The use of complementary and alternative medicine and approaches to coping with stress in women with breast cancer: a cross-sectional study

OBJECTIVE

The study aimed to reveal the approaches to coping with stress of women with breast cancer and the factors predicting these approaches, to determine the prevalence and characteristics of Complementary and Alternative Medicine (CAM), and to examine the relationship between use of CAM and approaches to coping with stress.

METHODS

A descriptive and cross-sectional study was conducted among 328 women with breast cancer at a training and research hospital in Türkiye. Data were collected with the "Descriptive Information Form" and the "Stress Coping Styles Scale (SCSS)".

RESULTS

Women's SCSS score was 47.26 ± 6.39 (effective) and 37.76 ± 6.33 (ineffective). The SCSS score were not significantly different between CAM users and non-CAM users (p > 0.05). The prevalence of CAM use was 36%, the most common types of CAM were herbal products (55.1%) and prayer (33.8%) and the reasons for using CAM were for relaxation (symptomatic) (43.2%). As a result of multivariate logistic regression analysis, level of income, working, number of living children, receiving chemotherapy, receiving surgery, having a family history of cancer, and the interest of their partner after the disease were associated with effective coping with stress (p < 0.05, adjusted R2 = 0.08, 0.05, and 0.33 respectively). Working, receiving chemotherapy, receiving surgery, stage of cancer, and having a history of cancer in a social environment were associated with ineffective coping with stress (p < 0.05, adjusted R2 = 0.14 and 0.11 respectively).

CONCLUSIONS

One-third of women were using CAM and had a good level of approaches to coping with stress. Healthcare providers, especially gynecology-oncology nurses, should provide counseling on CAMs and develop strategies for coping with stress for women with breast cancer.

Experiences of women with gestational diabetes about fear of having diabetes in their babies: A qualitative study

Gestational Diabetes Mellitus is an important public health problem that often occurs during pregnancy. This study aimed to reveal the experiences of women with gestational diabetes regarding the fear of having diabetes in their babies. A qualitative research method was carried out with a phenomenological approach. The interviews had a semi-structured form and were recorded on an online/face-to-face voice recorder, and thematic content analysis was performed on the MAXQDA22. Following the inclusion criteria, 12 women with gestational diabetes from the 2 hospitals in the study were included, and in this way, the study reached saturation. As a result of the interviews, 4 main themes and one subtheme were obtained from coding. The main themes were "sugar baby," "risky child," "raising a fearful baby," and "problematic gene carrier." From the main theme of "problematic gene carrier," the subtheme of "pregnancies with problematic genes" was created. This research sheds light on the problems women with gestational diabetes experience with themselves and their babies, and how they deal with these problems. Women with gestational diabetes try to accept and cope with the diagnosis. This research shows that the women were worried about both themselves and their babies. Illuminating the experiences of women with gestational diabetes is part of an integrative care approach that will help increase quality care and treatment in endocrine clinics. More qualitative studies are needed to learn more about the experiences of women with gestational diabetes in endocrine clinics.

Levels of depression and self-esteem in women with cancer of the endometrium and cervix receiving chemotherapy treatment in Türkiye

OBJECTIVE

Endometrium and cervical cancer is a common and important health problem that affects women in many physical, emotional and psychological aspects. This study aimed to determine the levels of depression and self-esteem in women with endometrial and cervical cancer receiving chemotherapy, determine the factors affecting them, and examine the relationship between the levels of depression and self-esteem.

METHODS

This descriptive and cross-sectional study was conducted with 158 women who came to the gynecology-oncology policlinic and chemotherapy unit of a training and research hospital in Izmir, western Türkiye, between April 2022 and April 2023. Data were collected with the "Descriptive Information Form", "Beck Depression Inventory" and "Rosenberg Self-Esteem Scale". Descriptive and inferential statistics were performed to analyse the association between the study variables.

RESULTS

In this study, 52.5% of women were diagnosed with endometrial cancer and 47.5% with cervical cancer. Beck Depression Inventory mean total score was 11.28 ± 6.35, and 20.3% of them were at risk of depression (BDI ≥ 17). Rosenberg Self-Esteem Scale mean total score was 21.06 ± 3.85, and 97.5% of them had high self-esteem. There was a statistically significant and strong negative correlation between the mean total scores of the Beck Depression Inventory and Rosenberg Self-Esteem Scale (r = 0.723; p < 0.05). It was determined that an increase in the Rosenberg Self-Esteem Scale mean total score by 1 unit decreased the Beck Depression Inventory mean total score by 1.2 units and was responsible for 52% of the variance (B = -1.192; R2 = 0.523).

