Dissertations / Theses: 'Breast Cancer Nursing Malaysia'

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Lord, Jacqueline. "Lymphoedema following surgery for breast cancer." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1997. https://ro.ecu.edu.au/theses/891.

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Lymphoedema of the ipsilateral upper limb is one of the most significant long term complications of the surgical treatment of breast cancer and may be described as a life sentence of bodily disfigurement. The resultant cosmetic disfigurement, physical discomfort and reduced physical mobility combined with the psychological sequelae, far exceeds the original expectations of the breast surgery patient (Tobin, Lacey, Meyer, and Mortimer, 1993). It is estimated that one hundred thousand women in Australia have developed lymphoedema (or will develop it before they die) as a result of mastectomy and radiotherapy alone (Casley-Smith, 1992). In breast cancer patients, lymphoedema can follow radical surgery including lymph node dissection, fibrosis due to radiotherapy or it can represent late recurrence of malignant tumour in the axilla occluding lymphatic pathways (Ellis & Caine, 1983). This descriptive correlational study focussed on describing the experiences of women with lymphoedema following surgery for breast cancer and identifying whether or not its occurrence is related to the type of surgery undergone, chemotherapy, radiotherapy and Tamoxifen therapy in a convenience sample of women (n=l44), who had had surgery for breast cancer. There was an 81.3% response rate to the questionnaire (n=ll7). The majority of the respondents were from an urban sector of Western Australia with a mean age of fifty three (53) years. Data were supplemented by information from participants' responses to open ended questions which were then quantified.

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Gaud, Lydia E. "Nursing Student's Breast Cancer Knowledge and Breast- self Examination Technique Confidence." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3246.

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Breast cancer is the second leading cause of cancer death in women in the United States. Several factors have been identified that interfere with women's breast cancer screening practices, including lack of knowledge and confidence in the breast self-examination (BSE) technique, and lack of information provided by health care provider. One of the reasons nurses do not teach breast cancer detection could be the little emphasis given to breast cancer examination in nursing schools. The BSE is a measure of significant value in detecting cancer of the breast. However, less than half of the women in the United States are participating in breast cancer screening. The purpose of this quantitative study was to investigate the relationship between the freshman and senior nursing students' breast cancer knowledge (BCK) and breast self-examination technique confidence (BSE_TC). An online survey was administered to measure the students' BCK and their BSE_TC. The social cognitive theory guided this study. A sample 100 nursing students (54 senior and 46 freshman) were included for hypothesis testing. The study results indicate that senior nursing students had higher mean scores on the BCK and BSE_TC, as would be expected. However, senior nursing students' BCK_BSE_TC scores were also very low. This is a concern for the future of breast cancer detection. This study provides data showing breast cancer screening concepts are unclear to freshman students, and remain unclear with senior students. Nursing educational curricula in breast cancer screening should be revised to affect improvements in nurses' role in advising and educating patients.

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Walker, Meagan. "Assessment of Cancer-Related Fatigue in Breast Cancer Survivors." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7348.

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Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The sources of evidence included multi-database searches and literature from professional organizations. Results were tracked using preferred reporting items for systematic reviews and metasystems and a literature review matrix. The search identified 14 sources, which were assessed for quality using the grading of recommendations, assessment, development, and evaluation process. The results of this systematic review did not support the use of any particular assessment tool; however, 2 clinical practice guidelines recommended screening using a numerical severity scale followed by detailed assessment of clinically significant fatigue using available assessment tools. Screening can be implemented into the survivorship clinic, allowing nurses to identify potentially clinically significant fatigue so that further workup is done and interventions are implemented. Identifying, assessing, and intervening for clinically significant fatigue can improve the quality of life for breast cancer survivors, contributing to positive social change.

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Jansen, Catherine E. "Cognitive function in breast cancer patients undergoing chemotherapy." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3261235.

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5

Maslin, Anna. "Early breast cancer sharing the decision : a critical appraisal." Thesis, Northumbria University, 2000. http://nrl.northumbria.ac.uk/854/.

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Great debate surrounds the issue of patients with breast cancer participating in surgical/medical decision making and their ability to give an informed consent. Health care professionals must balance the need to safeguard the rights of patients, respect their autonomy and yet be sensitive to the changes and individual variations a patient may demonstrate as they progress from diagnosis to the end point of their disease. The premise underpinning the study and literature review, reflected in the published works presented here, focuses on a woman's right to access, should she choose, accurate information to make an informed treatment choice based on an exploration of the literature which reviews the ethical issues including autonomy, informed consent, advocacy, communication, access to information, approaches to shared decision making, psychiatric morbidity and evidence based medicine. Objectives of the Study Reflected in the Published Work Presented Here: 1. To determine the acceptability of an interactive video system, in addition to the standard informational care and support provided by the clinicians and clinical nurse specialist, as a means of providing information about the risks and benefits of treatment choices-surgery and subsequent adjuvent chemotherapy - to women with early breast cancer who are facing choices about treating their early breast cancer. 2. To determine whether providing information to women with early breast cancer using an interactive system significantly reduces anxiety and depression associated with the diagnosis and treatment of this condition. 3. To determine whether providing information using an interactive video system, to women about treatment choices significantly increases patient satisfaction with the choice they have made. To assess this for a two year period patients attending for surgical treatment for early breast cancer were recruited, after full discussion and written consent, into a randomised control trial to evaluate the acceptability and effectiveness of the interactive video system. Eligible patients (100)included all women with an early primary invasive breast cancer who had a genuine choice between treatment options.. Patients excluded from recruitment and viewing the Interactive Video (IVD)/Shared Decision - Making Programme (SDP) were all women who did not have a straightforward choice. All patients in the intervention group completed the following: a. Acceptability of the Interactive Video; b. Assessment of Health Status, The SF36 (Ware and Sherbourne 1992) c. The Hospital Anxiety and Depression (HAD) scale (Zigmond & Snaith 1983) After nine months the patients were again asked to complete the three questionnaires but at this point Questionnaire 1. elicits the patient's satisfaction with their treatment choice.

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Khan, Hetty. "Decisional Conflict in Women with Newly Diagnosed Breast Cancer Seeking Breast Reconstruction Surgery| A Pilot Study." Thesis, Carlow University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10817290.

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Women who undergo immediate mastectomy for breast cancer experience tremendous anxiety when faced with breast reconstruction and are often conflicted regarding which type of breast reconstruction to choose. This pilot study aimed to analyze the impact of a decision aid, adapted from Stanford University Breast Center, on decisional conflict in women with newly diagnosed breast cancer seeking breast reconstruction. Twenty newly-diagnosed breast cancer patients seeking breast reconstruction at a large academic healthcare center were randomized into two groups. Comparisons were made between women who reviewed the standard educational materials prior to initial consultation, and women who reviewed these materials and then reviewed a decision aid brochure at initial consultation and two weeks post consultation, utilizing the Decisional Conflict Scale. Technical issues halted data collection after only nine participants completed the study. Although no reliable findings could be interpreted from such a small sample size, the results suggest the decision aid as a valuable tool for patient education. Nurses may gain increased awareness of the emotional conflicts faced by newly diagnosed breast cancer patients when making decisions for breast reconstruction.

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Shatley, Joseph Andrew, and L. Lee Glenn. "Sexuality and Quality of Life of Breast Cancer Patients Post Mastectomy." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7510.

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Excerpt: Manganiello et al., (2010) aimed to evaluate the sexual functioning of mastectomy patients and its association with their quality of life. There are two shortcomings with this study that render its conclusions invalid, or at least, weakly supported.

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Paterson, Carly Lynn. "Sexual Functioning and Body Image in Younger Breast Cancer Survivors." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5853.

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Younger breast cancer survivors often report problems related to sexuality following surgical and adjuvant treatment that often lead to sexual distress and body image distress. This research was conducted as an exploratory study within a larger R01 trial with the purpose to evaluate sexual distress and body image related-distress in younger women with breast cancer and to examine the extent to which the Mindfulness-Based Stress Reduction-Breast Cancer (MBSR(BC)) was efficacious in improving distress related to sexuality, i.e. sexual distress and body image related-distress. The aims of this study were to: 1) evaluate the efficacy of the MBSR(BC) program in improving the psychological symptoms of sexual distress and body image related distress; and 2) evaluate whether positive effects achieved from the MBSR(BC) program are modified by specific patient characteristics measured at baseline. Ninety-one participants were randomized to either the MBSR(BC) intervention or Usual Care (UC) and assessments were conducted at baseline, 6-week and 12-week follow-up for sexual distress, body image related distress, demographic data as well as clinical history. For aim 1, analysis of covariance (ANCOVA) and linear mixed model (LMM) analysis were the methods used to evaluate the efficacy of the MBSR(BC) program. For aim 2, ANCOVA and stepwise multiple linear regression were used to evaluate the patient characteristics at baseline that modified the effects achieved from the MBSR(BC) program. Results showed the mean age of the sample was 57 years and 74% were White, non-Hispanic. Chi square analyses found that there were no significant differences between the MBSR(BC) and UC groups on baseline demographic or clinical characteristics. For Aim 1, results of the ANCOVA analyses found that there was no significant difference between the MBSR(BC) and UC groups at the 6-week follow-up on sexual distress or body image related distress (both p > .05). However, ANCOVA analyses found that there was a significant relationship between baseline scores and scores at the 6-week follow-up for both sexual distress (p < .0001) and body image related distress (p < .0001). Further ANCOVA analyses for Aim 1 found that there was a trend towards a statistical significance for the difference between the MBSR(BC) group and UC groups at the 12-week follow-up for both sexual distress (p = .09) and body image related distress (p = .06). Results of the Linear Mixed Model (LMM) analyses, implemented to assess sexual distress over time, showed a significant main effect (ME) of time (p < .000) and a trend towards significance for the time by assignment interaction (p = .104). The LMM analyses for body image disturbance resulted in a significant ME of (p < .000) and an interaction that approached significance (p = .071). For aim 2, ANCOVA results found that age at baseline was a significant predictor of change at 6 weeks in levels of body image related distress (p = .007), but no relationship was observed for sexual distress. Further, analysis using a stepwise multiple linear regression analysis found age at baseline to be the only significant predictor of both baseline sexual distress (p = .004) and baseline body image related distress (p = .008). Although the MBSR(BC) program was not tailored for integrating sexuality content, results of this stress reducing program (MBSR(BC)) program, adapted for breast cancer survivors, appeared to benefit these young women. The findings of this study identify that there is a need for stress reducing interventions addressing problems related to sexual distress and body image related distress. In addition, these results identified that clinically, BCS should be assessed for sexual distress and body image disturbance post-treatment, and interventions to assist with this distress should be incorporated into their plan of care.

