자연주의적 탐구조사(Naturalistic Inquiry)

Breast cancer remains an important public health problem. This study aimed to investigate about female knowledge of breast cancer and self-reported practice of breast self-examination in Iran. This was a population-based survey carried out in Tehran, Iran. Data were collected via a structured questionnaire containing 15 questions on demographic status, history of personal and family breast problems, subjective knowledge about breast cancer covering its symptoms, the screening methods and practice of breast self-examination (BSE). A trained female nurse interviewed each respondent. Analysis included descriptive statistics and the Chi-squared test where necessary. A total of 1402 women were interviewed. The mean age of respondents was 43.4 (SD = 14.4) years; most were married (85%), and without any personal (94%) and family history (90%) of breast problems. It was found that 64% of the respondents were familiar with breast cancer and 61% (n = 851) believed that 'the disease is relatively common among women in Iran'. Most women (44%) perceived a painless mass as a breast cancer symptom. Overall, 61% of the respondents stated that they knew about breast cancer screening programs and most indicated that electronic media (television 34% and radio 14%) were their source of information. Only 17% of women said that 'they were conducting regular breast self-examination'. The main reason for women not doing breast self-examination was due to the fact that they did not know how to do it (64%). The findings indicated that performing breast self-examination is significantly related to: age, marital status, education, knowledge of breast cancer and knowledge about breast cancer screening programs (p < 0.05), but not to personal (P = 0.2) and family (P = 0.7) history of breast problems. This descriptive study provides useful information that could be utilized by both researchers and those involved in public health programmes. The findings indicated that the women awareness of breast cancer warning signs (painless lump, retraction of nipple, and bloody discharge) and effective screening methods i.e. clinical examination, and mammography were very inadequate. Thus, health education programmes to rectify the lack of women awareness is urgently needed. Indeed the focus of primary health care providers should be to raise awareness about breast care among women and to encourage them to report any unusual changes in their breasts to their family or care physicians.

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Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods

Objective This review evaluates the effectiveness of quality improvement (QI) strategies in reducing disparities in health and health care. Data sources We identified papers published in English between 1983 and 2011 from the MEDLINE® database, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science Social Science Index, and PsycINFO. Review methods All abstracts and full-text articles were dually reviewed. Studies were eligible if they reported data on effectiveness of QI interventions on processes or health outcomes in the United States such that the impact on a health disparity could be measured. The review focused on the following clinical conditions: breast cancer, colorectal cancer, diabetes, heart failure, hypertension, coronary artery disease, asthma, major depressive disorder, cystic fibrosis, pneumonia, pregnancy, and end-stage renal disease. It assessed health disparities associated with race or ethnicity, socioeconomic status, insurance status, sexual orientation, health literacy/numeracy, and language barrier. We evaluated the risk of bias of individual studies and the overall strength of the body of evidence based on risk of bias, consistency, directness, and precision. Results Nineteen papers, representing 14 primary research studies, met criteria for inclusion. All but one of the studies incorporated multiple components into their QI approach. Patient education was part of most interventions (12 of 14), although the specific approach differed substantially across the studies. Ten of the studies incorporated self-management; this would include, for example, teaching individuals with diabetes to check their blood sugar regularly. Most (8 of 14) included some sort of provider education, which may have focused on the clinical issue or on raising awareness about disparities affecting the target population. Studies evaluated the effect of these strategies on disparities in the prevention or treatment of breast or colorectal cancer, cardiovascular disease, depression, or diabetes. Overall, QI interventions were not shown to reduce disparities. Most studies have focused on racial or ethnic disparities, with some targeted interventions demonstrating greater effect in racial minorities--specifically, supporting individuals in tracking their blood pressure at home to reduce blood pressure and collaborative care to improve depression care. In one study, the effect of a language-concordant breast cancer screening intervention was helpful in promoting mammography in Spanish-speaking women. For some depression care outcomes, the collaborative care model was more effective in less-educated individuals than in those with more education and in women than in men. Conclusions The literature on QI interventions generally and their ability to improve health and health care is large. Whether those interventions are effective at reducing disparities remains unclear. This report should not be construed to assess the general effectiveness of QI in the health care setting; rather, QI has not been shown specifically to reduce known disparities in health care or health outcomes. In a few instances, some increased effect is seen in disadvantaged populations; these studies should be replicated and the interventions studied further as having potential to address disparities.

Closing the quality gap: revisiting the state of the science (vol. 3: quality improvement interventions to address health disparities).

Aims and objectives. This paper reviews study findings of preferred music on agitated behaviours for older people with dementia and provides implications for future research and practice.

Background. Music has been suggested as a feasible and less costly intervention to manage agitated behaviours in older people with dementia. However, no review of the literature focusing on study findings of preferred music on agitated behaviours in older people with dementia had been reported.

Methods. A review was undertaken using electronic databases with specified search terms for the period of 1993–2005. The references listed in the publications selected were also searched for additional studies.

