Displaying publications 1 - 20 of 82 in total

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  1. Padmanabhan H, Hassan NT, Wong SW, Lee YQ, Lim J, Hasan SN, et al.
    PLoS One, 2022;17(2):e0263675.
    PMID: 35167615 DOI: 10.1371/journal.pone.0263675
    There is an increasing number of cancer patients undertaking treatment-focused genetic testing despite not having a strong family history or high a priori risk of being carriers because of the decreasing cost of genetic testing and development of new therapies. There are limited studies on the psychosocial outcome of a positive result among breast cancer patients who are at low a priori risk, particularly in women of Asian descent. Breast cancer patients enrolled under the Malaysian Breast Cancer Genetic Study between October 2002 and February 2018 were tested for BRCA1, BRCA2 and PALB2 genes. All 104 carriers identified were invited by a research genetic counsellor for result disclosure. Of the 104 carriers, 64% (N = 66) had low a priori risk as determined by PENN II scores. Psychosocial, risk perception and health behaviour measures survey were conducted at baseline (pre-result disclosure), and at two to six weeks after result disclosure. At baseline, younger carriers with high a priori risk had higher Cancer Worry Scale scores than those with low a priori risk but all scores were within acceptable range. Around 75% and 55% of high a priori risk carriers as well as 80% and 67% of low a priori risk carriers had problems in the "living with cancer" and "children" psychosocial domains respectively. All carriers regardless of their a priori risk demonstrated an improved risk perception that also positively influenced their intent to undergo risk management procedures. This study has shown that with sufficient counselling and support, low a priori risk carriers are able to cope psychologically, have improved perceived risk and increased intent for positive health behaviour despite having less anticipation from a family history prior to knowing their germline carrier status.
    Matched MeSH terms: Breast Neoplasms/psychology*
  2. Zainordin NH, A Karim N, Shahril MR, Abd Talib R
    Asian Pac J Cancer Prev, 2021 Aug 01;22(8):2399-2408.
    PMID: 34452552 DOI: 10.31557/APJCP.2021.22.8.2399
    BACKGROUND: Increasing physical activity and reducing sitting time was recommended to cancer survivors after cancer treatment for sustained health and to enhance the quality of life. This study aimed to determine the association of physical activity and sitting time with quality of life among the Malay breast and gynaecological cancer survivors.

    METHODS: A cross-sectional study was conducted among 95 breast and gynaecology cancer survivor subjects. The Malay International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and sitting time. Quality of life was assessed using the Malay EORTC QLQ-C30 questionnaire. Sociodemographic, clinical characteristics and anthropometric measurements were also obtained in this study.

    RESULTS: The mean age of the subject was 51.8 ± 7.7 years old and the duration of survivorship was 4.3 ± 3.4 years. A total of 76.8% of subjects were categorized as having low physical activity level with a mean MET 403.5 ± 332.7 minutes/week and sitting time of 416.9 ± 151.0 minutes/day. Overall, subjects aged 50 years and above (p=0.006), widowed (p=0.032), retired (p=0.029) and had other non-communicable diseases (p=0.005) showed lower levels of physical activity. Increased physical activity had a positive effect on physical function (r=0.2, p=0.038), reduced insomnia (r=-0.3, p <0.001) and constipation symptoms (r=-0.3, p=0.012) domains of quality of life. The longer the sitting period showed more severe insomnia symptoms (r=0.2, p=0.03) but improved social function (r=0.2, p=0.012).

    CONCLUSIONS: Increasing physical activity and reducing sitting time have a positive effect on the quality of life of cancer survivors. The focus of health education should be prioritized to older adults (50 years and above), widows, retirees, and those with other comorbidities as they are at risk of being not physically active.
    .

    Matched MeSH terms: Breast Neoplasms/psychology*
  3. Hashim CG, Taib NA, Yoon HJ, Larkin D, Yip D, Lopez V
    J Nurs Meas, 2021 04 01;29(1):E18-E38.
    PMID: 33593987 DOI: 10.1891/JNM-D-19-00068
    BACKGROUND AND PURPOSE: There are a lack of documentation on psychometric assessments on the Malay version of 14-item Resilience scale (RS-14) in Malaysia. This study was to empirically assess its reliability and validity.

    METHOD: A prospective test-retest design was employed on Malaysian women with early breast cancer (N = 105). Data were analyzed using SPSS version 24.

