382 research outputs found

    Life journeys with advanced breast cancer in Mauritania:A mixed methods case study

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    Background: Breast cancer is the most common cancer for women, globally. Social, religious and healthcare contexts have been shown to influence women’s experiences of advanced breast cancer; however, research has tended to focus on resource-rich nations. There is limited research from low-resource contexts, and little is known on the experiences of Arab, Muslim and African women with advanced breast cancer. Aim: To explore and understand the experiences of advanced breast cancer in the Islamic Republic of Mauritania, West Africa. Methods: Using a constructivist Stakian multi-case study approach, eight cases were constructed around women (n=8) with advanced breast cancer, family members (n=10) and health professionals (n=9). Data were collected longitudinally (up to nine months per case) and consisted of interviews, audio-journals, a patient reported outcome measurement scale and a performance status scale. Withincase and cross-case analysis was undertaken, with thematic analysis of qualitative data. Findings: Three key themes were identified: 1. Destiny, 2. Patience & Acceptance and 3. Journeying in search of a cure. Mauritanian women appreciate that Allah is all powerful and maintains control over their destinies and their breast cancer. A fear of causing offence to Allah influences how they express negative experiences of breast cancer and its treatments. The women’s access to information and treatment is controlled by health professionals and families. Women are, therefore, required to use their own observations and interpretations to understand their breast cancer and empower their pursuit of treatment and a cure. Conclusion: Maure women’s experiences of advanced breast cancer in Mauritania are influenced by power imbalances. Allah is all-powerful. Families and health professionals exert power over Maure women’s access to information, healthcare decisions and how they express negative experiences. This thesis demonstrates that Maure women are cognisant of these challenges and, either, accept them as reality or attempt to work around them

    Stories of African American women who are long-term breast cancer survivors

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    The purpose of this study was to report the stories of African American (AA) women who are disease-free survivors of breast cancer, 10 or more years after initial diagnosis, and consider themselves to be thriving after cancer. Narrative inquiry was used to develop the stories into a cohesive whole. A womanist framework (Walker, 1983) was used as a lens through which to consider the data. In the narrative inquiry tradition, one blended story was derived from the data including an abstract for summary, orientation, complication to describe critical events, evaluation, result or outcome, and coda to relate the story of the past to the reality of today (Munhall, 2012). The story was developed from the following themes: (1) I'm still here; (2) And then I had cancer; (3) Can we talk?; (4) Peace in the valley; (5) They call it the red devil; (6) You are not alone; (7) The new normal; and (8) When I learn something, I share it. Findings from this study have implications for nursing research and practice, as well as care for long-term survivors of breast cancer. Using culturally relevant interventions can be helpful in caring for physical and spiritual needs. If researchers and clinicians can tailor their communication style and value the historical underpinnings of health-seeking behaviors in AA long-term breast cancer survivors, more support can be made available for this population

    An Exploration of the Lives of Young, African American Women with Triple-Negative Breast Cancer

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    Compared to other subtypes of breast cancer, triple-negative breast cancer: TNBC) accounts for a disproportionate number of metastatic cases and cancer deaths. Glaring disparities are present in the occurrence of TNBC, such that those diagnosed are more likely to be African American: prevalence of 26% vs. 16% in non-African Americans) and premenopausal: 24% vs. 15% postmenopausal). A critical factor to consider regarding the disparities associated with TNBC is the evidence documenting the link between psychosocial stress over the life course and the occurrence of large, aggressive tumors that are characteristic of this subtype. Because issues such as crime, isolation, stress, discrimination, and other factors associated with poverty have been found to significantly affect etiology of breast cancer among young, African American women, it is critical to also consider these issues after diagnosis occurs. Despite the fact that many of these factors impact the etiology of TNBC, little is known about how these factors come into play once the diagnosis has occurred. The present study qualitatively explores the critical biopsychosocial history and current environment of women facing such a diagnosis in order to shed light on the experience of TNBC. Using a grounded theory approach, in-depth, qualitative interviews were conducted with six women with TNBC and with a comparison group of six women with ER+ breast cancer. A prospective, longitudinal design was used with all women in the study to assess change over time and to cultivate prolonged engagement with participants. Data collection occurred in three waves, which corresponded with three critical points of the cancer care trajectory. Findings from this study demonstrate that the following stressors and strengths were unique for women with TNBC as compared to women with ER+ breast cancer: burden carriers throughout the life course, distant/strained relationships with mothers, absent fathers, experiences of sudden, unexpected deaths of loved ones, limited engagement in a spiritual community, limited engagement in neighborhood/community, and young age at time of diagnosis. Findings from these interviews resulted in a preliminary conceptual framework for understanding the contextual lives of women with TNBC, which can assist with guiding the formation of appropriate social work interventions

    Pap Testing Screening Experiences of HIV-Positive Women

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    Pap Testing Screening Experiences of HIV-Positive Wome

    Bent but not Broken : A Mixed Methods Study of Mothering During Chemotherapy for Breast Cancer

