1
|
Chi SC, Liu YC, Konara Mudiyanselage SP, Fetzer S, Lin MF. Treatment withdrawal experiences of women with breast cancer: A phenomenological study. J Clin Nurs 2024. [PMID: 38528376 DOI: 10.1111/jocn.17142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
AIM To obtain an in-depth understanding of the lived experiences, values, and beliefs of Taiwanese women with breast cancer who withdrew from cancer treatment. BACKGROUND Fear of side effects, negative experiences and personal beliefs were identified as reasons for withdrawing from cancer treatments. Body-mind consciousness and body autonomy play a crucial role in cancer treatment decisions. DESIGN Descriptive phenomenological approach. METHODS We conducted semi-structured, face-to-face and in-depth interviews with 16 women diagnosed with breast cancer. Participants were purposefully selected from the Cancer Registry database. Employing a phenomenological approach, our aim was to explore the lived experiences of these individuals. Data analysis followed Giorgi's five-step process. To ensure a comprehensive report the COREQ checklist was applied. FINDINGS 'The Determination to Preserve Me' is the essence of treatment withdrawal, identified by three themes and seven sub-themes. 'Raising Body-Mind Consciousness' was generated using body autonomy and preventing repeated psychological trauma from the participant's view. Their lifestyles, maintaining the family role, and returning to a normal trajectory help develop 'Maintaining Stability for Being a Patient and a Family Carer'. 'Self-Defending Against the Body Harm' was generated by concerns about maintaining health and preventing harm. CONCLUSION Women's behaviours became transformed by suffering. Actions were influenced by physical and psychological distress, misconceptions about treatments, and appearance changes by self-determination through self-protection. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should respect women's autonomy and work collaboratively to ensure their decision-making with accurate information and awareness of the potential risks and benefits of treatment withdrawal need to concern.
Collapse
Affiliation(s)
- Shu-Ching Chi
- Nursing Department, E-DA Hospital, Kaohsiung, Taiwan
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chen Liu
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | | | - Susan Fetzer
- Department of Nursing, University of new Hampshire, Durham, New Hampshire, USA
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
2
|
Tsai YT, Chuang TJ, Mudiyanselage SPK, Ku HC, Wu YL, Li CY, Ko NY. The impact of sleep disturbances on suicide risk among people living HIV: An eleven-year national cohort. J Affect Disord 2024; 346:122-132. [PMID: 37890538 DOI: 10.1016/j.jad.2023.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/22/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVES The suicide rate among individuals who experience sleep disturbances is five times higher than in the general population. Up to 70 % of people living with HIV (PLHIV) experience sleep disturbances. This study's purpose was to determine whether this population has higher rates of suicide compared to those without sleep disorders. Possible risk factors were also explored. METHODS A secondary analysis of nationwide data on all males and females over 15 years old with HIV living in Taiwan was conducted from January 1, 2005, to December 31, 2016. Sleep disturbances were identified through recorded diagnoses and medical treatments. Cox proportional hazard models and hazard ratios (HRs) and mediation analysis were employed to estimate the association between sleep disturbances and suicide risk during the follow-up period. RESULTS Of the 5680 PLHIV, 72 suicide events were reported. The suicide incidence rate among PLHIV suffering from sleep disturbances was 769 per 100,000 person-years. Sleep disturbances were associated with a significantly increased risk of suicide (AHR = 1.75, 95 % CI 1.02-3.02, p = 0.0429). A premium-based monthly salary of <24,000 (NT $) was also associated with an increased hazard of suicide (AHR = 4.14, 95 % CI 1.60-10.75, p = 0.0035). The pathway effect analysis using potential outcomes showed that depression did not mediate the effect of sleep disturbance on suicide. CONCLUSIONS Sleep disturbances were associated with higher suicide rates, even after adjusting for pre-existing depression. These findings suggest that paying attention to suicidal ideation among PLHIV suffering from sleep disturbances is necessary.