    RESULTS: The results showed overall Cronbach alpha values were .92 and .93 for test-retest, respectively. Intraclass correlation coefficient (ICC) values ranged between .62 and .75. This study accepted three factors and two factors for test-retest, respectively. Individual factors showed Cronbach alpha average ranged from .71 to .91.

    CONCLUSION: The Malay version RS-14 tool was found to be statistically valid, reliable, and reproducible. It was able to measure resilience level in those women under study.

    Matched MeSH terms: Breast Neoplasms/psychology*
  4. Md Yusof K, Mahmud R, Abdullah M, Avery-Kiejda KA, Rosli R
    Asian Pac J Cancer Prev, 2021 Apr 01;22(4):1055-1061.
    PMID: 33906296 DOI: 10.31557/APJCP.2021.22.4.1055
    INTRODUCTION: The survival rate of female breast cancer survivors has been reported to be higher than other types of cancer in Malaysia. Nonetheless, breast cancer survivors face new challenges from unwanted side effects of treatment or management such as fatigue, psychological disturbance, or arm swelling, which can lead to the decline of quality of life (QOL). This study aims to adapt the Malay version of the Functional Assessment of Cancer Therapy-Breast (FACT-B) to evaluate the QOL and to test its reliability and validity in Malaysian breast cancer survivors.

    METHODS: The Malay version of the FACT-B, with Disabilities of Arms, Shoulders and Hands (DASH), and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) were distributed to female breast cancer survivors which were recruited on a voluntary basis, from cancer support groups based in selected states in Malaysia. Reliability was assessed based on internal consistency (Cronbach's α), whereas concurrent validity was examined by comparing domains in FACT-B with DASH and PHQ-ADS. Finally, total scores of each domain were analysed between lymphedema and without lymphedema groups for known-group validity.

    RESULTS: A total of 113 breast cancer survivors agreed to participate (response rate = 100%) in the study. Our results showed that the Cronbach's α value for Malay FACT-B is 0.88, and each domain ranged from 0.62 to 0.88. A strong correlation was found between the physical well-being domain of FACT-B with DASH. Meanwhile, the breast cancer scale (BCS) displayed significant correlation with the instrument, Patient Health Questionnaire- Anxiety Depression Scale (PHQ-ADS), indicating that multiple factors including psychological distress were measured in the BCS domain. Furthermore, the instrument was able to detect differences in physical, functional and QOL between participants from lymphedema and without lymphedema groups.

    CONCLUSION: The Malay version of the FACT-B demonstrated reliable properties and is effective in assessing QOL and can be applied in Malaysian breast cancer survivors.

    Matched MeSH terms: Breast Neoplasms/psychology*
  5. Zainordin NH, Abd Talib R, Shahril MR, Sulaiman S, A Karim N
    Asian Pac J Cancer Prev, 2020 Dec 01;21(12):3689-3696.
    PMID: 33369469 DOI: 10.31557/APJCP.2020.21.12.3689
    OBJECTIVE: Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors.

    METHODS: Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods.  Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected.

    RESULTS: The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033).

    CONCLUSION: Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.

    Matched MeSH terms: Breast Neoplasms/psychology
  6. Ali R, Draman N, Mohd Yusoff SS, Norsa'adah B
    Asian Pac J Cancer Prev, 2020 Oct 01;21(10):2971-2978.
    PMID: 33112556 DOI: 10.31557/APJCP.2020.21.10.2971
    OBJECTIVE: To determine the level of self-efficacy for coping with breast cancer among Malaysian women and its association with socio-demographic and clinical variables.

    MATERIALS AND METHODS: This cross-sectional study involved 168 women diagnosed with breast cancer. The inclusion criteria were age >18 years old, having histologically confirmed breast cancer, and being diagnosed between January 1, 2009 to December 31, 2012. The exclusion criteria were being illiterate and having cognitive impairment. For data collection patients' medical records and the Cancer Behaviour Inventory-Brief (CBI-B) Malay version questionnaire were used. Simple and multiple logistic regression methods were used to analyse the data.

    RESULTS: Patients' mean (SD) age was 51.4 (10.8) years old. Most of the patients were Malays, married, diagnosed at stage 2 breast cancer (41%), and completed their breast cancer treatment. The mean score for self-efficacy for coping with breast cancer was 83.67 (95% CI: 81.87, 85.47). The significant factors positively correlated with self-efficacy for coping with breast cancer were higher educational background and a higher family income. However, factors such as a family history of breast cancer and breast surgery reduced the mean score of self-efficacy for coping with breast cancer.