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9

Liu, YingYing, and Chen Lin. "The Quality of Life and its Influencing Factors of Patientsundergoing Breast Reconstruction after Breast Cancer Surgery A descriptive review." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-36632.

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10

Wengström, Yvonne. "Nursing interventions in radiation therapy : studies on women with breast cancer /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-3999-3/.

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11

Ammerman, Cathy. "Prevention of Radiation-Induced Skin Reactions in Breast Cancer External Irradiation." TopSCHOLAR®, 2002. http://digitalcommons.wku.edu/theses/613.

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Radiation dermatitis is a common side effect of external beam radiation therapy. The purpose of this study was to evaluate the effectiveness of applying an aloe vera based skin gel to the target area skin in preventing the development of radiation dermatitis to postlumpectomy/ mastectomy patients receiving external beam radiation therapy in an ambulatory radiation-oncology clinic in the southeastern region of the United States. In this descriptive correlational study, a convenience sample of willing participants (n=18) was followed from initial treatment through the one-month follow-up examination to assess the intensity of their skin reaction. Five research questions were examined pertaining to the relationship between prognostic indicators and the development of radiation dermatitis when RadiacareR gel was used before and throughout external beam radiation therapy post-mastectomy or post-lumpectomy. The prognostic indicators used in this study were: Breast size > C-cup, prior chemotherapeutic exposure, length of incision, age of client, and weight changes since diagnosis. Analysis of Variance (ANOVA) and Pearson's Correlation Coefficients were used in the data analysis with a confidence of p=0.05. This study indicated that breast size and weight changes were the most prognostic of the factors studied. The small sample size and lack of randomization or control group limit the generalizability of these findings to clinical practice; however, it does support the need for continued research in this area. Recommendations for future studies include comparing Body Mass Index (BMI) to incidence and determining a relationship between gel use and treatment breaks and if there is a difference in the length of time until the skin is restored to baseline upon completion of therapy.

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12

McNamara, Nancy Taylor 1961. "Older healthy Hispanic women's beliefs about breast cancer." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/278170.

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An exploratory descriptive design was used to investigate older healthy Hispanic women's beliefs about breast cancer. A secondary analysis of a database from a larger study dealing with Hispanic and Anglo women's knowledge of breast cancer and use of breast cancer screening was conducted. Using Orem's theory of self-care and self-care deficit as the framework, and content analysis, data were obtained from a two part question of the original 63 item questionnaire. A major finding was that hopelessness/powerlessness received the largest number of responses, especially from the youngest subjects, 50 to 69 years old. The seventy year olds had the largest number of responses in the acceptance category, while the eighty year olds had the largest in the denial category. The results supported the importance of culturally relevant and sensitive nursing practice. Reasons for older healthy Hispanic women's beliefs about breast cancer are discussed as well as recommendations for nursing practice and future research.

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13

Hall, Gabrielle. "Variations in hormonal risk factors for breast cancer in Marin County, California." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1463618.

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14

Porock, Davina. "Predicting the severity of radiation skin reactions in women with breast cancer." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/992.

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Skin reactions are unavoidable side effects of radiotherapy for breast cancer that may limit the amount of treatment a patient is able to receive. As well, the discomfort associated with the treatment may negatively affect the patient's quality of life and their willingness to complete a course of treatment that typically extends over seven weeks. Prior literature suggests that variations in patients' tissue reactions to radiation may be related to Individual patient characteristics. Before health care providers can intervene to prevent or minimise skin reactions, a clinical model that helps predict which patients will experience more skin reactions is needed. The purpose of the study was twofold: firstly, to test the theoretical relationships between factors that impair healing and the severity of radiation skin reactions; and secondly, to develop a model to predict the severity of radiation skin reactions in women being treated for breast cancer. The theoretical framework for the study was based on two bodies of knowledge, radiobiology and wound healing. This framework specified three sets of potential predictors of radiation induced skin reactions. These were radiation factors (e.g. dose, fractionation), genetic factors (e.g. personal and family history or cancer, radiosensitive conditions) and personal factors (e.g. age, smoking history, nutritional status). It was hypothesised that the severity of the skin reaction was a function of the relationship between these constructs. A sample of 126 women was recruited to the study over a 14-month data collection period. All the women had undergone lumpectomy and were commencing a standard radiation protocol of 45 Gray to the whole breast delivered in daily fractions of 1.8 Gray over five weeks, and a 20 Gray electron boost to the lumpectomy site delivered in daily fractions of 2 Gray over two weeks. After obtaining written informed consent, data on potential factors were collected by interview at the commencement of treatment and from the medical records. Weekly observations of the skin using the Radiation Therapy Oncology Group scoring system were recorded throughout the seven weeks of treatment. The breast was divided into eight anatomical sites to increase specificity in the final analysis. The mean inter-rater reliability of RTOG scoring between the three observers was 0.85. Chi square analysis revealed that several factors were associated with a more severe reaction. Significant factors from the "personal construct" included smoking, chemotherapy, history of skin cancer, reaction of the skin to UV radiation, lymphocele aspiration, condition of the lumpectomy scar at the commencement of treatment, weight, and the size of the breast. Stepwise logistic regression analysis revealed the relative risk and predictive value of the factors. A predictive model was developed for each of the eight anatomical Sites of the breast for weeks three to seven of radiation treatment. The principal predictors were a large breast size, smoking during the treatment period, and having had a lymphocele aspirated on at least one occasion prior to radiotherapy. The results show that it is possible to predict the severity of skin reactions in individual patients. The research contributes to theory development in radiation skin reactions and to the practice of radiation oncology nursing. Practice implications centre on individualising the preparation, education and management of women undergoing radiation therapy for breast cancer. Further research with larger samples and using different anatomical sites will contribute to the development of a skin reaction risk assessment tool for general use in radiation oncology nursing.

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Lucas, Jean Marie. "Factors Associated with Fear of Breast Cancer Recurrence Among Survivors." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4720.

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The purpose of this cross-sectional, secondary data analysis was to explore, non-modifiable (stable) trait factors and modifiable (transient) state factors associated with fear of recurrence (FOR) in breast cancer survivors. Antecedent trait factors included demographic, clinical, social/behavioral factors, postulated mediator state factors included pain, fatigue, sleep disturbances, depression, state anxiety and perceived stress, and FOR was the outcome variable. The study used baseline data from an R-21 NCI funded (grant #R21CA109168) randomized control trial that examined the effects of mindfulness based stress reduction in early stage breast cancer recovery. Instruments from this study for antecedent variables (trait factors) included a Demographic and Clinical History Form, STAI; instruments used for mediator variable (state factors) included CES-D, STAI, PSS and MDASI subscales for pain and fatigue, sleep; the instruments used for the outcome variable FOR - CARS overall fear and nature of worry. The study sample included 82 women within 18 months post breast cancer treatment (stage 0, I, II, III). The Theoretical Model for psychosocial nursing research was used as a heuristic framework to examine the associations between trait factors and state factors and their mediating effects on FOR. Aim 1 explored the relationship between the antecedent (trait) variables associated with FOR (CARS overall fear and CARS nature of worry) using Pearson's and Spearman's correlations and analysis of variance (ANOVA). The findings revealed a negative association between age and FOR, CARS overall fear (r = -.236, p = .033) and FOR, CARS nature of worry (r = -.269, p = .015). Trait anxiety was positively associated with FOR, CARS overall fear (r = .433, p = .000) and FOR, CARS nature of worry (r = .358, p < 0.001). Race/ethnicity, education, marital status, employment, exercise, cancer stage, cancer treatment, exercise, smoking, drinking, hormone use and family history of breast cancer were not associated with FOR. Aim 2 explored the relationship between postulated mediator (state) variables, such as pain, fatigue, sleep disturbances, state anxiety, depression, perceived stress associated with FOR (CARS overall fear and CARS nature of worry) using Pearson's correlations. Findings revealed that depression (r = .347, p = .001), state anxiety (r = .467, p < 0.001), perceived stress (r = .365, p = .001) were positively associated with FOR, CARS overall fear of recurrence, and that pain (r = .220, p = .047), fatigue (r = .247, p = .025), state anxiety (r = .369, p = .001), and perceived stress (r = .410, p < 0.001) were positively associated with FOR, CARS nature of worry. Aim 3 used a mediation analysis (bootstrapping method) to examine the indirect effects of the statistically significant modifiable mediator state factors on the statistically significant antecedent trait factors and FOR (CARS overall fear and CARS nature of worry). With trait anxiety as the antecedent variable, state anxiety was indirectly associated (a mediating variable) with FOR, CARS overall fear (β = .1381, 95% CI = .0053 - .3050, p = .0299). Similarly, with a composite age/trait anxiety antecedent variable, state anxiety was indirectly associated (a mediating variable) with FOR, CARS overall fear (β = .5579, 95% CI = .1201 - 1.1669, p = .0157). Perceived stress and depression did not mediate the relationship between age and trait anxiety and concerns about recurrence overall fear. With trait anxiety as the antecedent variable, perceived stress was indirectly associated (a mediating variable) with FOR, CARS nature of worry (β = .5474, 95% CI = .0178 - 1.3298, p = .0294). Similarly, a composite age/trait anxiety antecedent variable, perceived stress was indirectly associated (a mediating variable) with FOR, CARS nature of worry (β = 2.0375, 95% CI = .1136 - 4.5976, p = .0495). Pain, fatigue and state anxiety did not mediate the relationship between age and trait anxiety and FOR nature of worry. This study suggests that breast cancer survivors who are anxious at baseline and report a current state of anxiety or perceived stress may be at higher risk for fears of breast cancer recurrence. Understanding the individual patient characteristics such as age, history of anxiety and current status of perceived stress or anxiety and the relationship with fears of recurrence allow nurses to offer individualized interventions for patients at greatest risk for psychological distress.

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Zanotti, Renzo. "Subjective constructs and first appraisal in women with breast cancer." Case Western Reserve University School of Graduate Studies / OhioLINK, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=case1057862117.

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Crane, Tracy E., and Tracy E. Crane. "Symptom Clusters and Trajectories of Depression and Anxiety in Latina Breast Cancer Survivors." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621858.