Results. Eight research-based articles met the inclusion criteria and were included in the review. The preferred music intervention demonstrated positive outcomes in reducing the occurrence of some types of agitated behaviours in older people with dementia. The findings from these studies were relatively consistent in finding improvement in agitated behaviours although the findings in one study did not reach statistical significance. The small sample sizes and some variations in the application of the preferred music intervention mean that caution is needed in drawing conclusions from these studies.

Conclusions. This review highlights that preferred music has positive effects on decreasing agitated behaviours in older people with dementia; however, the methodological limitations indicate the need for further research.

Relevance to clinical practice. Findings from the review highlight the beneficial outcomes of preferred music in reducing agitated behaviours for older people with dementia. The incorporation of preferred music has the potential to provide a therapeutic approach to the care of older people with dementia.

Use of preferred music to decrease agitated behaviours in older people with dementia: A review of the literature

• The strength of the future nursing workforce depends on a continuous flow of new registered nurses from the nursing education pipeline. Delays in the education sector will lead to failures into the future. Investment in nursing education and jobs is needed to improve retention of the current nursing workforce and address the global nurse shortage. KEY MESSAGES Nursing education and the emerging nursing workforce in COVID-19 pandemic

The International Council of Nurses.

Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community

Comparison of two different educational methods on teachers’ knowledge, beliefs and behaviors regarding breast cancer screening

Objective: This study was carried out in an effort to determine the effect of music therapy on depression and physiological parameters in elderly people who were living in a nursing home.Method: The study was a randomized controlled trial. The study sample consisted of 64 elderly people who complied with the criteria of inclusion for the study. The data were collected using the ‘Elderly Information Form’ and ‘Geriatric Depression Scale’. The music group listened to music three days in a week during 8 weeks. The depression levels were assessed at baseline (week 0) and follow-up in the eight week.Results: It was found that the difference between post-test depression scores of the two groups was found to be statistically significant (t = −2.86, p <.01). The mean scores of post-test systolic blood pressure in the music group were found to be significantly lower than those of the control group (t = −3.11, p < .05).Conclusion: It was concluded that music therapy decreased the depression level and systol...

The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial

Purpose: This study aimed to analyse female academician health beliefs for breast cancer screening and levels of self-esteem. Materials and Methods: This cross-sectional study was conducted between October 2010 and March 2011, covering female academicians working in all faculties and vocational schools at Ondokuz Mayis University, except for the ones in the field of health (n=141). Data was collected using a questionnaire developed by researchers in the light of the related literature, the Champion’s Health Belief Model Scale for Breast Cancer, and the Coopersmith Self-Esteem Inventory. Descriptive statistics, the t-test, Mann-Whitney U and correlation analysis were used to analyze the data with the SPSS 13.0 statistical package. Results: 53.8% of the participants were single, 58.6% did not have children, 80.7% had regular menstrual cycles, 28.3% was taking birth control pills, 17.9% were undergoing hormone therapy, 11% suffered breast problems, 8.3% had relatives with breast cancer, 78,6% knew about breast self-examination (BSE), 68.3% was performing BSE, 16.2% were performing BSE monthly, 17.9% had had mammograms, and 30.3% had undergone breast examinations conductedby physicians. The women who had breast physical examinations done by physicians had higher susceptibility, self-efficacy and health motivation, and fewer barriers to mammography than those who did not have breast physical examinations. Conclusions: There was a relationship between the female academician self-esteem and their perceived seriousness of breast cancer, perceived barriers to BSE and health motivation. Our Turksih female academicians had medium levels of self-esteem.

Turkish female academician self-esteem and health beliefs for breast cancer screening.

Objectives: Breast cancer is the most frequently occurring cancer among women globally as well as in Turkey and mammography is known to be an effective screening tool for this disease. This study was undertaken to characterize health beliefs and practices related to mammography of women in Turkey and also to survey mammography rates.



Design: Cross-sectional. The study was performed between September 2006 and January 2007 in Samsun, Turkey. Of 503 women, aged 35 years or older and registered at a local Health Center, 387 (76.94%) agreed to participate in this study.



Methods: A self-administered descriptive questionnaire and the Champion Revised Health Belief Model Scale for breast cancer screening (CHBMS) were used as data collection instruments. Analysis included descriptive statistics, Chi-square, and independent t test. Logistic regression analysis was conducted to identify the extent to which individual variables significantly predicted mammography use.



Results: Study participants did not undergo mammography at optimal rates (23.5%), but perceived benefits were higher than were perceived barriers to the procedure after education about mammography. Consequently women reported they were likely to adopt the practice of regular mammography in the future.



Conclusions: Mammography rates were low in this rural area in Turkey, but may improve after education about the procedure.



Clinical Relevance: Mammography is an important tool in the early diagnosis of breast cancer. Many women still do not understand the benefit of mammograms and further education may help increase rates of early screening.

İlknur Aydin Avci

Papers

Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community

Comparison of two different educational methods on teachers’ knowledge, beliefs and behaviors regarding breast cancer screening

The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial

Turkish female academician self-esteem and health beliefs for breast cancer screening.

Health Beliefs and Mammography Rates of Turkish Women Living in Rural Areas