    CONCLUSION: The mean score of self-efficacy for coping with breast cancer in this study was moderate. Self-efficacy for coping with breast cancer in Hospital Universiti Sains Malaysia was not adequate among sufferers and improvement is needed probably by providing education to these patients.

    Matched MeSH terms: Breast Neoplasms/psychology*
  7. Nurnazahiah A, Shahril MR, Nor Syamimi Z, Ahmad A, Sulaiman S, Lua PL
    Health Qual Life Outcomes, 2020 Jul 10;18(1):222.
    PMID: 32650777 DOI: 10.1186/s12955-020-01478-x
    BACKGROUND: Lack of physical activity throughout one's lifetime has been associated with obesity and it is also an important risk factor of breast cancer. This study aimed to determine the relationship between objectively measured physical activity and sedentary behaviour with health-related quality of life (HRQoL) among breast cancer survivors in the East Coast region of Peninsular Malaysia.

    METHODS: A cross-sectional study involving 83 breast cancer survivors was carried out in two main government referral hospitals in the region. Participants wore the ActivPAL3™ microdevice physical activity monitor for seven consecutive days. The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) were used to measure their HRQoL. Multiple linear regression analysis was conducted to determine the relationship between objectively measured physical activity and sedentary behaviour with HRQoL.

    RESULTS: Longer time spent on moderate to vigorous physical activity (MVPA) was significantly associated with an improvement of HRQoL (p = 0.039) whereas longer time spent on sedentary behaviour significantly reduced the functioning score (p = 0.005). In addition, prolonged sedentary bouts were also significantly associated with better body image that led to improved HRQoL (p = 0.013).

    CONCLUSIONS: The study findings suggest that an increase in the time spent on MVPA was associated with improved HRQoL while sedentary behaviour was associated with poorer HRQoL among breast cancer survivors. Thus, it is essential to displace sedentary behaviour with MVPA to improve the quality of life of breast cancer survivors.

    Matched MeSH terms: Breast Neoplasms/psychology*
  8. Lu Shin KN, Mun CY, Shariff ZM
    Asian Pac J Cancer Prev, 2020 Jul 01;21(7):1939-1950.
    PMID: 32711419 DOI: 10.31557/APJCP.2020.21.7.1939
    OBJECTIVE: This study aimed to investigate how nutrition indicators and physical function may influence Health-related Quality of Life (HRQoL) of breast cancer patients undergoing treatment.

    METHODS: This was a cross sectional study among a total of 163 breast cancer patients. Series of measurements including anthropometry, biochemical, and dietary were employed to assess patients' nutritional status while physical function was assessed by handgrip strength. HRQoL of patients was determined using European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC-QLQ-C30) version 3.0. Multiple linear regression was used to identify factors associated with HRQoL.

    RESULTS: Breast cancer patients perceived moderately their overall quality of life (QoL), with the mean global health status (GHS) score of 69.12. Emotional functioning was the poorest functional scale while fatigue was the most distressing symptom presented by the patients. Approximately 20% of patients had low corrected arm muscle area while more than half had low hemoglobin level. More than 90% of patients did not meet the overall dietary recommendation and had poor handgrip strength. Mid-upper arm circumference (MUAC) was associated with GHS (β: 0.906; 95% CI: 0.22, 1.56) and cognitive functioning (β: -1.543; 95% CI: -3.07, -0.01). Handgrip strength was positively associated with most of HRQoL outcomes.

    CONCLUSIONS: Breast cancer patients reported overall good nutritional status and moderate QoL during treatment. Being well-nourished improved HRQoL and handgrip strength could be a potential proxy for functional outcomes as well as overall QoL.

    Matched MeSH terms: Breast Neoplasms/psychology*
  9. Htay MNN, Donnelly M, Schliemann D, Loh SY, Dahlui M, Ibrahim Tamin NSB, et al.
    Asian Pac J Cancer Prev, 2020 Jan 01;21(1):217-223.
    PMID: 31983187 DOI: 10.31557/APJCP.2020.21.1.217
    BACKGROUND: Breast cancer is the most common cancer among women in Malaysia, and the incidence of 31.1 per 100,000 population is comparatively higher than other Southeast Asian countries. Diagnosis tends to occur at later stages which may be due, partly, to inadequate knowledge about warning signs and symptoms. Therefore, this study investigated the validity and reliability of a UK-developed measure in the context of assessing women's awareness of breast cancer in Malaysia.

