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Dietary changes among breast cancer patients in Malaysia

Shaharudin SH, Sulaiman S, Shahril MR, Emran NA, Akmal SN

Cancer Nurs, 2013 Mar-Apr;36(2):131-8.
PMID: 22293157 DOI: 10.1097/NCC.0b013e31824062d1

BACKGROUND: Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence.
OBJECTIVE: The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients.
METHODS: One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected.
RESULTS: Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables.
CONCLUSION: Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small.
IMPLICATIONS FOR PRACTICE: This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.
A comparison of the information needs of women newly diagnosed with breast cancer in Malaysia and the United kingdom

Gopal RL, Beaver K, Barnett T, Ismail NS

Cancer Nurs, 2005 Mar-Apr;28(2):132-40.
PMID: 15815183

Little is known about the information needs of women with breast cancer in non-Western societies. This study examined the priority information needs of 100 women with breast cancer in Malaysia and compared the findings to previous work involving 150 women diagnosed with breast cancer in the United Kingdom. The study used a valid and reliable measure, the Information Needs Questionnaire (INQ). The INQ contained 9 items of information related to physical, psychological, and social care, used successfully in Canada and the United Kingdom. The INQ was shown to have cross-cultural relevance and sensitivity. For Malaysian women, information about likelihood of cure, sexual attractiveness, and spread of disease were the most important information needs. For UK women, similar priorities were evident, apart from the item on sexual attractiveness, which was ranked much lower by women in the United Kingdom. The cultural similarities and differences that emerged from this study have implications for nurses in the cancer field caring for people from a diversity of cultural backgrounds. Breast care nurses are not a feature of the Malaysian healthcare system, although the findings from this study support the view that specialist nurses have a vital role to play in meeting the psychosocial needs of women with breast cancer in non-Western societies.
Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia

Chui PL, Abdullah KL, Wong LP, Taib NA

Cancer Nurs, 2017 7 21;41(3):189-199.
PMID: 28723722 DOI: 10.1097/NCC.0000000000000527

BACKGROUND: Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice.
OBJECTIVE: The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy.
METHODS: A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM).
RESULTS: We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users.
CONCLUSIONS: Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden.
IMPLICATIONS FOR PRACTICE: Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.
Uncertainty and Quality of Life in Women With Breast Cancer: Moderating Role of Coping Styles

Ahadzadeh AS, Sharif SP

Cancer Nurs, 2018 3 1;41(6):484-490.
PMID: 29489477 DOI: 10.1097/NCC.0000000000000552

BACKGROUND: The negative relationship between uncertainty and quality of life is well reported in the literature. Also, there is abundant research linking coping strategies to cancer patients' quality of life. However, there exists a paucity of information on the moderating effect of coping styles on the relationship between uncertainty and quality of life in cancer patients.
OBJECTIVE: The aim of this study was to examine whether uncertainty in illness is negatively correlated with quality of life and whether this relationship is moderated by coping strategies, namely, problem-focused, avoidant, and active emotional coping.
METHODS: A convenience sample of 135 Malaysian women with breast cancer participated in the study. Participants completed measures of uncertainty in illness, quality of life, and coping styles.
RESULTS: Uncertainty in breast cancer was negatively related to quality of life (β = -0.379, P < .001), and active emotional coping was found to moderate this negative relationship (β = 0.155, P < .05). The model explained 22.20% of the variance of quality of life.
CONCLUSION: Lack of information about breast cancer, treatment, hospitalization, and disease recurrence is related to poorer quality of life. However, this negative relationship becomes weaker when active emotional coping strategies are used.
IMPLICATIONS FOR PRACTICE: Nurses and health providers should help patients reduce their uncertainty in illness by providing them information on breast cancer or referring them to relevant sources. Moreover, they could reduce the deleterious effect of uncertainty on quality of life by encouraging patients to use more active emotional coping strategies.
Survivorship Experiences of Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Systematic Review

Ruan J, Cheng H, Liu Q, Xu F, Kwok WYY, Luo D, et al.

Cancer Nurs, 2024 Jul 16.
PMID: 39016254 DOI: 10.1097/NCC.0000000000001383

BACKGROUND: The number of allogeneic hematopoietic stem cell transplantation (allo-HSCT) survivors is increasing globally. Although qualitative studies in this population are reported, clear understanding of how allo-HSCT survivors experience survivorship is lacking.
OBJECTIVE: This study aimed to identify, appraise, and synthesize evidence from qualitative research on survivorship experience among allo-HSCT survivors.
METHODS: A qualitative systematic review was conducted. A literature search of 9 databases and OpenGrey, Google Scholar, and Google was performed from inception to February 2023. Two reviewers independently screened and assessed the eligibility of each study. Descriptive information was extracted from the studies by one reviewer and checked by another. Findings were extracted and analyzed using thematic synthesis.
RESULTS: Seventeen articles were included. Four themes and 12 subthemes regarding allo-HSCT survivors' experiences emerged: (1) recovery as being a longer process than they thought (influenced by long-term physical symptoms, disturbed by survivorship uncertainty); (2) experiencing a restricted survivorship life (shrunken social world, forced dietary limitations, centered around hospitals); (3) suffering from stigma and discrimination (perceived as a burden, seen differently by others, difficulties establishing and maintaining romantic relationships and marriage, limited opportunities in work); and (4) realizing something positive obtained during survivorship (enriched survivorship self-management skills, enhanced personal growth, developed positive relationships).
CONCLUSIONS: The findings reveal the challenges, needs, and growth that allo-HSCT survivors experienced during survivorship. Some understudied areas were identified, which warrant further exploration.
IMPLICATIONS FOR PRACTICE: Targeted survivor-centered care should be provided to allo-HSCT survivors, and interventions to resolve issues experienced during survivorship should be developed.
Nurse-Led Interventions in Managing Cancer-Related Fatigue: A Systematic Review

Mazlan ANF, Tuan Rusli NA, Wee LH, Ahmad M, Chan CMH

Cancer Nurs, 2024 Sep 11.
PMID: 39259694 DOI: 10.1097/NCC.0000000000001409

BACKGROUND: Cancer-related fatigue (CRF) is common among patients with cancer. Various interventions have been reported to reduce fatigue, and some evidence suggests that nurse-led interventions may be effective in the management of CRF. A systematic review was conducted to assess the effectiveness of nurse-led interventions for CRF in patients with cancer and survivors.
OBJECTIVE: The aim of this study was to review and appraise the evidence for the effectiveness of different types of nurse-led interventions on fatigue in patients with cancer and survivors.
METHODS: Electronic databases such as PubMed, Scopus, Cochrane Library, Web of Science, and ScienceDirect were searched to identify studies published from January 2013 to October 2023. The studies that described nurse-led interventions in patients with cancer or survivors regardless of treatment duration, modes of intervention delivery, and any based intervention were included. The studies were excluded if no fatigue was an outcome measure.
RESULTS: Twelve studies from 2013 to 2023 were included and eligible for the review. Nine studies obtained a Jadad score of 3 or more, indicating high quality for the quality assessment. Eleven of the included studies reported a significant effect of the nurse-led interventions in reducing fatigue in patients with cancer or survivors.
CONCLUSIONS: Nurse-led interventions that focus on multidisciplinary, exercise, psychological, and behavioral approaches appear promising in the management of CRF. More research is needed in order to determine the most acceptable forms of intervention.
IMPLICATIONS FOR PRACTICE: The development of evidence-based interventions for managing CRF is significant to nursing practice.