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    Breast cancer is the most common cancer diagnosis of women, with an estimated 232,670 new cases in 2014. With 89.2% of breast cancer patients surviving five years or longer, studies are needed to investigate the long-term impact of breast cancer on women and families (National Cancer Institute, 2014). The purpose of this study was to examine, using a mixed methods approach, the impact of chemotherapy on mothering occupations for patients diagnosed with breast cancer. Thirty-one women (mean age=39.6, SD=5.79), with breast cancer of any stage, who were currently undergoing chemotherapy and had at least one child under the age of 18 living in the home, were recruited from a comprehensive breast cancer care center. These participants completed the Fatigue Symptom Inventory Then Test, the Parent Disability Inventory, the FACT-G quality of life inventory, and a demographic questionnaire. Of these 30 participants, ten participants were selected using purposeful sampling to participate in semi-structured interviews focusing on the impact of chemotherapy on mothering occupations. Qualitative data were analyzed using a grounded theory approach (Corbin & Strauss, 2008) and quantitative data were analyzed using SPSS version 22 to determine descriptive statistics and correlations among variables. After analysis, the central category that emerged from the data was “Keeping life the same while weathering cancer treatments,” which was developed from categories of learning, adapting, accepting support, growing and normalcy. Quantitative analyses found a correlation between fatigue and parent disability (Spearman rho correlation = -0.476, p \u3c 0.05), quality of life and fatigue interference (-0.481, p \u3c 0.001) and parent disability and quality of life (0.745, p\u3c0.001). Implications for future occupational therapy practice are discussed

    “A peculiar time in my life”: making sense of illness and recovery with gynaecological cancer

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    Purpose: Worldwide there are nearly 1.1 million new cases of gynaecological cancer annually. In England, uterine, ovarian and cervical cancers comprize the third most common type of new cancer in women. Research with gynaecological cancer patients within 6 months of diagnosis is rare, as is data collection that is roughly contemporaneous with treatment. Our aim was to explore the experiences of women who were, at study entry, within 6 weeks of surgery or were undergoing chemotherapy or radiotherapy. Methods: An interpretative phenomenological analysis (IPA) of data from 16 women in five focus groups was conducted in the UK, exploring women’s experiences of being diagnosed with and treated for gynaecological cancer. Results: Participants conceptualized their experiences temporally, from the shock of diagnosis, through their cancer treatment, to thinking about recovery. They tried to make sense of diagnosis, even with treatment being complete. In the context of the Self-Regulation Model, these women were struggling to interpret a changing and multi-faceted illness identity, and attempting to return to pre-illness levels of health. Conclusions: This study adds to this under-studied time period in cancer survivorship. The results suggest that survivors’ goals may change from returning to pre-illness status to reformulating goals as survival time increases.N/

    The Experience of Non-Spousal Close Intimate Relationships for Women with Breast Cancer: A Journey of Support

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    An estimated 331,530 women will be diagnosed with breast cancer in 2019 ( American Cancer Society, 2019, p. 10). The purpose of this qualitative, phenomenological, descriptive study was to explore the lived experience of non-spousal close/intimate relationships of women with breast cancer. There are very few studies in the literature examining relationships between women with cancer other than those of partner or spouse. This study’s participants consisted of six women, ages 32 to 68. Analysis of these data identified themes reflected along their breast cancer trajectory (1) The journey starts (2) Mid-journey passage, and (3) Journeys end/coming home, as well as nine subthemes. Findings of this study suggest support offered by non-spousal close/intimate individuals is a dynamic provision, by diverse support systems that change over time throughout the breast cancer continuum. Assessment of support required by women with breast cancer is especially important at the beginning of the breast cancer journey but then again at various intervals, for a holistic approach and provision of functional and structural support so desperately needed by women with breast cancer

    Sex and Sexuality of Breast Cancer Survivors

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    With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own stories were used to explore the impact that survivorship, diagnosis, and treatment may have on a woman’s sexual self. Results are presented through manuscripts exploring the role of sexual script theory and the role of the breast in the lives of women after breast cancer. This study found that women’s sexual scripts were impacted by a diagnosis of breast cancer. For participants of this study, new scripts emerged that assisted in making meaning of the experience

    The Impact of Cancer Caregiving on Cancer Caregivers: Stories of Lives in Transition

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    The purpose of the study was to examine the impact of cancer caregiving on primary caregivers, exploring their personal narratives looking back on the entire experience from diagnosis, through treatment, and beyond. Caregiving is associated with exacerbation of stress-related disorders such as hypertension and heart disease and may also be associated with increased mortality rates. Transitions theory served as the conceptual framework for the study. Eleven adult caregivers, pre-retirement age, each participated in two semi-structured interviews. Caregivers were recruited from a community cancer resource center and were purposively selected to achieve maximum variation in terms of outcome of cancer treatment. The sample included 8 females and 3 males; there were 3 husbands, 6 wives, and 2 daughters. Caregivers provided care for patients with a variety of cancer types and a variety of treatment outcomes, from cancer free with sequelae to deceased. Each caregiver interview recording was transcribed, and preliminary examination of each transcript helped guide subsequent interviews. NVivo9 software was used to assist with data management. Data saturation was achieved. Narrative within-case analyses as well as thematic analysis were used to address research questions. Thematic analysis resulted in seven themes: Burden: The Load that Never Ends; Disconnectedness and Isolation: The Invisible Person; Helplessness and Loss of Control: Tied to This Ride; Dealing with the Healthcare System; Role Disruption: Spinning the Plates; Loss, Change, and Grief: Reaction to the Whole; and Carrying Forward with Scars: New Priorities and Permanent Change. All of the caregivers changed their employment or social responsibilities due to the demands of caregiving. Themes were present in different parts of the cancer trajectory and in differing intensities in all interviews. Findings included disconnectedness and isolation as a central feature of cancer caregiving, plus significant grief present through the cancer trajectory, especially in the post-treatment phase. Furthermore, the experience of cancer caregiving remained one of significant impact years after treatment had ended. Successful transitioning requires connectedness and mastery, but participants in this study identified that their caregiving trajectories were full of isolation, grief, burden, and helplessness. Many suggested the need for support, even though they tended to deny their own physical and emotional needs while caregiving. Healthcare professionals can help by providing information, support, listening, and grief counselling. Research is needed on interventions that may reduce isolation, helplessness, and burden for caregivers
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