    AIMS: This study aimed to translate, adapt and validate the internationally recognised Breast Cancer Awareness Measure (B-CAM) into the Malay language.

    METHODS: The original B-CAM (Cancer Research UK) was forward and backward translated and content validation was ascertained. Face validity (n=30), test-retest reliability (n=50) and the internal consistency of the B-CAM-M (M for Malay language) were assessed in a community sample of adults (n=251) in 2018.

    RESULTS: The translated B-CAM-M was validated by an expert panel. The Item-Content Validity Index ranged from .83 to 1.00. The results from the survey (n=251) indicated that the B-CAM-M was well received by Malay-speaking women across the main ethnic groups (85 Malay, 84 Chinese and 82 Indian adults). Cronbach alpha scores for the knowledge about breast cancer symptoms (0.83) and the barriers to healthcare seeking items (0.75) were high. Test-retest reliability (separated by 2-week-interval) with 50 randomly selected participants from the community survey produced intra-class correlations ranging from 0.39 to 0.69.

    CONCLUSION: The Malay-version, the B-CAM-M, is a culturally acceptable, valid and reliable assessment tool with which to measure breast cancer awareness among Malay-speaking women.

    Matched MeSH terms: Breast Neoplasms/psychology*
  10. Che Mohamed N, Moey SF, Lim BC
    Asian Pac J Cancer Prev, 2019 09 01;20(9):2865-2873.
    PMID: 31554389 DOI: 10.31557/APJCP.2019.20.9.2865
    Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers
    sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM)
    with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire
    items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The
    sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to
    read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study.
    Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the
    psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram,
    perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast
    cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits
    of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed
    variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in
    the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant
    validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the
    study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and
    mammogram screening in health care practice and research.
    Matched MeSH terms: Breast Neoplasms/psychology
  11. Pahlevan Sharif S, Ong FS
    J Relig Health, 2019 Aug;58(4):1060-1071.
    PMID: 29511922 DOI: 10.1007/s10943-018-0587-1
    The purpose of this study was to investigate the relationship between spirituality with quality of life and stress of Malay Muslim breast cancer patients in Malaysia. In addition, the moderating role of education on this relationship was examined. Participants consisted of 145 conveniently selected Malay breast cancer patients. The results indicated that the more spiritual respondents reported a higher level of quality of life and lower level of stress. Moreover, education weakened the relationship between spirituality with quality of life and stress.
    Matched MeSH terms: Breast Neoplasms/psychology*
  12. Ramli HA, Moey SF, Abdul Mutalib AM
    Asian Pac J Cancer Prev, 2019 06 01;20(6):1913-1920.
    PMID: 31244318 DOI: 10.31557/APJCP.2019.20.6.1913
    Background: Breast cancer (BC) awareness is relatively poor among Malaysian women indicated by the presence of BC at a late stage and the low rate of mammography screening. Only a few theoretically based studies have been conducted on Malaysian women’s participation in mammography. Therefore, the objective of this study is to use health belief model (HBM) and stage of change model (SCM) to determine the relationship between health beliefs on the behavioral adoption of mammography amongst women in Kuantan, Pahang. Methods: Five hundred and twenty women were randomly selected to complete the survey. Data were analyzed using multinomial logistic regression (MLR) to ascertain the multivariate relationships between health beliefs and stage of mammography behavioral adoption. Results:
    The MLR test indicates that there is no significant difference in perceived severity, benefits, motivator factors and cues to action between participants in the action stage and the maintenance stage. However, significant differences existed in perceived severity, susceptibility, motivator factors and self-efficacy between the pre-contemplation, relapse and contemplation stage to that of the referenced (maintenance) stage of mammography adoption. Conclusion: Women in the action stage are more likely to progress towards maintenance stage as they perceived breast cancer as a disease that leads to death and that mammogram screening is beneficial in detecting the disease at an early stage. However, women in the pre-contemplation, relapse and contemplation stage are found unlikely to move towards the maintenance stage as they perceived their risk of getting breast cancer is low.
    Matched MeSH terms: Breast Neoplasms/psychology*
  13. Mohamad M, Kok HS
    Asian Pac J Cancer Prev, 2019 May 25;20(5):1427-1432.
    PMID: 31127903
    Objective: This study aims to investigate the public pattern in seeking breast cancer screening information in
    Malaysia using Google Trends. Methods: The Google Trends database was evaluated for the relative Internet search
    popularity of breast cancer and screening-related search terms from 2007 to 2018. Results: Result showed downward
    trends in breast cancer search, whereas mammogram and tomosynthesis search fluctuated consistently. A significant
    increment was found during Pink October month. Breast cancer search term achieved the highest popularity in the east
    coast of Malaysia with [x2 (5, N=661) = 110.93, P<0.05], whereas mammogram attained the highest search volume in
    central Malaysia [x2 (4, N=67) = 18.90, P<0.05]. The cross-correlation for breast cancer was moderate among northern
    Malaysia, Sabah, and Sarawak (0.3 ≤ rs ≤ 0.7). Conclusion: Public interest trend in breast cancer screening is strongly
    correlated with the breast cancer awareness campaign, Pink October. Breast cancer screening should be promoted in
    the rural areas in Malaysia.
    Matched MeSH terms: Breast Neoplasms/psychology
  14. Rajaram N, Lim ZY, Song CV, Kaur R, Mohd Taib NA, Muhamad M, et al.
    Psychooncology, 2019 01;28(1):147-153.
    PMID: 30346074 DOI: 10.1002/pon.4924
    OBJECTIVES: Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women.

