-related fatigue to be reduced in the intervention group from pre- to post-intervention, and this persisted over the 8-weeks follow-up period (F = 69.8, p<0.001). All subscales of the cancer fatigue scale demonstrated statistically significant effects with partial eta-squared values ranging from 0.15 (the smallest effect in cognitive fatigue) to 0.21 (the largest for affective fatigue). Changes in the health promotion life style indicated a significant promotion from pre- to post-intervention, and this again continued after 8-weeks follow-up (F = 41.6, p < 0.001). All six domains of a health promoting life style featured significantly elevated values, the largest effect being seen in the interpersonal relations subscale (F=57.7, partial η²=0.21, p<0.001) followed by physical activity (F=51.9, partial η²=0.18, p<0.001).

Conclusions:

The program was effective in decreasing cancer related fatigue and promoting a healthy lifestyle.

Association Assessment among Risk Factors and Breast Cancer in a Low Income Country: Bangladesh

BACKGROUND

In the low incoming country Bangladesh, breast cancer is second most common neoplasm and is increasing at an alarming rate among females. Lack of awareness and illiteracy are contributory factors for late presentation and therefore mortality.

PURPOSE

To examine associations of different factors with breast cancer mortality and to raise awareness among the women of society in Bangladesh.

MATERIALS AND METHODS

This descriptive case-control study was conducted on 160 participants from April 2011 till July 2014. Through a valid questionnaire covering personal and family history, data were collected by face to face interview. For analyzing correlations among factors with breast cancer data, binary logistic regression, Pearson's χ2- value, odd ratios and p-value tests were conducted with SPSS version 20.

RESULTS

The mean age of the patients was 43.0 (SD= ± 11.12). In ascending order the leading significant factors were hormone therapy (p<0.0000, OR=4.897), abortion (p<0.0001, OR=3.452), early start menarche (p<0.0002, OR=3.500), family history (p<0.0022, OR=3.235), and late menopause (p<0.0093, OR=3.674) with both χ2 test and logistic regression analyses. Non-significant factors were cancer experience, fatty food habits, marital status and taking alcohol.

CONCLUSIONS

Regarding the investigation of this study, significant and insignificant factor's correlation visualization with breast cancer will be helpful to increase awareness among Bangladeshi women as well as all over the world.

Evaluation of Common Risk Factors for Breast Carcinoma in Females: a Hospital Based Study in Karachi, Pakistan

BACKGROUND

Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available.

MATERIALS AND METHODS

A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 % confidence intervals.

RESULTS

A total of 14 variables were analyzed and based on and 7 were found to be risk factors: old age, family history of breast cancer, family history of other carcinomas, personal history of breast carcinoma, early age of menarche, older age of mother at first delivery and lower number of children. Five factors, parity, breast feeding, history of oral contraceptive pills intake, past history of oophorectomy and hysterectomy showed protective associations. One variable, use of hormonal replacement therapy, showed a controversial link and one other, marital status, was not significant in this study.

CONCLUSIONS

It is concluded that most of the well-known risk factors for breast cancer are also associated with the disease in the female population of Karachi, Pakistan. High risk patients should be the focus with the help of this study so that screening can be more effective for early diagnosis before clinically evident breast malignancy.

Effective Factors on Health-Promoting Lifestyle Among Iranian Chemical Veterans in 2014 Based on Health Promotion Model: A Path Analysis

Background

Health-promoting behaviors can enhance physical and mental health among individuals with disability, particularly veterans.

Objectives

The current study aimed to examine both one-way direct and indirect effects of the factors of the Health Promotion Model (HPM) on health-promoting behaviors in chemical veterans from Ilam province in Iran.

Materials and Methods

This cross-sectional study was conducted in 2014. In this study, 239 moderate-to-severe chemical veterans from Illam province supported by the veterans’ affairs department of Ilam were evaluated via census sampling. Data including health-promoting behaviors, perceived self-efficacy, perceived barriers and benefits, perceived social support, and perceived health status were collected using standard questionnaires.

Results

The results show that the HPM is a poor predictor of the health-promoting lifestyles of chemical veterans (R² = 15%). Social support (factor loading = 0.38) is the strongest predictor of health-promoting behaviors and it influences such behaviors directly, while perceived barriers (factor loading = -0.11) and perceived self-efficacy (factor loading = 0.02) indirectly predict behavior through social support.

Conclusions

Perceived social support is the most important factor that influences health-promoting behaviors. Increasing social support by enhancing self-efficacy and decreasing perceived barriers can improve health-promoting behaviors among veterans.