A cross-sectional study was conducted to examine the knowledge of breast cancer, attitudes toward breast self-examination (BSE), and practice of BSE among a sample of female health care workers in Tehran, Iran. Using a purposed questionnaire, a total of 410 women from seven health centers completed the questionnaire. The mean age of the respondents was 32.9 years (SD = 9.5), most (58%) were married, and family history of breast cancer was reported by 11%. Seventy-five percent of the women knew about breast cancer prevalence, but only 27% knew that breast pain is not a symptom of breast cancer. Although 73% of women did know that contact with a relative with breast cancer could not lead to development of breast cancer, the respondents' knowledge of risk factors of breast cancer was not satisfactory. With regard to women's attitudes toward BSE, the majority believed that it is not difficult and time consuming or troublesome (63% and 72%, respectively). Sixty-three percent of the respondents claimed that they know how to examine their breasts, but only 6% performed BSE monthly. The practice of BSE was significantly associated with age (p = 0.01), the level of education (p < 0.0001), personal history of breast problems (p < 0.0001), and knowledge of how to examine the breasts (p < 0.0001). The study findings suggest that the knowledge and behaviors of female health care workers concerning breast cancer is relatively poor and it needs to be improved. Considering the role that health care workers may play in communicating health behaviors to the general public, planning health education interventions for this group of females is essential.
The objective of this study was to test the reliability and validity of the Iranian version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). The English-language version of the questionnaire was translated into Persian (Iranian language), and its final form was approved by the EORTC Study Group on Quality of Life before it was used in this study. The questionnaire was administered at two time points to a consecutive sample of 168 newly diagnosed breast cancer patients, and almost all of them (99%) found the questions easy to understand and acceptable. Crohnbach's alpha coefficient for multi-item scales (to test reliability) ranged from 0.48 to 0.95 at baseline and from 0.52 to 0.98 at follow-up administration of the questionnaire. Validity was checked using two methods: inter-scale correlation and known-groups comparison. Almost all inter-scale correlations were statistically significant in the expected direction. Known-groups comparison analysis showed that all functioning and symptom scales discriminated between subgroups of patients differing in clinical status as defined by their performance status and disease stage. In general, the findings of this study indicate that the Iranian version of the EORTC QLQ-C30 is a reliable and valid measure of quality of life in cancer patients and can be used in clinical trials and studies of outcome research in oncology.
A prospective study was conducted to measure anxiety and depression in Iranian breast cancer patients before and after diagnosis using the Hospital Anxiety and Depression Scale (HADS). The HADS was administered at two points in time: before diagnosis and 3 months after. In all, 168 breast cancer patients were interviewed. While 48% of patients had severe symptoms of anxiety at both baseline and follow-up, more than 60% of patients had no symptoms of depressive illness at pre-and post-diagnosis assessments. Comparing anxiety and depression before diagnosis and after 3 months, there were no significant differences between patients' scores on anxiety (P = 0.42) and depression (P = 0.98) subscales. The results showed that patients with advanced disease and a lower performance status were more anxious and experienced more depression. The study findings suggest that severe symptoms of anxiety are the most frequent symptoms in Iranian breast cancer patients. It seems that during the process of diagnosis and 3 months after psychological morbidity persists in patients who suffer from breast cancer.
Abstract. This study was carried out to examine the status of cancer patient education in Iran. Using the Multinational Association of Supportive Care in Cancer's (MASCC) patient education questionnaire, 310 individuals - a sample of heterogeneous cancer patients ( n=167) and their relatives ( n=143) - were enrolled in the study. The pooled results indicated that only 15% of respondents believed more than 80% of cancer patients were told of their diagnosis. In contrast, 30% of respondents thought less than 20% of patients knew their cancer diagnosis. When asked, "Were you given written materials about (i) cancer, (ii) treatment, and (iii) symptom management", the vast majority of respondents said "No" (91%, 87%, and 87%, respectively). When respondents were asked, "Would you like to learn more about cancer and treatments", 97% said "Yes". Most respondents indicated the need for information on the treatments available (27%) and general information about cancer (20%); most had sought information from health professionals (31%), other cancer patients and friends (29%), and television (22%). Finally, it was found that concern about patients' depression (17%), lack of printed materials (13%), the idea that it was better for patients not to know (12%), and families' requests not to tell the patient (11%) were the most frequently stated barriers to or reasons for restricted cancer patient education. The findings of the study suggest that cancer patient education in Iran is very poor and there is an urgent need to develop policy guidelines on disclosure of cancer diagnoses and patient education.
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