    METHODS: Breast cancer patients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients.

    RESULTS: The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes.

    CONCLUSION: Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.

    Matched MeSH terms: Breast Neoplasms/psychology*
  15. Shaw T, Ishak D, Lie D, Menon S, Courtney E, Li ST, et al.
    Psychooncology, 2018 12;27(12):2855-2861.
    PMID: 30264524 DOI: 10.1002/pon.4902
    OBJECTIVE: Malays comprise an Asian cultural group reported to have low breast cancer screening uptake rates and poor cancer outcomes. Little is known about Malay cultural factors influencing beliefs and practice of cancer screening and genetic testing. Our study aims to explore health beliefs of Malay women around breast cancer screening and genetic testing.

    METHODS: We conducted focus groups among healthy English-speaking Malay women in Singapore, aged 40 to 69 years, using a structured guide developed through literature review, expertise input and participant refinement. Thematic analysis was conducted to extract dominant themes representing key motivators and barriers to screening and genetic testing. We used grounded theory to interpret results and derive a framework of understanding, with implications for improving uptake of services.

    RESULTS: Five focus groups (four to six participants per group) comprising 27 women were conducted to theme saturation. Major themes were (a) spiritual and religious beliefs act as barriers towards uptake of screening and genetic testing; (b) preference for traditional medicine competes with Western medicine recommendations; (c) family and community influence health-related decisions, complexed by differences in intergenerational beliefs creating contrasting attitudes towards screening and prevention.

    CONCLUSIONS: Decisions to participate in breast cancer screening and genetic testing are influenced by cultural, traditional, spiritual/religious, and intergenerational beliefs. Strategies to increase uptake should include acknowledgement and integration of these beliefs into counseling and education and collaboration with key influential Malay stakeholders and leaders.

    Matched MeSH terms: Breast Neoplasms/psychology
  16. Ishak A, Yahya MM, Halim AS
    Clin Breast Cancer, 2018 10;18(5):e1011-e1021.
    PMID: 29784600 DOI: 10.1016/j.clbc.2018.04.012
    BACKGROUND: Breast reconstruction after mastectomy is important in breast cancer care.

    MATERIALS AND METHODS: A cross-sectional study was designed to assess surgeons' and patients' perceptions toward breast reconstruction. Questionnaires were distributed to general and breast surgeons in East Coast Malaysian hospitals and Hospital Kuala Lumpur and to postmastectomy patients with and without breast reconstruction at the Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. The response rates were 82.5% for the surgeons (n = 33), 95.4% for the patients with reconstruction (n = 63), and 95.5% for the patients without reconstruction (n = 278).

    RESULTS: The median surgeon age and experience was 42 and 6 years, respectively. Each surgeon saw an average of 20 new breast cancer cases annually. Most surgeons (86.7%) discussed reconstruction options with their patients but had only referred an average of 4 patients for reconstruction during a 3-year period. Surgeons' concerns regarding the qualitative outcome increased the likelihood of a breast reconstruction discussion (β = 4.833; P = .044). The women who underwent breast reconstruction were younger (mean age, 42 vs. 50 years), were more often working (69.4% vs. 42.2%), and more often had previous awareness of the option (90.3% vs. 44.3%). The most common reasons for undergoing breast reconstruction were "to feel more balanced" (92.1%) and "surgeon's strong recommendation" (92.1%). Previous knowledge of breast reconstruction increased the likelihood of reconstruction (odds ratio, 5.805; P = .026). Although 70% of surgeons thought that patients would not be interested in reconstruction, only 37.9% of patients with previous awareness reported having no interest.