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Background: Latinas experience a greater number of symptoms and are at an elevated risk for depression and anxiety following a diagnosis of breast cancer compared to Non-Hispanic Whites and African Americans. Cancer-related symptom clusters are frequently reported in women with breast cancer and research suggests these women follow distinct trajectories for depression and anxiety. However, little is known about the trajectories of anxiety and depression or cancer-related symptom clusters in Latinas with breast cancer. Methods: 296 Latinas previously recruited and diagnosed with breast cancer comprised this sample. Questionnaires for depression (the Center for Epidemiological Studies-Depression) and Anxiety (Speilberger State-Trait Inventory and PROMIS Anxiety) were administered at baseline, 2 and 4 months post enrollment. To identify classes of Latina breast cancer survivors based on patterns of symptom occurrence, symptoms latent class analysis was used to describe symptom clusters. Group-based growth mixture modeling was utilized to identify classes of women who followed distinct trajectories of depression and anxiety. Results: On average women reported 4.2±3 symptoms with an overall symptom distress score of 6.4±2.5 (out of a scale of 10). Three symptom classes were identified: Weary and Sleepy (class 1), Weary (class 2) and Weary, Sleepy and Hurting (class 3). Women were most likely to cluster in class 1, followed by class 2 and 3 with fatigue (labeled weary) being the most prevalent symptom for all three classes. Three trajectories emerged for both depression and anxiety. For depression, the majority of women (79.6%) fell in the high then reducing trajectory for depression followed by the low and remaining low (17%) and the high and increasing (worsening) trajectories of depression (3%). For anxiety the majority (78% of women) followed the moderate to increasing (worsening) trajectory of anxiety followed by 14% in the moderate to declining (improving) and 8% in the low to slightly increasing (worsening) trajectories for anxiety. Conclusion: This study suggests Latina breast cancer survivors experience burdensome cancer-related symptom clusters and distinct trajectories for depression and anxiety. Further research is needed in minority women with breast cancer to adequately understand and treat cancer-related symptom clusters as well as depression and anxiety.

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Wang, Tze-Fang 1964. "Antecedents and self-help outcomes: Interventions for women with breast cancer." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/291771.

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The purpose of this secondary analysis of data from the pilot study of Self-Help Intervention Project (SHIP) was to describe the relationship among subject background and nursing interventions (self-help class, independent study, and nurse case manager) in 29 women with breast cancer at time one, prior to participation in one of three nurse interventions. Twenty six women provided data upon completion of the nurse interventions. A low statistical relationship was found between demographic variables of age (r =.29, p =.10) and income (r =.32, p =.09) with the nurse case manager intervention. Having had a partial mastectomy (r =.34, p =.07) was positively related to the independent study. Having received chemotherapy (r =.33, p =.08) was positively related to the self-help class intervention. The information seeking style blunter subscale was found to have a negatively statistically significant relationship with the self-help class intervention (r = -.31, p =.10) and a positive relationship with the nurse case manager intervention (r =.33, p =.08). The nurse case manager intervention was found to be positively related to adult self-care (r =.29, p =.10). Results indicate that nurses should continually assess their patients' individual variables in order to provide appropriate interventions.

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Schuldheis, Sherrie Lind. "Evaluation of a nursing intervention for women experiencing treatment for breast cancer." Diss., The University of Arizona, 2000. http://hdl.handle.net/10150/284118.

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The primary purpose of this study was to evaluate the effectiveness and the costs of a community based nursing intervention for Hispanic women undergoing treatment for breast cancer. The purposes were: (1) Determine if the self-help nursing intervention resulted in significant improvements in the outcome variables of self-care, symptom burden, functional status, and productivity; and (2) describe the costs of each component of the SHIP II project; and (3) describe the average costs per woman participating in SHIP II; and (4) estimate the cost-effectiveness of SHIP II. Data from the Self-Help Intervention Project (SHIP II), an experimental, randomized block, repeated measures design study of women undergoing treatment of breast cancer were analyzed using growth curve analysis and path analysis in EQS. Results revealed that a woman's initial status upon entering the project subsequently affected her outcomes of self-care, symptom burden, productivity, and functional status. The nursing intervention did not affect the outcomes of the women in this sample. An economic analysis revealed that the most expensive program component was that of personnel salaries and represented 91% of the total intervention costs. Recommendations include: (1) exploration of the functional relationships between the nursing intervention and the outcome variables; and (2) exploration of mediating and moderating variables; and (3) further instrumentation work on the outcome variables.

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Barlow, F. V. "Women's experiences of breast cancer and spiritual healing : a unitary appreciative inquiry." Thesis, Bournemouth University, 2011. http://eprints.bournemouth.ac.uk/20519/.

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The aim of this study was to gain a better understanding of the effects and outcomes of Spiritual Healing in the context of women with breast cancer receiving long-term hormonal therapy. Background Spiritual Healing is widely available and used by many but is a neglected area of research. Whilst the exact mechanisms are not understood and healers make no claim to cure, evidence suggested that Spiritual Healing as a holistic complementary therapy could support women whose quality of life is negatively affected by breast cancer and its treatments. After initial surgical, radiological and/or chemical treatments, the majority of women are prescribed hormonal therapy for at least five years, giving rise to immediate and long-term symptoms that compromise their quality of life and force some to take respite from treatment. Spiritual Healing was thought to have the potential to improve quality of life and encourage continued compliance with potentially life-saving orthodox therapy. Method This qualitative study used Unitary Appreciative Inquiry to explore the fullness and richness of patients’ changing life patterns. An observational study of Spiritual Healing took place in a clinical research facility within a district general hospital, and was given by healers with a nationally recognised qualification. Twelve breast cancer patients, who reported at least one onerous treatment side-effect, self-referred to the study and were given ten Spiritual Healing sessions of approximately 40 minutes’ duration each. Data included direct observations noted by healers, patient’s daily logs, researcher’s field diary and one-to-one semi-structured interviews. Findings The effects of breast cancer and its treatments were long-lasting and permeated every aspect of these participants’ lives. The physical effect of cancer and its treatments restricted usual activities, leading to low morale and emotional distress. Patients’ narratives expressed loss and regret and for all patients fear was a constant companion. Observational data illustrated how the experience of Spiritual Healing reduced physical side-effects, including hot flushes, and afforded a sense of serenity and hope. Conclusions This study highlights the potential for Spiritual Healing as a complementary therapy to alleviate many of the distressing effects of breast cancer and its treatments, most notably during long-term hormonal therapy. These findings appear to justify further research to understand the potential value of Spiritual Healing as a complementary therapy to support orthodox medical care.

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Kirshbaum, Marilyn. "Disseminating research evidence to breast care nurses : the case of exercise for breast cancer patients." Thesis, University of Manchester, 2004. http://eprints.hud.ac.uk/10717/.

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Background: Historically, nursing has struggled to introduce researchbased interventions into routine clinical practice. Reasons for this difficulty range from poor communication between clinically and academically based nurses to limitations within organisations that obstruct the implementation of new ideas. Aims: To identify the barriers to research utilisation and the preferred methods of research dissemination amongst breast care nurses (BCNs), to develop a dissemination intervention for BCNs and to evaluate a dissemination intervention for BCNs. Method: The study was conducted in three stages. In Stage 1, a national survey was conducted using the Barriers to Research Utilisation Scale (Funk et al. 1991), questions about dissemination preferences and a demographic questionnaire. In Stage 2, the Conceptual Framework for Selecting a Targeted Experimental Dissemination Method based on social interactionalist theory was developed. In Stage 3, a pre-test/post-test randomised controlled design was used to evaluate the dissemination method developed in Stage 2; the unit of randomisation and analysis were hospital clusters of BCNs. Sample: 263 BCNs from 13 regions within the U.K. comprised the sample in Stage 1. In Stage 3, the sample consisted of 92 BCNs from 62 hospitals in the north of England. Analysis: In Stage 1 analysis was undertaken using descriptive and nonparametric statistics. In Stage 3, analysis consisted of descriptive statistics 19 and clustered regression techniques with estimation of robust standard errors: clustered logistic regression for knowledge items, clustered linear regression for knowledge scores, ologit for attitude and reported practice items and clustered multiple regression for paired and multiple variable analyses. Findings: The results from the Barriers Scale revealed ‘statistical analyses not understandable’, ‘insufficient time on the job to implement new ideas’, ‘facilities inadequate for implementation’, ‘research not reported clearly and readably’ and ‘no time to read research’ as the greatest barriers to research utilisation. Free text responses revealed additional problems with communication and conditions within provider organisations and identified facilitators for research utilisation and dissemination. These data led to the selection and production of a targeted information booklet, entitled Exercise and Breast Cancer: A Booklet for Breast Care Nurses, specifically designed to be accessible, time efficient, understandable and relevant to the target audience. In evaluation, the booklet was shown to overcome the perceived barriers of the sample associated with accessing and understanding research. A statistically significant increase in knowledge and changes of reported practice and attitudes were found. Robust variables affecting knowledge acquisition were identified as the promotion of health, promotion of exercise and understanding of how exercise can reduce cancer-related fatigue. Implications: This study has demonstrated that printed materials can be used as an effective dissemination method provided that they are developed in line with the needs, values and context of a target audience. The 20 Conceptual Framework can be followed to develop similar booklets on different topics and could provide a purposeful contribution to the promotion of evidence-based practice for all nurses.

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22

Pelusi, Jody Louise. "Cancer survivorship: The other side. The lived experience of partners of long-term breast cancer survivors." Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/284071.

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As the number of women diagnosed with early stage breast cancer continues to rise, so does the population of long-term breast cancer survivors. Many factors influence the overall outcome of their experience, one of which is the support from their partners. Much has been written on the issues of women with breast cancer, but what is lacking in the literature are the voices of their partners during the long-term survival phase of the disease. The purpose of this study was to conduct a phenomenological study to (1) describe the essential structure of the experience of being a partner of a long-term breast cancer survivor, and (2) compare theme patterns of the partners of long-term breast cancer survivors with those of long-term breast cancer survivors. The sample consisted of seven participants with the average age of 55 years. Time together as partners averaged 25.2 years. The average time since the cancer diagnosis was 9.5 years. The research method consisted of open-ended audiotaped interviews. Colaizzi's eight-step method of analysis was utilized. Ten theme categories were identified from the data: the invisible enemies--cancer and uncertainty, a sense of duty, constant vigilance, from dreams to reality, turning my eyes away but not my heart, paying the price, don't worry--be happy, who are we now, rebuilding our home, and the everlasting journey. From these theme categories, the essential structure was identified. In searching for the meaning of the journey, the partner is influenced by several factors: their own as well as the patient's coping skills and quality of life, as well as the patient's overall response to cancer treatment. Partners experience many of the same issues as the patient, but their response to and the ability to travel along this cancer journey is based on their role as a partner and their sense of duty to the patient. The partner's goal is to bring structure and stability to the uncertainty of cancer and to find meaning for oneself and the patient during this experience.

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23

Suarez, Stephanie. "Interventions for treatment related side effects in older women with breast cancer." Honors in the Major Thesis, University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/915.