CONCLUSION

It was determined that one-fifth of women experienced moderate/severe depression and the majority of them had high self-esteem. The increase in women's depression levels decreased their self-esteem. Health professionals and oncology nurses should perform screenings to determine the depression and self-esteem levels of women with endometrial and cervical cancer and provide necessary education, counseling, and care to women.

Sexual quality of life between healthy women and women with gynecological cancer: Results of a hospital-based case-control study in Türkiye

BACKGROUND

Gynecological cancers among women were both chronic and vitally health problems. The increasing prevalence of women with surviving gynecological cancers and the receiving treatments of cancer negatively affected the sexual quality of life.

AIM

The study was conducted to determine the sexual quality of life of healthy women and women with gynecological cancer and to determine the predictors of sexual quality of life in women with gynecological cancer.

METHODS

The research is a hospital-based case-control study was conducted. The study was carried out with 65 patients with histologically confirmed gynecological cancer were compared with 75 controls, who were admitted to the different departments of the same hospital in the Izmir, in western Türkiye.

RESULTS

The Sexual Quality of Life Questionnaire score (SQOL) of cases was 60.12 ± 9.01 and controls was 78.92 ± 7.08. SQOL scores of cases were significantly lower than controls (p < 0.05). Multiple linear regression analysis results showed that age (B = -0.295, p = 0.072), working (B = 4.981, p = 0.016), smoking (B = -4.590, p = 0.035), diagnosed with cervical cancer (B = -4.214, p = 0.045), and receiving chemotherapy (B = -4.722, p = 0.028) were associated with sexual quality of life in women with gynecological cancer (p < 0.05, R2 : 0.40).

CONCLUSION

Women with gynecological cancer had lower quality of sex life compared with healthy women. Gynecological cancers negatively affect women's sexual quality of life. Health professionals (especially nurses) should be aware of the potential problems that women with gynecological cancer may experience with their sexual lives. They should develop coping strategies and offer solutions for the problems experienced by women with gynecological cancer.

The Use of Complementary and Alternative Medicine and Coping with Stress by Patients with Gynecological Cancer: A Cross-Sectional Study in Türkiye

INTRODUCTION

Gynecological cancers are long-term, challenging, and stressful diseases. In Türkiye, the majority of patients with gynecological cancer use complementary and alternative medicine (CAM). Considering the stress that gynecological cancer patients are exposed to, patients need to know how to cope with stress.

OBJECTIVE

This study aimed to determine the use of CAM and coping with stress by patients with gynecological cancer and the relationships between them and the factors that predict the approaches to coping with stress in women with gynecological cancer in Türkiye.

METHODS

This is a descriptive and cross-sectional study. The study was conducted with 204 patients between April and August 2022. The data of the study were collected by face-to-face interview and filled out by the patients using the Descriptive Information Form and the Stress Coping Styles Scale (SCSS). Number, percentage, mean, χ2, one-way ANOVA, t test, and the Spearman correlation analysis were used in the data analysis. To analyze the multivariate independent associations between variables, a multivariate ordinal logistic regression model was used, with the SCSS domains as dependent variables. A 95% confidence interval was calculated, and all statistical tests had an alpha level of 0.05.

RESULTS

The mean age of the patients was 58.38 ± 12.64 years (32-80). The prevalence of CAM use by patients was 39.2%, and the most common types of CAM were herbal products (43.8%) and supplication (42.5%). The reasons for using CAM were relaxation (symptomatic)-feeling healthy (63.8%) and treating cancer (36.2%). No statistically significant difference was found between the use of CAM and their approaches to coping with stress (p > 0.05). As a result of multivariate ordinal logistic regression analysis, education level under high school, having ovary, cervix, and endometrium cancer, being in the first stage of cancer, receiving chemotherapy, receiving surgical treatment, having another cancer patient in the social environment and increased interest in a partner after the diagnosis of cancer was associated with an effective coping with stress (p < 0.05, adjusted R2 = 0.27, 0.79, and 0.32, respectively). Not working, experiencing an abortion, having another cancer patient in their social environment, being in the third stage of cancer, having an extended family, and living in a rural area of residence were associated with ineffective coping with stress (p < 0.05, adjusted R2 = 0.20 and 0.24, respectively).

CONCLUSIONS

The prevalence of CAM use by patients was low. While determining the approaches of the patients to cope with stress, their education level, place of residence, family type, diagnosis of cancer, stage of cancer, treatment, partner support, and stressful life events should be considered. As nurses, we need to be more knowledgeable about the use of CAM to provide correct guidance to our patients for access to accurate and effective information. We need to determine our patients' stressors and how our patients cope with stress.