Collapse
Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Tzu-Jung Chuang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - Han-Chang Ku
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
3
|
Konara Mudiyanselage SP, Wu YL, Kukreti S, Chen CC, Lin CN, Tsai YT, Ku HC, Fang SY, Wang JD, Ko NY. Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up. Breast Cancer 2023; 30:226-240. [PMID: 36319889 DOI: 10.1007/s12282-022-01413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/27/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. METHODS Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. RESULTS After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. CONCLUSION The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
Collapse
Affiliation(s)
- Sriyani Padmalatha Konara Mudiyanselage
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Operation Theatre Department, The National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Yi-Lin Wu
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Chang-Chun Chen
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Chia-Ni Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Yi-Tseng Tsai
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Han-Chang Ku
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Su-Ying Fang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
4
|
Liu YC, Hung TT, Konara Mudiyanselage SP, Wang CJ, Lin MF. Beneficial Exercises for Cancer-Related Fatigue among Women with Breast Cancer: A Systematic Review and Network Meta-Analysis. Cancers (Basel) 2022; 15:cancers15010151. [PMID: 36612147 PMCID: PMC9817866 DOI: 10.3390/cancers15010151] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022] Open
Abstract
CONTEXT Cancer-related fatigue (CRF) is the most common cause of physical powerlessness in women with breast cancer (BC). The practice of continuous effective exercise is beneficial with respect to reducing CRF. OBJECTIVE To explore exercise efficacy and respective ranks with respect to reducing CRF in women with BC within the inter-treatment and post-treatment periods. METHODS Throughout this systematic review and network meta-analysis, articles published from 2000 to March 2022 were included. Article searches were conducted on the MEDLINE, Embase, CINAHL, and CENTRAL databases. Adult women with BC and different exercise programs were compared with those involved in regular care as a control during or after treatment. In addition, randomized controlled trials (RCT) were also included. A risk-of-bias assessment, with the revised Cochrane risk-of-bias tool regarding RCT and probability-based ranking, was established based on the surface under the cumulative rank (SUCRA) method via network meta-analysis. RESULTS a total of 5747 women with BC followed seven exercise interventions. Yoga (SMD = -0.54, 95% CI [-0.86, -0.22]) was ranked first (94.5%), with significant effects in respect of mitigating CRF, followed by resistance exercise (66.2%), and aerobic resistance (63.3%), while Qigong ranked last (22.2%) among the 36 RCT in inter-treatment. Aerobic resistance exercise (SMD = -0.52, 95% CI [-0.98, -0.07]) induced significant effects in respect of mitigating CRF in the 38 RCTs in the post-treatment period. Yoga, aerobic yoga, and aerobic resistance exercise ranked as the top three (75.5%, 75.0%, and 72.4%, respectively), whereas relaxation ranked last (38.8%) in the post-treatment period. CONCLUSION Yoga, aerobic resistance, and aerobic yoga are recommended for the purposes of inter- and post-treatment exercise to reduce CRF in women with BC by enhancing their physical resilience and long-term quality of life.