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Over half (57%) of the women diagnosed with breast cancer are age 65 and older. Treatment for breast cancer may exacerbate current chronic illnesses and/or cause multiple treatment related side effects such as insomnia, fatigue, decreased physical functioning, alterations in body image, poorer quality of life, and changes in psychosocial health. While many women with breast cancer experience these changes, research suggests that older women have different needs than younger women and may not always benefit from interventions. The purpose of this integrative review of literature was to evaluate interventions designed to improve treatment related side effects in female breast cancer survivors age 65 years and older. This review of literature was conducted using CINAHL, PsycINFO, and MEDLINE databases using various key terms. Inclusion criteria consisted of peer reviewed research articles, women who have experience breast cancer, interventions directed at decreasing side effects, and research articles written in the English language.While using these search criteria, no interventions were found therefore, the age group was lowered to include women 50 and older. Eleven studies met the inclusion criteria. Interventions addressed a variety of treatment related side effects and were delivered in multiple formats. The findings indicate that interventions resulted in a significant improvement in sleep and fatigue, physical function, perception of body image, psychosocial health, and quality of life for older women with breast cancer. While these findings are positive, the literature did not break down results based on developmental stage or "older" age groups. Currently, there is limited literature that examines interventions in women age 65 and older, this may limit nurses' ability to suggest successful interventions to some of our oldest cancer survivors.
B.S.N.
Bachelors
Nursing
Nursing

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24

Messerli, Patricia Kay 1954. "Information seeking styles and sources of information used by women with breast cancer." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/277859.

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This secondary analysis of data collected in the Self-Help Intervention Project (Braden, Mishel, Longman & Burns, 1990) was undertaken to describe relationships of information seeking styles and sources of information used by women with breast cancer. Descriptive statistics were used to analyze the data, using frequencies and percentages for the demographic data. Correlation statistics were used to answer the research questions. A moderate statistical relationship (.6165, p =.001) was found to exist between the variable of marital status and the American Cancer Society as a source of information. Other data reflected low statistical correlations. Results indicate the need for more research on this topic with larger samples to discover if relationships may be strengthened.

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25

Mayer, Kelly Kish 1966. "A phenomenological study of surviving breast cancer following a bone marrow transplant." Thesis, The University of Arizona, 1994. http://hdl.handle.net/10150/291809.

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The qualitative research methodology of phenomenology was used to explore the experience of surviving breast cancer following a bone marrow transplant. Three women who had undergone a bone marrow transplant for breast cancer were interviewed using an open-ended question. The interviews were audiotape recorded. The interviews were analyzed using an adaptation of Colaizzi's eight step procedure. Eight theme categories were identified: Coming to Know You Have Breast Cancer, Going to War, The Core of Survival, Knowing Myself, Control of Survival, Family Survival, Time Orientation, and Possibility of Death. An essential structure was derived from the data indicating that survival of breast cancer following bone marrow transplant is three dimensional. The dimensions include a perspective of the survival experienced in the past intertwined with daily survival and a future perspective.

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26

Lindblom, Maria, and Ida Westergren. ""Leva med cancer" Bröstcancerdrabbade kvinnors upplevelser av att hantera sin situation - en litteraturstudie." Thesis, University of Gävle, Department of Caring Sciences and Sociology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-766.

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Breast cancer is the most common form of cancer which struck women around the world. When a human is exposed to threat or stress, e.g. breast cancer, different coping strategies are used in order to cope with the situation by the afflicted person. The aim of this literature study was to describe how women, who suffered from breast cancer, experienced coping with their situation. Scientific articles were found in the databases Medline (Pub Med) and Cinahl. A total of 14 articles were chosen regarding to the inclusion criteria and were assessed, analyzed and compiled. The result of the study showed that the women coped with their situation with different and varied strategies. These strategies were categorised in all ready known main categories: problem based, emotional, meaning based and religious coping. The sub categories that emerged under problem based were: seek and find support, educate oneself, have a positive attitude and remaining strategies, under emotional; avoidance and distraction, live a normal life, emotionally composed activities, the use of humour, have a passive attitude, under meaning based; acceptance, the will to survive, lean on hope, newfound meaning and personal development, under religious; faith and spirituality, the relationship to God, prayer for strength and support and remaining categories. Altogether the result displayed a variety of coping strategies that were different depending on the person and the unique situation and it is of great importance that medical staff possesses this knowledge in order to understand patients different ways to cope with their illness.

Bröstcancer är den vanligaste cancerformen som drabbar kvinnor världen över. När människan utsätts för hot och påfrestningar, som t ex vid bröstcancer, används olika copingstrategier av de drabbade för att hantera situationen. Syftet med denna litteraturstudie var att beskriva hur kvinnor med bröstcancer upplever att de hanterade sin situation. Vetenskapliga artiklar söktes i databaserna Medline (Pub Med) och Cinahl. Utifrån fastställda inklusionskriterier valdes 14 artiklar ut, dessa värderades, analyserades och sammanställdes. Resultatet visade att kvinnorna hanterade sin situation med olika och varierande strategier. Dessa strategier kategoriserades i de kända huvudkategorierna: problembaserad, emotionell, meningsbaserad och religiös coping. De underkategorier som framkom under problembaserad var; söka och finna stöd, utbilda sig, ha en positiv attityd och övriga strategier, under emotionell; undvikande och distraktion, leva ett normalt liv, känslostillande aktiviteter, använda humor, ha en passiv attityd, under meningsbaserad; accepterande, viljan att överleva, förlita sig på hopp, nyfunnen mening och personlig utveckling, under religiös; tro och andlighet, relationen till Gud, böner för styrka och stöd och övriga strategier. Sammantaget visade resultatet på en mångfald av copingstrategier som var olika beroende på individ och situation och det är av stor vikt att vårdpersonal har vetskap om detta för att kunna förstå patienters olika sätt att hantera sin situation.

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27

Beck, Laura. "Evaluation of a Mind-Body Website by Women with Breast Cancer." Doctoral diss., University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/5904.

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Despite having access to volumes of information, women newly diagnosed with breast cancer report a moderate level of distress related to their diagnosis, treatment, life expectancy, threat to current roles, and life-changing surgery and treatment choices. Web sites designed to teach people strategies to reduce distress are readily available online. The online format may be useful and practical for women who can access the site at their convenience, learn the components of the interventions at their own pace, and practice the strategies in the comfort of their home. The purpose of this study was to evaluate an online Mind-Body web site (http://www.www.preparingforyoursurgery.com) designed to reduce distress related to surgery for its usability, practicality, and appropriateness for women newly diagnosed with breast cancer. Results of this study will be used to either adopt use of the web site into standard of care at our cancer center or explore development of a similar web site to meet the needs of women newly diagnosed with breast cancer. Women recently diagnosed with breast cancer, who had breast cancer surgery in the past 60 days, were asked to evaluate an online Mind-Body web site and then respond to an online questionnaire measuring the web site usability, practicality, and appropriateness. Thirty-one women evaluated the web site and completed the online survey. The majority of women agreed the web site is useful, practical, appropriate, and would recommend to others. There was no significant relationship between age, income, level of education, frequency of Internet use, or experience with Mind-Body techniques and women who agreed the web site is useful, appropriate, or practical compared to women who were neutral or disagreed the web site is useful, appropriate, or practical. The results of this study suggest the web site could be introduced to women newly diagnosed with breast cancer at our cancer center regardless of age, income, education, frequency of Internet use, or experience with Mind-Body techniques.
D.N.P.
Doctorate
Nursing
Nursing
Nursing Practice

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28

Alsharif, Fatmah Hazza. "The Use of Complementary and Alternative Medicine by Women with Breast Cancer in Saudi Arabia." Case Western Reserve University School of Graduate Studies / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1494327791173777.

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29

Paterson, Lesley Alison. "Factors influencing communication between the patient diagnosed with cancer of the breast and the professional nurse." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/4071.