Einleitung

Gynäkologische Krebserkrankungen sind langfristige, herausfordernde und belastende Krankheiten. In der Türkei nehmen die meisten Patientinnen mit gynäkologischen Krebserkrankungen Komplementär- und Alternativmedizin in Anspruch. Angesichts der großen Belastungen, denen Patientinnen mit gynäkologischen Krebserkrankungen ausgesetzt sind, müssen sie wissen, wie sie mit Stress umgehen können.

Ziel

Mit dieser Studie sollen die Inanspruchnahme von Komplementär- und Alternativmedizin und die Stressbewältigung von Patientinnen mit gynäkologischer Krebserkrankung ermittelt werden und es sollen die Zusammenhänge zwischen diesen beiden Aspekten und den prädiktiven Faktoren für die Ansätze zur Stressbewältigung bei Frauen mit gynäkologischer Krebserkrankung untersucht werden.

Methoden

Es handelt sich um eine deskriptive Querschnittsstudie. Die Studie wurde mit 204 Patientinnen zwischen April und August 2022 durchgeführt. Die Erhebung der Studiendaten erfolgte durch persönliche Befragung und mithilfe des deskriptiven Informationsformulars sowie der Stress Coping Styles-Skala, die die Patientinnen ausfüllten. Für die Datenanalyse wurden Anzahl, Prozentanteil, Mittelwert, Chi-Quadrat-Test, einfaktorielle ANOVA, t Test und die Spearman-Korrelationsanalyse verwendet. Zur Analyse der multivariaten unabhängigen Zusammenhänge zwischen den Variablen wurde ein multivariates ordinales logistisches Regressionsmodell verwendet mit den SCSS (Stress Coping Styles-Skala)-Domänen als abhängigen Variablen. Es wurde ein 95%-Konfidenzintervall berechnet, und das Signifikanzniveau betrug für alle statistischen Tests α = 0.05.

Ergebnisse

Das Durchschnittsalter der Patientinnen betrug 58.38 ± 12.64 Jahre (32–80 Jahre). Die Prävalenz der Inanspruchnahme von Komplementär- und Alternativmedizin (CAM) durch die Patientinnen lag bei 39.2%, und die häufigsten CAM-Arten waren pflanzliche Produkte (43.8%) und Bittgebete (42.5%). Die Gründe für die Inanspruchnahme von Komplementär- und Alternativmedizin waren Entspannung (symptomatisch), das Gefühl von Gesundheit (63.8%) und die Behandlung der Krebserkrankung (36.2%). Es fand sich kein statistisch signifikanter Unterschied zwischen der Inanspruchnahme von Komplementär- und Alternativmedizin und ihren Ansätzen zur Stressbewältigung (p > 0.05). Die multivariate ordinale logistische Regressionsanalyse zeigte, dass ein Bildungsniveau unterhalb der Oberstufe sowie Ovarial-, Zervix- und Endometriumkarzinom, Krebs im Anfangsstadium, Chemotherapie, operative Behandlung, eine andere Krebspatientin im sozialen Umfeld und ein gesteigertes Interesse an einem Partner nach der Krebsdiagnose mit effektiver Stressbewältigung assoziiert waren (p < 0.05, adjustiertes R2 = 0.27, 0.79 bzw. 0.32). Fehlende Berufstätigkeit, Fehlgeburt/Schwangerschaftsabbruch, eine andere Krebspatientin im sozialen Umfeld, eine Krebserkrankung im dritten Stadium, eine Großfamilie zu haben und in einer ländlichen Gegend zu leben waren mit ineffektiver Stressbewältigung verbunden (p < 0.05, adjustiertes R2 = 0.20 bzw. 0.24).

Schlussfolgerungen

Die Prävalenz der Inanspruchnahme von Komplementär- und Alternativmedizin durch die Patientinnen war gering. Bei der Ermittlung der Ansätze der Patientinnen zur Stressbewältigung sollten ihr Bildungsniveau, ihr Wohnort, ihr Familientyp, die Krebsdiagnose, das Krebsstadium, die Behandlung, die Unterstützung durch den Partner und belastende Lebensereignisse berücksichtigt werden. Als Pflegekräfte müssen wir mehr über die Inanspruchnahme von Komplementär- und Alternativmedizin wissen, um unsere Patientinnen in Hinblick auf den Zugang zu genauen und wirksamen Informationen die richtige Orientierungshilfe zu geben. Wir müssen die Stressfaktoren unserer Patientinnen ermitteln und herausfinden, wie unsere Patientinnen mit Stress umgehen.