Collapse
Affiliation(s)
- Yu-Chen Liu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tsai-Tzu Hung
- Nursing Department, National Cheng Kung University Hospital, Tainan 70101, Taiwan
| | | | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-2353535 (ext. 5035); Fax: +886-6-237-7550
| |
Collapse
|
5
|
Tsai YT, Ku HC, Maithreepala SD, Tsai YJ, Chen LF, Ko NY, Konara Mudiyanselage SP. Higher Risk of Acute Respiratory Distress Syndrome and Risk Factors among Patients with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression. Int J Environ Res Public Health 2022; 19:15125. [PMID: 36429842 PMCID: PMC9690625 DOI: 10.3390/ijerph192215125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review, meta-analysis and meta-regression. SETTING AND PARTICIPANTS Hospitals or nursing homes and patients with acute respiratory distress syndrome after COVID-19. METHODS The literature review was systematically conducted on Embase, MEDLINE, CINAHL, and Web of Science, in addition to manual searches and reference list checking from 1 January 2019 to 2 March 2022. The search terms included coronavirus, acute respiratory syndrome, acute respiratory distress syndrome and observational studies. Three reviewers independently appraised the quality of the studies and extracted the relevant data using the Joanna Briggs Institute abstraction form and critical appraisal tools. A study protocol was registered in PROSPERO (CRD42022311957). Eligible studies were meta-analyzed and underwent meta-regression. RESULTS A total of 12 studies were included, with 148,080 participants. The risk ratio (RR) of ARDS was 23%. Risk factors were age ≥ 41-64 years old (RR = 15.3%, 95% CI =0.14-2.92, p = 0.03); fever (RR = 10.3%, 95% CI = 0.03-2.03, p = 0.04); multilobe involvement of the chest (RR = 33.5%, 95% CI = 0.35-6.36, p = 0.02); lymphopenia (RR = 25.9%, 95% CI = 1.11-4.08, p = 0.01); mechanical ventilation with oxygen therapy (RR = 31.7%, 95% CI = 1.10-5.25, p = 0.002); European region (RR = 16.3%, 95% CI = 0.09-3.17, p = 0.03); sample size ≤ 500 (RR = 18.0%, 95% CI = 0.70-2.89, p = 0.001). CONCLUSIONS AND IMPLICATIONS One in four patients experienced ARDS after having COVID-19. The age group 41-64 years old and the European region were high-risk groups. These findings can be used by policymakers to allocate resources for respiratory care facilities and can also provide scientific evidence in the design of protocols to manage COVID-19 worldwide.
Collapse
Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
| | - Han-Chang Ku
- Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
| | - Sujeewa Dilhani Maithreepala
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Yi-Jing Tsai
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
| | - Li-Fan Chen
- Department of Nursing, An-Nan Hospital, China Medical University, Tainan 709, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, Tainan 704, Taiwan
| | - Sriyani Padmalatha Konara Mudiyanselage
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
- Operation Theatre Department, The National Hospital of Sri Lanka, Colombo 00700, Sri Lanka
| |
Collapse
|
6
|
Tran Thi TH, Konara Mudiyanselage SP, Huang MC. Effects of Distraction on Reducing Pain During Invasive Procedures in Children with Cancer: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2022; 23:281-292. [PMID: 35031216 DOI: 10.1016/j.pmn.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Distraction is a known behavioral intervention that is widely used for pain management in the pediatric population. However, there is a shortage of reviews reporting the efficacy of distraction for procedural pain reduction in pediatric oncology settings. AIM To determine the current evidence on the effects of distraction on procedural pain in children with cancer. DESIGN This systematic review and meta-analysis was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines SETTINGS: Six different databases from 1990 to June 2019. METHOD A literature search was conducted to identify the effects of distraction on procedural pain reduction in children with cancer. A meta-analysis was undertaken along with applying a mixed effect model to quantify the standardized mean difference in the 95% confidence interval (CI) as the overall effects. RESULTS Ten randomized controlled trials were included. Distraction during an invasive procedure had a large effect on pain intensity (-0.92, 95% CI -1.48 to -0.36, p = .001) and on needle insertion as well (-1.12, 95% CI -1.52 to -0.72, p = .000), but only a moderate effect on lumbar puncture procedures (-0.57, 95% CI -1.02 to -0.12, p = .012). Uncertain effects on pain relief showed up in a virtual reality (VR) distraction (-0.93, 95% CI -2.63 to 0.76, p = .28) and during active distraction (-0.72, 95% CI -1.48 to 0.03, p = .06). CONCLUSIONS Distraction is an efficacious intervention to reduce procedural pain during needle insertion or lumbar puncture procedures in children with cancer. However, the efficacy of active distraction and VR remain uncertain. Future research should focus on specific comparisons of different forms of distractions with larger sample sizes.
Collapse
Affiliation(s)
- Thu Hang Tran Thi
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; Department of Nursing and Medical Technology, Pham Ngoc Thach University of Medicine, Vietnam
| | | | - Mei-Chih Huang
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; Deaprtment of Nursing, National Tainan Junior College of Nursing, Taiwan.
| |
Collapse
|