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Thesis (MCur (Nursing Science))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: Communication in nursing is to establish a nurse-patient relationship. Some nurses are quite effective at this whilst others are not so effective. The female patient diagnosed with cancer of the breast can face many dilemmas ranging from a physical, psychological and psychosocial domain. Nursing, being an interactive skill, requires the nurse to be able to communicate with the patient. The inability to communicate can hamper this very crucial relationship. For the purpose of this study it was decided to provide an in-depth account of the management of the nurse-patient communication in the ward. The rationale for choosing this setting (ward) were based on the comprehensive functions of a professional nurse and his/her ability to communicate. The objectives set for the study were to describe the manner in which professional nurses communicated with the patient diagnosed with cancer of the breast and who underwent a mastectomy, barriers that prohibited the communication and the patient’s perception of the communicative processes. A quantitative, exploratory and descriptive approach was applied to investigate and describe factors that influence communication between the patient with breast cancer and the professional nurse within a provincial hospital in the Western Cape. The total population included only female patients diagnosed with cancer of the breast who underwent a mastectomy and who were referred to the breast outpatient clinic. These female patients had to be diagnosed during a twenty month period as of January 2007 to August 2008 and had to be hospitalised within a ward setting after their diagnosis. The population size consisted of 27% of the total population with a 9% refusal rate. A survey was done using a six point Likert scale ranging from strongly disagree, disagree and mildly disagree to mildly agree, agree and strongly agree. The questionnaire consisting of close-ended questions were used for the collection of data and the researcher personally collected data. Ethical approval was obtained from the Committee of Human Science Research at Stellenbosch University and the Department of Health - Cape Town. Consent to conduct the research was obtained from the institution and informed consent from the participants. A pilot study was conducted to test the questionnaire which did form part of the study. A 10% sample of the population, namely 10 participants, was involved in this study. The validity and reliability was assured through the pilot study and the use of a statistician, experts in oncology nursing, an oncology doctor and the research methodologist. Data was tabulated and presented in histograms and frequencies. Statistical significant associations were drawn between variables, using the Chi square test. The Spearman rank (rho) order correlation was used to show the strength of the relationship between two continuous variables. Findings included statistical significance between the level of schooling and the nurse, who took the respondents at face value and communicated what she deemed necessary (rho=0.29, p=0.00). The respondents also showed concern and disagreed that the ward nurses provide their family with relevant information (p=0.00). R ecommendations include:  Nursing education should include a module in communication on a graduate and post graduate level  In-service training programmes should focus on the interpersonal relationship between the nurse and the patient and the importance thereof.  Continuous Quality Improvement should include patient satisfaction surveys.  Awareness campaigns about the importance of communication between the patient and the health professional should be conducted  Developing protocols and policy guidelines that can assist the nursing staff with the communication process. Since communication is an interactive process it requires skillful conduct. Nurses need to realize the importance communication plays in the health sector and the impact it has on patients, irrespective of whether it is from a verbal or non-verbal content. Effective communication or not can have an everlasting impact.
AFRIKAANSE OPSOMMING: Kommunikasie in verpleging behels die vestiging van ’n verpleegster-pasiënt verhouding. Sommige verpleegsters is taamlik effektief hierin, terwyl andere nie so effektief is nie. Die vroulike pasiënt wat met borskanker gediagnoseer is, kan baie dilemmas in die gesig staar wat wissel van ’n fisiese, psigologiese tot ’n psigo-sosiale domein. Verpleging, wat ’n interaktiewe vaardigheid is, vereis dat die verpleegster met die pasiënt moet kan kommunikeer. Die onvermoë om te kan kommunikeer, kan hierdie beslissende verhouding belemmer. Vir die doel van die studie is besluit om ’n indringende verslag van die bestuur van die verpleegster-pasiënt kommunikasie in die saal te doen. Die rasionaal vir die keuse van die omgewing (saal) is gebaseer op die komprehensiewe funksies van ’n professionele verpleegster en sy/haar vermoë om te kan kommunikeer. Die doelstellings wat uiteengesit is vir hierdie studie is om die manier te beskryf waarop professionele verpleegsters met die pasiënt wat met borskanker gediagnoseer is, en wat ’n mastektomie ondergaan het, omgaan, asook die hindernisse wat kommunikasie en die pasiënt se persepsie van die kommunikatiewe prosesse belemmer het. ’n Kwantitatiewe, verkennende en beskrywende benadering is toegepas om faktore te ondersoek en te beskryf wat kommunikasie tussen die pasiënt met borskanker en die professionele verpleegster in ’n provinsiale hospitaal in die Wes-Kaap beïnvloed. Die totale bevolking het slegs vroulike pasiënte wat met kanker gediagnoseer is en ’n mastektomie ondergaan het en na die bors buite-pasiënt kliniek verwys is, ingesluit. Hierdie vroulike pasiënte moes gedurende ’n periode van twintig maande vanaf Januarie 2007 tot Augustus 2008 gediagnoseer en gehospitaliseer gewees het in ’n saalomgewing na hul diagnose. Die bevolking grootte het bestaan uit 27% van die totale bevolking met ’n 9% verwerpingskoers. ’n Opname was gedoen wat die ses punt Likert skaal gebruik wat wissel vanaf sterk verskil van mening, verskil en effense verskil van mening tot effens saamstem, saamstem en sterk saamstem. Die vraelys wat uit geslote vrae bestaan, was gebruik vir die insameling van data en die navorser het die data persoonlik gekollekteer. Etiese goedkeuring was verkry van die Raad vir Geesteswetenskaplike navorsing aan die Universiteit van Stellenbosch en die Departement van Gesondheid – Kaapstad. Toestemming om die navorsing uit te voer is verkry van die inrigting en ingeligte toestemming van die deelnemers. ’n Loodsprojek is uitgevoer om die vraelys te toets wat deel van die navorsing uitgemaak het. ’n 10% Steekproef van die bevolking, naamlik 10 deelnemers, was betrokke by die studie. Die geldigheid en betroubaarheid was verseker deur die loodsprojek en die gebruik van ’n statistikus, kenners in onkologie verpleging, ’n onkologiese dokter en die navorsingsmetodoloog. Data is getabulleer en aangebied in histogramme en frekwensies. Statistiese beduidende assosiasies is gemaak tussen veranderlikes, deur gebruik te maak van die Chi-kwadraat toets. Die Spearman rang (rho) orde korrelasie is gebruik om die sterkte van die verhouding tussen die aaneenlopende veranderlikes te wys. Bevindings het statistiese beduidendheid ingesluit tussen die vlak van geleerdheid en die verpleegster wat die respondente op sigwaarde geneem het en die kommunikasie wat sy noodsaaklik gevind het (rho=0.29, p=0.00). Die respondente het ook besorgdheid getoon en het nie saamgestem dat die saalverpleegsters hul gesinne van die relevante inligting voorsien het nie (p=0.00). A anbevelings sluit in:  Verpleegopleiding behoort ’n module in kommunikasie op graad en nagraadse vlak in te sluit.  Indiensopleidingsprogramme behoort te fokus op die interpersoonlike verhouding tussen die verpleegster en die pasiënt en die belangrikheid daarvan.  Deurlopende kwaliteitsverbetering behoort pasiënt tevredenheidsopnames in te sluit.  Bewusmakingsveldtogte oor die belangrikheid van kommunikasie tussen die pasiënt en die gesondheidsprofesioneel behoort geloods te word.  Protokolle en beleidsriglyne wat die verpleegpersoneel kan help met die kommunikasie proses behoort ontwikkel te word. Sienende dat kommunikasie ’n interaktiewe proses is, word vaardige gedrag geverg. Verpleegsters behoort die belangrikheid wat kommunikasie speel in die gesondheidssektor te besef en die impak wat dit op die pasiënte het, ongeag of dit verbaal of nie-verbaal is. Effektiewe kommunikasie aldan nie, kan ’n ewigdurende impak hê.

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30

Chiang, Hui-Ling 1969. "Help-seeking and quality of life in women with breast cancer." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/282589.

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The purpose of this study was to examine direct and interactive relationships of stimuli and adaptive modes on help-seeking and quality of life. Stimuli were external (social network characteristics, social support need) and internal (age, symptom, symptom severity, satisfaction with social support). Adaptive modes were physiologic function, self-concept (enabling skill, mastery), role function (socioeconomic status, self-care), and interdependence (trust in health care provider, dyadic adjustment). The conceptual framework was based on Roy's Adaptation Model. Data were secondary analyzed using stepwise multiple regression to test the research hypothesis. The sample consisted of 102 married/cohabitating women with breast cancer. Thirteen instruments measured the variables. Factor analysis constructed indices for variables having multiple measures. Social support need had a direct effect on help-seeking. Number in the network interacted with education on help-seeking. Number of symptoms interacted with mastery on help-seeking. Self-care had a direct effect on quality of life. Satisfaction with social support, number of symptoms, and number in the network interacted with self-care on quality of life. Age interacted with self-care and trust in health care provider on quality of life. Severity of symptom interacted with mastery on quality of life. Social support need, the interaction between number in the network and education, and the interaction between number of symptoms and mastery significantly contributed to help-seeking. The interaction between satisfaction with social support and self-care significantly contributed to quality of life. Based on multiple interactive effects of stimuli and adaptive modes relative to help-seeking and quality of life rather than separate direct effects, Roy's Adaptation Model may better specify interactive relationships of stimuli and adaptive modes than simple direct relationships. To promote women's help-seeking, nurses should assess the number in women's social networks and women's level of education, be aware of women's level of social support need, recognize women's symptoms, and enhance women's sense of mastery. To promote women's quality of life, nurses should assist women toward improved perception of social support, which should increase their level of satisfaction with social support, and encourage performance of self-care activities.

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31

Fenlon, Deborah Ruth. "Menopause after breast cancer : a randomised controlled trial of relaxation training to reduce hot flushes." Thesis, University of Southampton, 2005. https://eprints.soton.ac.uk/58901/.

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This study was set up to test the effectiveness of relaxation techniques to reduce hot flushes and to find out more about the experience of menopause after breast cancer. A randomised, controlled trial was conducted on 150 women to investigate whether relaxation training reduces hot flushes in women with breast cancer. A diary was devised and tested in order to gather accurate data on hot flushes. A purposeful sample of eight women were selected for interview and information was gathered about the experience of hot flushes in the context of breast cancer through the interviews and diaries. From the interviews it was found that there was much uncertainty about menopausal difficulties after breast cancer. The women faced profound changes in their bodies, which could bring feelings of being out of control. Ultimately they found that menopause was secondary in relation to having cancer and that they were expected to adapt, although menopausal difficulties could remain for many years. Menopausal difficulties after breast cancer were found to be a major problem for many women, causing severe disruption to life. Hot flushes were experienced by 68% of women and continued for more than five years in 34% of women. Women in this sample experienced a median of five flushes per day. Sleep disruption was a major problem with 72% of women having disturbed sleep. There was a diurnal pattern to flushes, with more occurring in the morning and the evening. This pattern was more marked in women taking tamoxifen. Relaxation was found to be an effective intervention, which significantly reduced the incidence of hot flushes by 22% (p<0.001), the severity of flushes (p<0.01) and the distress caused by flushes (p=0.01). The actual reduction in flushing was relatively small, being the equivalent of one flush per day. It was therefore recommended that relaxation be incorporated into a programme of self-management measures to relieve hot flushes, which can be adopted by women who have had breast cancer.

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32

Duong, Diep Ngoc 1958. "Evaluation of the Self-Help Interventions Program (SHIP): Psychoeducational interventions for patients with breast cancer." Diss., The University of Arizona, 1996. http://hdl.handle.net/10150/282225.

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The purpose of this study was to further develop treatment theory for SHIP psychoeducational interventions in order: (1) to discover those interventions which proved to contribute toward significant change rate in the self-reported perceptions of breast cancer patients concerning their feelings of personal 'well-being', (2) to assess the stability of the SHIP's treatment effect during the follow-up data collection period, (3) to profile which individuals were most likely to benefit from specific components of SHIP interventions, and (4) to test the processes by which the SHIP interventions affected the outcome. Outcomes studied were change in: self-help, enabling skills (belief-in-self, cognitive reframing, & problem solving), uncertainty level, psychological adjustment, and 'well-being'. Profiling factors were personal characteristics, medical characteristics, baseline support level, and baseline mastery level. Data were derived from the Self-Help Interventions Project (SHIP), an experimental, longitudinal study which had provided psychoeducational interventions to women with breast cancer in order to help them cope with their situation. The SHIP interventions consisted of education and psychological components. A nonprobability sample of 307 women was randomized into one of five possible treatment groups and a natural learning condition/control group. Study results revealed that, in general, change patterns in outcomes were as expected, though magnitude of change rates was modest to moderate. Significant impact was strongest for those who participated in: the Self-Help Independent Study plus Uncertainty Management combined intervention, and the Self-Help Independent Study intervention. Recommendations include: (1) re-examine intervenors' characteristics through further secondary data analysis of the SHIP study; (2) replicate part of this study using only the stronger components such as the combined Self-Help Independent Study/Uncertainy Management groups, and the individual Self-Help control group in a more homogeneous and larger sample size; (3) use alternative methods of measurement to capture the changes in outcomes. For example, measure functional status through the categories of 'performing self-care', and 'returning to school/work/hobby'; and (4) measure more frequently in order to determine the possibility of using "booster" lessons.

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Williams, Anne. "A qualitative study of supported self-care in women with lymphoedema associated with breast cancer." Thesis, Edinburgh Napier University, 2011. http://researchrepository.napier.ac.uk/Output/4705.

