Health Behavior Changes among Survivors of Breast Cancer after Treatment Completion
Keywords:
Health Behavior Changes, Breast Cancer, Qualitative Study, SurvivorsAbstract
Despite the high prevalence of breast cancer survival in Thailand, the treatments of cancer leave long-term side effects on the survivors. Health behavior changes are found to contribute to favorable health outcomes, minimizethe chanceof recurrence, and elevate breast cancer survivors’ quality of life. This qualitative descriptive study is apart of a combined study to answer the question of how breast cancer survivors perform health behaviorchanges after treatment is completed. In-depth interviews were carried out with 15 breast cancer survivors following treatment completion. Data analysis was performed using content analysis.
From qualitative findings, three categories were identified from health behavior changes of the participants: (1) change diets to prevent cancer recurrence that encompassed having healthy diets to strengthen immunity, and avoiding diets that enhanced the growth of cancer cell; (2) doexercise that involved early arm exercise and regular leg exercise; and (3) attempt to reduce psychological distress. These health behavior changes were reflected through participants' efforts to improve physical appearance, engage in mind-body relaxation, maintain a positive attitude, practice religion, and seek support from supernatural powers.
The findings indicatedthe need to improve the quality of health behavior changes, and health professionals, including nurses, should design activities and interventions that are suitable for the particular needs of breast cancer survivors.
References
American Cancer Society. Cancer Facts & Figures 2018 [ACS] [Internet] 2019 [cited 2019 Jun 6]. Available from
Peuker AC, Armiliato MJ, de Souza VE, de Castro EK. Causal attribution among women with breast cancer. Psicologia: Reflexão e Crítica. 2016; 29:2-6. doi.org/10.1186/s41155-016-0007-y.
Wanchai A, Armer JM, Stewart BR. A qualitative study of factors influencing Thai women with breast cancer to
use complementary and alternative medicine. Pacific Rim Int J of Nurs Res. 2016; 20:60-70.
Office of the Permanent Secretary Ministry of Public Health. Public health statistic A.D.2014. Bangkok: The War
Veterans Organization of Thailand under Royal Patronage of His Majesty the King Press, 2015. [In Thai].
DeSantis C, Ma J, Brya L, Jemal A. Breast cancer statistics 2014. CA Cancer J Clin. 2014; 64:52-62.
Mullan F. Seasons of survival: Reflections of a physician with cancer. New England J of Med. 1985; 313:270-273.
National Cancer Institute. Follow-up Care After Cancer Treatment. [Internet] 2018 [cited 2018 Aug 6]. Available
from http://www.cancer.gov/about-cancer/coping/survivorship/follow-up care/ follow-up-fact-sheet.
Wei D, Liu XY, Chen YY, Zhou X, Hu HP. Effectiveness of physical, psychological, social, and spiritual intervention
in breast cancer survivors: An integrative review. Asia Pac J Oncol Nurs. 2016; 3(3):226-232. doi:10.4103/
-5625.189813
Belfer I, Schreiber KL, Shaffer JR, Shnol H, Blaney K, Morando A, et al. Persistent postmastectomy pain in breast
cancer survivors: analysis of clinical, demographic, and psychosocial factors. J Pain. 2013; 14:1185-1195.
American Cancer Society. Survivorship: during and after treatment. [Internet] 2018 [cited 2018 Feb 16]. Available from https://www.cancer.org/treatment/survivorshipduring-and-after-treatment.html
Anderson DJ, Yates P, Mccarthy A, Lang CP, Hargraves M, Mccarthy N, Porter‐Steele J. Younger and older women's concerns about menopause after breast cancer. European J of Cancer Care. 2011; 20:785-794.
Farmer BJ, Smith ED. Breast cancer survivorship: Are African American women considered? A concept analysis.
Oncol Nurs Forum. 2012; 29:779-787.
Sivarux J, Pongthavornkamol K, Wattanakitkrilert D, & Tunticharoensin S. Factors predicting quality of life in Thai breast cancer survivors at 1 year after treatment completion. Thai Cancer J. 2012; 32(1): 2-14.
Stanton AL, Rowland JH, Ganz PA. Life after diagnosis and treatment of cancer in adulthood: contributions from
psychosocial oncology research. American Psychol. 2015;70(2):159-174.
Gaston-Johansson F, Fall-Dickson JM, Nanda JP, Sarenmalm EK, Browall M, Goldstein N. Long-term effect of
the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with highdose chemotherapy. Psychol-Oncol. 2013; 22:530-539.
Honchai T, Soivong P, Lukkahatai N. Effects of a selfmanagement support on self-management behaviors and
symptom distress among breast cancer patients receiving chemotherapy. Nurs J. 2013; 40:14-22.