    CONCLUSION: The low reconstruction rate (20.6%) can be attributed to the low referral rate. Patients' likelihood to undergo reconstruction with their surgeon's recommendation and with previous awareness were reflective of the surgeons' strong influence on their patients. Thus, clarification of surgeons' hypothetical criticisms could conceivably increase the reconstructive surgery rate.

    Matched MeSH terms: Breast Neoplasms/psychology
  17. Dominic NA, Thirunavuk Arasoo VJ, Botross NP, Riad A, Biding C, Ramadas A
    Asian Pac J Cancer Prev, 2018 Jul 27;19(7):1809-1815.
    PMID: 30049192
    Background: There is a lack of evidence on the effectiveness of multifaceted group-based interventions to
    improve psychological well-being and health-related quality of life (HRQOL) of breast cancer (BCa) survivors in
    Malaysia. This study is aimed at assessing the effectiveness of such intervention program among the BCa survivors.
    Materials and Methods: This was a group-based intervention program with pre- and post-test design, carried out
    among BCa survivors (n=37) who were members of Breast Cancer Support Group Centre, Johor Bahru. A validated
    self-administered questionnaire was used to assess the impact of the program on psychosocial well-being and HRQOL of
    the participants. Results: The mean age of BCa survivors was 58.1 years (SD=9.7), with mean age at diagnosis of
    49.9 years (SD=9.6). Majority of them were of Chinese ethnicity, married and had secondary level education, but
    were unemployed. More than 86% of them were diagnosed to have early BCa diagnosis and have since completed
    the treatment. There were significant decreases in median depression (p=0.001), anxiety (p<0.001) and stress (p<0.001)
    scores at post-intervention. More than 85% of the participants rated themselves to have a good or very good QOL
    at post-intervention, as opposed to 75.9% at pre-intervention. Significant improvements in several HR-QOL domain
    scores were seen, with psychological score improving the most (p<0.001), followed by social relationship (p=0.002)
    and physical health (p=0.004). Conclusions: Group-based multifaceted intervention can be a viable solution to improve
    psychosocial well-being of BCa survivors.
    Matched MeSH terms: Breast Neoplasms/psychology*
  18. 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.

    Matched MeSH terms: Breast Neoplasms/psychology*
  19. Pahlevan Sharif S, Ahadzadeh AS, Perdamen HK
    Appl Nurs Res, 2017 Dec;38:88-94.
    PMID: 29241526 DOI: 10.1016/j.apnr.2017.09.012
    PURPOSE: This study aimed to investigate the relationship between uncertainty in illness and quality of life, and examine the mediating role of coping strategies and mood states in this relationship among breast cancer patients.

    METHODS: A convenience sample of 135 Malaysian women with breast cancer completed questionnaires measuring uncertainty in illness, mood states (i.e. anxiety and depression), quality of life, and copying styles.

    RESULTS: The results showed an inverse correlation between uncertainty and quality of life after controlling for the effects of age, cancer stage and time since diagnosis. Moreover, the negative association between illness uncertainty and quality of life was mediated by coping strategies and mood states.

    CONCLUSION: The findings revealed that breast cancer patients experiencing a high level of uncertainty more likely use avoidant and less likely use active emotional coping strategies which in turn amplifies anxiety and depression and undermines their quality of life. While some interventions to reduce the adverse consequences of uncertainty are recommended, the findings indicated the need for targeted psychological interventions seeking to gradually shift cancer patients' coping strategies from avoidant to active emotional coping.

    Matched MeSH terms: Breast Neoplasms/psychology*
  20. Pahlevan Sharif S
    Eur J Oncol Nurs, 2017 Apr;27:28-35.
    PMID: 28279393 DOI: 10.1016/j.ejon.2017.01.005
    PURPOSE: The main objective of this study was to investigate the mediating role of uncertainty in the relationship between locus of control with quality of life, anxiety, and depression.

    METHODS: A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS).

    RESULTS: The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant).

    CONCLUSIONS: The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life.

    Matched MeSH terms: Breast Neoplasms/psychology*
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