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Aim: This study explored the nature of supported self-care for women who had lymphoedema associated with breast cancer treatment, and the work of lymphoedema practitioners. Background: Health policy indicated a need to examine the potentially evolving roles of individuals with long term conditions who undertake self-care, and health professionals who provide support. Lymphoedema affects around one in five women who undergo treatment for breast cancer. A woman with lymphoedema can experience long term swelling, most commonly of her arm, affecting her life in various ways. Methods: Three small group discussions were undertaken with women who had lived with lymphoedema for more than two years (n=7). Field observation (n=16) of clinic appointments with women who had lymphoedema, were undertaken alongside interviews (n=15) with eight lymphoedema practitioners. Women who had newly developed lymphoedema (n=10) were interviewed three times over a period of six months. The study was underpinned by social constructionist perspectives, and informed by feminism and relational autonomy theory. Findings: Various structures of power influenced the capacity for supported self-care in women and practitioners. Lymphoedema influenced women's self-identity, and women experienced substantial distress and frustration relating to the initial development of lymphoedema, the chronic nature of the condition, and in adapting to self-care. Lymphoedema practitioners provided support for women from within a mainly bio-medical framework of care, often based within acute clinical settings. Accessing local, trusted information and advice relating to lymphoedema self-care was challenging for some women. Conclusion: An anticipatory approach to supported self-care was identified. The development of reflexivity and self-discovery was considered equally relevant to women with lymphoedema and lymphoedema practitioners. Professional approaches to support should recognise this anticipatory perspective and enable timely access for women to individualised and appropriate support at key points in their lymphoedema trajectory.

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Andersson, Lena, and Ina Geschwindt. "Yngre kvinnors livssituation vid bröstcancer : The lifesituation of younger women with breast cancer." Thesis, Örebro University, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-698.

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Bröstcancer utgör den främsta cancerdiagnosen hos kvinnor i Sverige. Stor

betydelse för uppkomst av bröstcancer har de kvinnliga könshormonerna. Behandling

av bröstcancer sker genom operation, cytostatika, antihormoner och/eller strålning.

Behandlingen kan leda till fysisk och psykisk påverkan. Syftet med denna

litteraturstudie är att beskriva hur yngre kvinnors livssituation påverkas av

bröstcancer samt hur sjuksköterskan kan möta dessa kvinnors behov. Artiklarna till

litteraturstudien har sökts fram i databaserna Cinahl, Medline och PsycInfo samt

genom manuell sökning och resultatet kom att omfatta 16 artiklar. Dessa artiklar har

värderats, bearbetats, analyserats och sedan sammanställts. Resultatet visar att en

cancerdiagnos innebär många olika känslor för de yngre kvinnorna, vilket får dem att

fungera sämre i det dagliga livet. Förhållandet till familjen förändras och sjukdomen

får en stor inverkan på kvinnans yrkesliv och ekonomi. De stora områden som

påverkas i samband med bröstcancer hos yngre kvinnor är infertilitet, för tidig

menopaus, förändrad kroppsuppfattning samt påverkan av kvinnans sexualitet.

Sjuksköterskan har en viktig roll i vården av yngre kvinnor med bröstcancer och kan

påverka kvinnan både positivt och negativt. Det framkommer också att behovet av

relevant information för kvinnans ålder är stort. När yngre kvinnor drabbas av

bröstcancer påverkar det hennes liv på många sätt. Områdena som berörs skiljer sig

många gånger från andra grupper med bröstcancer. Detta måste tas hänsyn till inom

sjukvården, för att ge optimal vård.

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35

Agars, Julia. "An evaluation of comparative strategies for teaching breast self-examination." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1991. https://ro.ecu.edu.au/theses/1126.

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This study addresses the issue of breast self-examination (BSE) in female nurses, as nurses who perform BSE are more likely to promote BSE to their clients. The purpose of the study is twofold: first, to assess the effects of three alternative methods of BSE instruction on nurses’ BSE practice; and second, to determine the influence of nurses’ health beliefs on their practice of BSE. Previous studies have indicated that various teaching strategies have improved BSE practice. However, the three methods of BSE instruction to be assessed on this study which includes booklet with written instruction, film and group discussion, and to one-to-one discussion, modelling and rehearsal have not been previously researched collectively in a single day. The study is guided by the Health Belief Model (HBM) which attempts to explain preventative health behaviour in terms of attitudes, values and beliefs. The following hypotheses have been formulated for investigation: (a) there will be a significant difference in the effectiveness of BSE practice in the experimental groups at follow-up twelve weeks post intervention; and (b) the health belief scores of nurses who do practise BSE will be higher than the health belief scores of nurses who do not practise BSE.

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LeitÃo, Nilza Maria de Abreu. "Assessment of health-related quality of women with cancer of women with breast and ovarian cancer in adjuvant chemotherapy Life." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11918.

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This research work aimed to assess the Health-Related Quality of Life of women with breast and gynecological cancer undergoing adjuvant antineoplastic chemotherapy. A descriptive study with cross-sectional design and quantitative approach. The research took place at the chemotherapy ward of a nonprofit tertiary referral hospital for cancer surgery in Fortaleza-CE, Brazil. The study sample consisted of 72 women. Data collection happened from April to May 2012. After given informed consent, all women participated in individual interviews and completed the research protocol consisting of a questionnaire of socio-demographic data and the scale of the European Organization for Research and Treatment of Cancer: Quality of Life Evaluation in cancer patients (QLQ-C30 version 3.0). From the analytical study, we highlight the following results: most patients considered the overall QOL measure as âgreatâ with predominant scores 06 and 07. The sub-scale of the item for Social Functioning had the best score with 54.2. On the other hand, we observed the worst performances of women in the Role Performance, Emotional, Physical, and Cognitive Functioning. Regarding the most frequent or intense symptoms, the most reported were pain, fatigue, insomnia, and loss of appetite. At the opposite extreme were dyspnea, nausea and vomiting, with a mean score of 81.9 and 86.1, respectively. The item relating to Financial Difficulty represented a factor that negatively influences the Quality of Life with representation of 44.4 on the average score. Thus, we conclude that the interaction between clinical situation and treatments for the coexisting disease have cumulative and deleterious effects on Quality of Life, emphasizing the specific concerns related to cancer. It is worth mentioning that the predictive factors for Health-Related Quality of Life identified in this study should receive more attention in the health care practice, they may represent also starting points for future studies that address in depth the different aspects involving the QOL of cancer patients.
Este trabalho de investigaÃÃo teve como objetivo avaliar a Qualidade de Vida Relacionada Ã SaÃde de mulheres com cÃnceres de mama e ginecolÃgico submetidas Ã quimioterapia antineoplÃsica adjuvante. Estudo de natureza descritiva com delineamento transversal e abordagem quantitativa. O local da pesquisa foi o setor de quimioterapia de uma instituiÃÃo hospitalar filantrÃpica de nÃvel terciÃrio e referÃncia em cirurgia oncolÃgica na cidade de Fortaleza-Ce. A amostra do estudo foi composta por 72 mulheres. A coleta de dados foi realizada no perÃodo de abril a maio de 2012. ApÃs dado o consentimento informado, todas as mulheres participaram de uma entrevista individual e preencheram o protocolo de investigaÃÃo constituÃdo por um questionÃrio de dados sÃcio demogrÃficos e pela escala da European Organization for Research and Treatment of Cancer: AvaliaÃÃo da Qualidade de Vida do doente oncolÃgico (QLQ-C30 versÃo 3.0). Do estudo analÃtico realizado, destacam-se os seguintes resultados: A medida global de QV foi considerado pela maioria como âÃtimaâ com predomÃnio das notas 6 e 7. A sub-escala no item Funcionamento social obteve melhor escore com 54,2. Em contrapartida, os piores desempenhos das mulheres foram observados no nÃvel do Desempenho de PapÃis, Funcionamento Emocional, FÃsico e Cognitivo. Quanto aos sintomas mais frequentes ou intensos foram relatados a dor, fadiga, insÃnia e perda de apetite. No extremo oposto, estavam a dispnÃia, nÃuseas e vÃmitos, com um escore mÃdio de 81,9 e 86,1, respectivamente. O item referente Ã Dificuldade Financeira mostrou-se como fator que influencia negativamente na Qualidade de Vida com representaÃÃo de 44,4 na mÃdia de escore. Conclui-se que a interaÃÃo entre os quadros clÃnicos e os tratamentos da doenÃa coexistente tem efeitos cumulativos e deletÃrios sobre a Qualidade de Vida, acentuando as preocupaÃÃes especÃficas relacionadas ao cÃncer. Ressalta-se que os fatores preditivos de Qualidade de Vida Relacionada Ã SaÃde identificados neste estudo devem ser foco de maior atenÃÃo na prÃtica assistencial e podem representar pontos de partida para estudos futuros que abordem, em profundidade, os diferentes aspectos que envolvem a QV de pacientes com cÃncer.

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Merriman, John D. "Predictors of the trajectories of self-reported attentional fatigue in women with breast cancer undergoing radiation therapy." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1465497.

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38

Naraphong, Wipasiri. "Effects of a Culturally Sensitive Exercise Program on Fatigue, Sleep, Mood, and Symptom Distress among Thai Women with Breast Cancer Receiving Adjuvant Chemotherapy: A Pilot Randomized Controlled Trial." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1368084924.

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39

Topping, Annie. "Being there for women : the work of breast care nurses." Thesis, University of Huddersfield, 2001. http://eprints.hud.ac.uk/id/eprint/4754/.

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Breast cancer is a major health challenge. It is also is a high profile disease with extraordinary media attention that places an immense burden on women, families, children and health resources. Over the last two decades the way in which women experience breast cancer has undergone significant changes. The implementation of the National Health Service Breast Screening Programme, development of specialist multidisciplinary teams, and greater involvement of women in decision making surrounding treatment choice are just some of these changes. A discrete clinical nurse specialism has developed to provide support and information to women undergoing treatment and care for breast cancer. This multi-method two staged study explored the work of breast care nurses supporting women with breast cancer. The particular focus was on the body image and sexuality dimensions of the breast cancer experience. Firstly, a postal survey using modified versions of the Sex Knowledge and Attitude Test (Lief and Reed 1972) and the Williams-Wilson Sexuality Survey instrument (Wilson and Williams 1989) was undertaken and completed by breast care nurses (n=100) across England. Secondly, adopting an interpretative perspective, breast care nurses (n=29), recruited via the earlier survey participated in focused conversational interviews. In addition a secondary analysis of two focus group interviews with women breast cancer patients (n=14), and a further two individual interviews with lesbian women were undertaken. The audio taped data was analysed using a thematic approach assisted by ATLAS.ti 4.1 qualitative software (Muhr 1996). Three major themes: the delivery of breast cancer care, knowing women, and the territory of breast care nursing were developed. The theme of knowing women was connected with three sub themes titled: authenticity and domesticity, moral journeys, and the (in)visibility of lesbian women. The thematic analysis presents a critical account of contemporary breast care nursing in the endeavour of "being there for women".

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Smith, Hilary. "Attitudes and Beliefs of Nurse Practitioners to Augment Breast Cancer Screening with Ultrasonography." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/594387.

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Recent studies have suggested that the diagnostic reliability and accuracy of breast ultrasonography in place of mammography in women with dense breast tissue results in more accurate breast cancer screening in this population. Since breast cancer is the second leading cause of cancer deaths among United States women, a more accurate and reliable breast cancer screening tool is needed (American Cancer Society [ACS], 2014). This process starts with describing breast screening practice patterns of nurse practitioners and analyzing their attitudes and beliefs of alternative screening modalities gathered from the survey results obtained from this DNP project. The purpose of this study is to determine the attitudes and beliefs of if nurse practitioners towards the use of ultrasonography alone in lieu of mammography followed by sonography in women aged 40-74 with mammographically dense breast tissue. A survey consisting of 23 questions was sent to nurse practitioners in Arizona through the Coalition of Arizona Nurses in Advanced Practice listserv, and through an email list provided by the president of the Allied Health Providers of Yuma. Analysis of survey responses indicated that the majority of respondents believe that it is difficult to detect cancer using mammography in women with dense breast tissue, and more than half of respondents believe that ultrasounds are more accurate and reliable at detecting cancer in women with dense breast tissue. The results also demonstrate that the majority of nurse practitioners surveyed are not familiar with current literature regarding ultrasonography screening in women with dense breast tissue.

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Larson, Cheryl Ann Davisson. "Spiritual, psychosocial, and physical correlates of well-being across the breast cancer experience." Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/280719.

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Spirituality has gained increasing attention by scientists for its importance in contributing to understanding human health experiences. The purpose of this study was to examine the relationships of spiritual, psychosocial, and physical correlates to well-being and depression over the trajectory of breast cancer experience. Nursing theory, lifespan development, and chronic illness trajectory provided the conceptual framework for the study. A correlational, retrospective design was used allowing for collection of longitudinal data during a one-time measurement process. The sample consisted of 64 women (constituting a 91% response rate) 60 years or older with Stage I, II, or III breast cancer, who had chemotherapy and/or radiation, and were 8 to 24 months post treatment. A set of questionnaires was used to obtain data over three phases of their breast cancer experience: Anticipatory; Therapy; and Survivor. For data analysis, it was determined that all instruments had adequate reliability and validity, and statistical assumptions were met. Multiple regression results indicated that two variables in particular (self-transcendence and symptom distress) were consistently significant in explaining well-being and depression (with explained variance ranging from 57% to 85%) across all three phases. Other variables (hope, spiritual perspective, social support) also contributed significantly to the explained variance across some phases. Repeated Measure ANOVA and post hoc tests indicated that the scores on several variables differed significantly depending upon the phase of illness. While symptom distress is often a primary concern of patient and nurse, it was concluded that spiritual variables are also important factors in experiences of well-being and depression across the trajectory of the illness. A second conclusion was that, as with physical or social aspects, spirituality includes many dimensions of human experience and should be studied for the variety of spiritual factors that may be significant across the trajectory of illness. In this study, at least one or more different spiritual variables were significant in the regression equations for every phase of illness. Findings provided empirical evidence to refine and further develop a mid-range theory on how spirituality functions as an important resource for well-being within the context of other variables, across the breast cancer experience.

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Hansen, Christine A. "A Pilot Study on Bowenwork® for Symptom Management of Women Breast Cancer Survivors with Lymphedema." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/222852.

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The objective of this pilot study was to examine the feasibility of using Bowenwork as a complementary intervention for symptom management of breast cancer treatment-related lymphedema in women breast cancer survivors. The aims of the investigation were to 1) determine recruitment and retention rates 2) determine adherence to the intervention, 3) assess the safety and comfort level of the intervention 4) describe the effects of the six week intervention on lymphedema symptoms. A quasi-experimental, repeated measure design was chosen for this pilot study. Twenty-one community-dwelling women breast cancer survivors were recruited from three cities in Arizona, United States. The intervention was delivered in four consecutive sessions five to ten days apart. Baseline and post-intervention questionnaires were completed by the participants. Quality of life was measured with the SF-36 and the FACT-B questionnaires. The FACT-B was also used to measure functional status. Pain was measured with the Brief Pain Inventory. A paired t-test analysis was performed on the baseline and post intervention data. An ANOVA was performed on repeated physical measures (arm circumference and range of motion).Ninety-five percent of the women who enrolled completed the study. Adherence to the intervention and home exercises was high, at 100% and 95% respectively. The intervention was evaluated as safe without any reported major changes in medical condition or level of discomfort that required discontinuation from the study. A paired t-test analysis on the scores from SF-36 (mental health) and the FACT-B (quality of life and functional status) improved significantly following the Bowenwork intervention (p<.05). An ANOVA revealed a statistical significantly improvement in arm circumference and range of motion (p<.05).Bowenwork was shown to be an effective management strategy that improved mental health, increased quality of life and daily functional status, in addition to reducing arm circumference and increasing range of motion in women breast cancer survivors with lymphedema. A future full-scale study is needed to further explore these findings.

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Stakelin, Deborah Heard. "Cultural Competence to Decrease Advanced Stage Breast Cancer Diagnosis in an Appalachian Kentucky Population." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5946.

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Despite American College of Radiology guidelines for breast cancer screening, the Appalachian Kentucky population has an increasing number of advanced stage breast cancer diagnoses related to a delay in mammogram screening initiation. A potential contributing factor for the delay in screenings is a lack of culturally competent care to support the need for early detection of breast cancer in the identified population. The purpose of this staff education project was to improve the knowledge base and skill set of health care employees concerning the most advantageous practice to increase cultural competence in the health care setting. A practice-focused question related to cultural competence through staff education as well as current research served as the foundation for this evidence-based project. Leininger's cultural care theory, Knowles's adult learning theory, and Kirkpatrick's 4 levels of training evaluation provided guidance for the project. Using the cultural competency checklist of 20 questions, the pre- and posttest responses of participants (n = 14) in the employee orientation setting were assessed to determine the outcomes of the staff education project. Statistical analyses were performed using a 2-sample proportion hypothesis test for each result, positive and negative responses, and a mean hypothesis test on weighted responses. In each statistical analysis, a significance level of .05 (5%) was reported. As a result of the statistical outcomes, permanent implementation of a staff education program to increase cultural competence, create social change through cultural awareness, and aid in decreasing advanced stage breast cancer diagnoses in the Appalachian Kentucky population was recommended.

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Koinberg, Ingalill. "Traditional or individualised follow-up in women after breast cancer surgery /." Linköping : Univ, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med873s.pdf.

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Yackzan, Susan G. "FACTORS INFLUENCING PREFERENCE FOR SURGICAL CHOICE AMONG WOMEN WITH EARLY STAGE BREAST CANCER." UKnowledge, 2017. https://uknowledge.uky.edu/nursing_etds/34.

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Breast cancer is the most common cancer among women in the United States with over 60% of cases diagnosed as early stage disease. For those women without prohibiting clinical or cosmetic concerns, a choice between breast-conserving surgery and mastectomy can be made. Either choice confers equivalent survival. The decision-making process also involves consideration of recurrence risk as well as management of the unaffected, contralateral breast for both future surveillance and risk reduction. In recent years, increasing rates of mastectomy with contralateral prophylactic mastectomy have been reported among women with unilateral, early stage breast cancer. If eligible for a choice among surgical options, a woman’s decision becomes one of personal preference. The decision-making process is complex and involves consideration of potential benefits and harms with each option. The purpose of this dissertation was to: 1) analyze the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale, 2) critically review Decisional Conflict Scales and 3) prospectively identify demographic, clinical, cognitive and affective factors influencing a woman’s decision to choose either breast conserving surgery or mastectomy with contralateral prophylactic mastectomy and to identify self-reported sources of information in the surgical decision-making process. Three manuscripts make up the dissertation. A secondary data analysis was conducted to test the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale (DASS). The results of this analysis supported the reliability and validity of the DASS anxiety subscale. A critical review of decisional conflict measures for use with early stage breast cancer patients making surgical treatment decisions was conducted. The results of this review supported the use of Decisional Conflict Scales from a clinical and research perspective. Existing Decisional Conflict Scales show moderate to acceptable reliability. The first two manuscripts provided background and support for the use of scales included in the research study described in the third manuscript. This study was a prospective, exploratory, cross-sectional, mixed-methods study describing factors influencing preference for surgical choice among women with early stage breast cancer. A sample of 78 participants enrolled in the study, 47 who chose breast conserving surgery and 31 who chose mastectomy with contralateral prophylactic mastectomy. Differences were tested between the groups. Women who chose mastectomy with contralateral prophylactic mastectomy were younger, more likely to work full or part-time, had larger tumors and participated in preoperative genetic counselling. Women who chose breast conserving surgery were more likely to have participated in preoperative breast magnetic resonance imaging. Overall, women choosing either surgery were not experiencing severe levels of distress, depression, anxiety or stress although there were individual variations. Women choosing mastectomy with contralateral prophylactic mastectomy were more anxious and had more frequent intrusive thoughts about the diagnosis. They also had less decisional conflict as compared to women choosing breast conserving surgery. Information sources were similar but the most influential information source differed among the two groups. In both groups, intention for surgical choice was matched by the final decision. There are many factors influencing surgical choice among women with early stage breast cancer. Previous work has focused on clinical, demographic and diagnostic processes influencing the decision. With this study, evidence regarding the influence of cognitive and affective factors is described.

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Zaro, Maren Lothyan. "Breast Cancer Risk Assessment: Evaluation of Screening Tools for Genetics Referral." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/8824.

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Purpose: This study assessed effectiveness of five tools recommended by the US Preventive Services Task Force (USPSTF), designed to help primary care clinicians determine which unaffected patients to refer to genetics specialists for breast cancer risk assessment based on concerning family history. Design: This descriptive secondary analysis included 85 women aged 40-74. All participants had a first-degree female relative previously diagnosed with breast cancer who also had uninformative negative BRCA1/2 tests. Methods: Each pedigree was evaluated using the five tools including the Family History Screen-7 (FHS-7), Pedigree Assessment Tool (PAT), Manchester Scoring System, Referral Screening Tool (RST), and Ontario-Family History Assessment Tool (Ontario-FHAT). All five tools were applied to each study participant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to describe each tool’s ability to identify women with elevated risk as calculated by the Claus model. Receiver operating curves (ROC) were also plotted. Differences between areas under the curve (AUCs) for all possible pairs of tools were estimated through logistic regression to assess for differences in tool performance. Results: Claus calculations identified 14 women out of 85 whose lifetime risk of breast cancer was elevated at > 15%. Only two tools, the Ontario-FHAT and FHS-7, identified all 14 women with elevated risk, a sensitivity of 100%. The FHS-7 tool flagged all 85 participants, meaning its specificity was zero. The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a negative predictive value (NPV) of 100%, indicating that if a woman was not found to need a referral to a genetics professional, it is likely she did not have an elevated lifetime risk of developing breast cancer. AUC values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. Conclusion: In this population, the Ontario-FHAT out-performed other tools in terms of sensitivity and negative predictive value; however, low specificity and positive predictive value must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to a genetics specialist.

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Gabriel, Israel Olatunji. "Effects of a psychosocial intervention on the quality of life or primary caregivers of women with breast cancer in Abuja, Nigeria." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27474.

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Studies have shown that limited attention has been paid to the psychosocial wellbeing of caregivers of patients undergoing care and treatment for breast cancer in Nigeria. There are no interventions in place to cater for their needs despite, the psychological problems faced by this group of people. This study investigated the effectiveness of a psychosocial intervention in term of impact on the quality of life (QOL) of primary caregivers of women with breast cancer in Abuja, Nigeria. Using a quasiexperimental design, sample of 108 participants assigned to the intervention and control groups, the study made use of the Zarit Burden Interview (ZBI) and Caregiver Quality of Life Index-Cancer (CQOLC) to measure caregiver burden and QOL respectively. The hypothesis for the study was that the primary caregivers of women with breast cancer who receive a psychosocial intervention programme will report improved QOL compared with caregivers who do not attend a psychosocial intervention programme. The study established that there were a negative linear relationship between caregiver burden and QOL (R = -0.45, p < 0.001) as a basis for intervention, and also that 29% variance of QOL could be explained by caregiver burden. The intervention results showed that at baseline 51.9% participants reported moderate to severe burden and 48.1% reported severe burden. These figures reduced to 22.3% and 12.6% for moderate to severe and severe burden respectively at 6 weeks after intervention, and further reduced to 18.6% and 4.9% respectively at 12 weeks after intervention. Comparing the QOL of the intervention and control groups, the results showed a significant difference on the score at baseline, 6 and 12 weeks. However, looking at performance of the intervention group, there was no significant different at baseline and 6 weeks (t=0.83, p < 0.05), and baseline and 12 weeks (t=1.65, p < 0.05). With reference to the caregiver burden of the intervention and control groups, it was found that a significant difference existed at baseline (t=9.33, p < 0.001). In respect of the impact of the intervention on caregiver burden of the intervention group, results showed a significant difference between baseline and 6 weeks (t=30.34, p < 0.001) and between baseline and 12 weeks (t = 36.80, p < 0.001) after intervention. The study concluded that the psycho-education intervention significantly affected caregiver burden but did not affect caregivers' QOL. Therefore, there is a need for a psycho-education intervention for caregivers of patients with breast cancer, in order to reduce the burden and help them cope with the work of caregiving. Appropriate supportive interventions should be made available to support the close family members of patients with breast cancer in order to reduce caregiver burden. Relevant stakeholders in the healthcare sector especially in palliative care should promote awareness of carer needs. The provision of intervention programmes for caregivers requires further research to develop contextually specific programmes and services which will improve the QOL of caregivers.

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Budhrani, Pinky H. "Race/Ethnicity, Subjective and Objective Sleep Quality, Physical and Psychological Symptoms in Breast Cancer Survivors." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4645.

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Breast cancer is a major health problem and comprises the largest population of cancer survivors in the United States, estimated at 2.9 million women, accounting for 22% of all cancer survivors (National Cancer Institute, 2013). The advances in breast cancer screening, diagnosis and treatment has increased the importance of survivorship needs. A major concern among breast cancer survivors (BCS) is sleep disturbances. This study used an innovative approach to examine ethnic and racial disparities in sleep disturbances present in BCS. In addition, this study also explored sleep disturbances across different races/ethnicities. This study was a secondary data analysis of baseline data from the supplement study of the MBSR Symptom Cluster Trial for Breast Cancer Survivors/ 1R01CA131080, conducted by Dr. Lengacher. Sleep was measured using the Pittsburgh Sleep Quality Index, sleep diary (subjective), and sleep actigraphy (objective). The sample consists of 79 women who had been diagnosed with breast cancer (Stage 0, I, II, III), completed lumpectomy and/or mastectomy, and were within 2 weeks to 2 years post radiation and/or chemotherapy treatment. The aims for this study were to: 1) explore racial/ethnic differences in objectively measured sleep patterns among BCS; 2) estimate and compare the correlation between objective and subjective sleep quality by racial/ethnic groups among BCS; 3) examine which sleep actigraphy measure appears to have the strongest relationship with physical and psychological symptoms; and 4) explore whether these relationships (i.e. between objective sleep and self-reported symptoms) appear to be modified by race/ethnicity. The first aim was conducted using analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Results indicated that white, non Hispanic BCS had improved objective sleep quality compared to minority BCS. The second aim was conducted using Pearson's correlation with significant correlations found between subjective and objective sleep onset latency (r= .310, p= .016), and total sleep time (TST) (r= .328, p= .011) for the white, non-Hispanic group. The third aim was conducted using Pearson's correlation with significant correlations between sleep onset latency and depression (r= .247, p= .029); sleep efficiency and depression (r= -.233, p= .040); sleep efficiency and fatigue (r= -.207, p= .045); and WASO and pain (r= .277, p= .014). There were no significant correlations between the anxiety score and actigraphy parameters. Using the significant correlations from the results of the third aim, multiple regression analysis was conducted with age as a covariate to test the fourth aim. The main effect of depression on sleep efficiency was significant (p= .044) with less depression associated with higher sleep efficiency. The interaction term, depression by race/ethnicity, had a non-significant effect on sleep efficiency (p= .299). The main effect of pain on WASO was significant (p= .008), and increased pain was associated with longer WASO. The interaction term, race/ethnicity by pain, had a non-significant effect on WASO (p= .148). The main effect of depression predicting sleep onset latency was significant (p= .027), and the interaction term, depression by race/ethnicity, had a trend towards a significant effect (p= .092) on predicting sleep onset latency. The interaction between depression and race/ethnicity predicting sleep onset latency was further decomposed using multiple regression. The average sleep onset latency was longer in the minority group with high depression levels (42 minutes) compared to the white, non-Hispanics with high depression levels (29 minutes). Race modified the effect of depression on sleep onset latency in this sample of BCS. These finding suggest that the experience of objective sleep disturbances is different among races/ethnicities. Additional research is needed to further explore racial/ethnic differences in subjective and objective sleep disturbances and its impact on physical and psychological symptoms among BCS. As the number of BCS continue to rise, it is becoming increasingly important to recognize sleep disturbances and their potential physical and psychological effects early in BCS, specifically in different races and ethnicities. It is anticipated that these findings may contribute to improved symptom management for women of different races and ethnicities.

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Alinat, Carissa Bea. "Genetic Moderation of Pain and Fatigue Symptoms Resulting from the Mindfulness-Based Stress Reduction for Breast Cancer Program." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7257.

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Breast cancer survivors (BCS) account for the largest group of cancer survivors living in the United States and they often experience lingering physical symptoms that may affect quality of life, with fatigue and pain the most commonly reported. This genetic research study was conducted within a parent R01 study, with the purpose of exploring associations between genetic variants and fatigue and pain symptoms and the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program. The aims of this study were to: 1) identify specific genotypes involved in fatigue and pain symptoms, and 2) explore whether single nucleotide polymorphism (SNP) rs1800795 in gene IL6, SNP rs16944 in gene IL1B, and SNP rs4680 in gene COMT, moderate the effects of the MBSR(BC) intervention on fatigue and/or pain symptoms. As part of a larger R01 trial, one-hundred-fifty-eight participants were randomized to either a six-week MBSR(BC) intervention or Usual Care (UC). Data were collected at baseline, six-week, and 12-weeks on subjective measures of pain, fatigue, along with demographic and clinical history information. In addition, DNA was collected for genotyping among the 158 participants using the PCR analysis method. For Aim 1, one-way linear trend analysis of variances (ANOVAs) were implemented to explore associations between the SNPs in genes with subjective symptom measures of pain and fatigue. For Aim 2, comparison of mean scores along with linear mixed model (LMM) analyses were used to explore if the patient’s SNPs moderated the effects of the MBSR(BC) intervention on fatigue and pain symptoms. Results found the mean age of the total sample was 58.4 years and 89% were White, non-Hispanic. Although participants were randomized 1:1 to either the MBSR(BC) or UC groups, chi square analyses found that there was a significant difference for time since treatment, with the UC group being closer to treatment end (< 1 year) than the MBSR(BC) group (p < .05). No other statistically significant differences between groups for baseline demographic or clinical characteristics were found. For Aim 1, one-way linear trend ANOVAs among fatigue and pain scores and the three SNPs (COMT rs4680, IL1B rs16944, IL6 1800795) included as part of this study, fatigue and/or pain, resulted in no statistically significant associations (p > .05). Linear Mixed Model (LMM) analyses, implemented to assess the between-group interactions between pain and/or fatigue symptom, time, and SNP, resulted in no statistically significant findings for SNP rs4680 in COMT and SNP rs16944 in IL1B, however significant findings were found for the interaction between assignment (MBSR(BC) versus UC) and genotype for SNP rs1800795 in IL6. Second, a comparison of means suggests that participants in the MBSR(BC) group who had CG genotype for SNP rs1800795 in IL6 benefited more from the intervention than those with CC or GG genotypes for fatigue severity, fatigue interference, pain severity, and pain interference, with small to large effect sizes ranging from d = 0.38 to d = 0.72. Although this genetic study was exploratory in nature, the results suggests that the effects of the MBSR(BC) program may be moderated by SNPs in genes that are involved in cytokine production, which means that BCS with specific genotypes experience a greater improvement in symptoms than those with other genotypes. The results of this study also suggest that further research is needed, with larger sample sizes, to assess the genetic moderation of symptoms experienced by BCS.

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Jakusheva, Alina. "Kvinnors upplevelser av mastektomii samband med bröstcancer -en litteraturstudie : Women´s experiences of mastectomyin liaison with breast cancer -a literature study." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-84360.

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Dissertations / Theses on the topic 'Breast Cancer Nursing Malaysia'

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