Nizamli F, Anooshe M, Mohammadi E. Experiences of Syrian women with breast cancer regarding chemotherapy: a qualitative study. Nurs and Health Sci. 2011; 13:481-487.
Norman P, Conner M. Predicting health-check attendance among prior attenders and non-attenders: The role of prior behavior in the theory of planned behavior. J of Applied Soc Psychol. 1996; 26:1010-1026.
Janelsins MC, Mustian KM, Peppone LJ. Interventions to alleviate symptoms related to breast cancer treatments and areas of needed research. J Cancer Sci Therapy. 2011;29(2): S2-001. DOI:10.4172/1948-5956.S2-001
Dobos GJ, Voiss P, Schwidde I, Choi KE, Paul A, Kirschbaum B, Saha FJ, Kuemmel S. Integrative oncology
for breast cancer patients: introduction of an expert-based model. BMC Cancer. 2012; 21:512-539. doi: 10.1186/
-2407-12-539.
McLay JS, Stewart D, George J, Rore C, Heys SD. Complementary and alternative medicines use by Scottish
women with breast cancer. What, why and the potential for drug interactions? Europe J Clin Pharmacology. 2012;
(5):811-819. doi: 10.1007/s00228-011-1181-6 Epub 2011 Dec 14
Kaewvilai W. Complementary therapy among breast cancer survivors (Unpuplished master’s thesis). Graduate School, Chiang Mai University, Thailand.2004
Sirisupluxana P. Experience of using complementary therapy among Thai women breast cancer. (Doctor of philosophy). Graduate School, Chiang Mai University, Thailand.2008
Sirisupluxana P, Sripichyakan K, Wonhongkul T, Sethabouppha H, Pierce PF. The meaning of complementary therapy from the perspective of Thai women with breast cancer. Nurs Health Sci. 2009; 11:64-70.
Wonghongkul T, Dechaprokul N, Phumivichuvate L, Kertsang S. Quality of life and alternative therapy used in
long-term breast cancer survivors. Chiang Mai University, Thailand.2002
Creswell JW. Qualitative Inquiry & Research Design: Choosing among Five Approaches (3rd ed.). Thousand
Oaks, CA: SAGE; 2013.
Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park, CA: Sage; 1985.
Gonzalez H, Hagerling C, Werb Z. Roles of the immune system in cancer: from tumor initiation to metastatic progression. Genes Dev. 2018; 32(19-20):1267-1284. doi:10. 1101/gad.314617.118
Liao GS, Apaya MK, Shyur LF. Herbal medicine and acupuncture for breast cancer palliative care and adjuvant
therapy. Evid Based Complement Alternat Med. 2013; 2013:437948. doi:10.1155/2013/437948
Tonorezos ES, Jones LW. Energy balance and metabolism after cancer treatment. Semin Oncol. 2013; 40(6):745-756. doi: 10.1053/j.seminoncol.2013.09.011
Dieli-Conwright CM, Orozco BZ. Exercise after breast cancer treatment: current perspectives. Breast Cancer
(Dove Med Press). 2015; 10(7):353-362. doi:10. 2147/BCTT.S82039. PMID: 26543382; PMCID:PMC4622557.
van Vulpena JK, Peeters P, Velthuis M, van der Wall E, Maya AM. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: A meta-analysis. Maturitas. 2016; 85:104-111.
Wirtz P, Baumann FT. Physical Activity, Exercise and Breast Cancer-What Is the Evidence for Rehabilitation,
Aftercare, and Survival? A Review. Breast Care (Basel). 2018; 13(2):93-101. doi:10.1159/000488717
Fang SY1, Lin YC, Chen TC, Lin CY. Impact of marital coping on the relationship between body image and sexuality among breast cancer survivors. Support Care Cancer. 2015; 23(9):2551-2519. doi: 10.1007/s00520-015-
-1. Epub 2015 Jan 24
Agarwal RP, Maroko-Afek A. Yoga into cancer care: A review of the evidence-based research. Int J Yoga. 2018;
(1):3-29. doi: 10.4103/ijoy.IJOY_42_17
Yagli NV, Ulger O. The effects of yoga on the quality of life and depression in elderly breast cancer patients. Complement Ther Clin Pract. 2015; 21(1):7-10. doi: 10.1016/j. ctcp.2015.01.002. Epub 2015 Jan 29.
Sztachańska J, Krejtz I, Nezlek JB. Using a gratitude intervention to improve the lives of women with breast cancer: A daily diary study. Front Psychol. 2019; 10:1365. Published 2019 Jun 12. doi:10.3389/fpsyg.2019.01365
Chinnawong T. The influences of Thai Buddhist culture on cultivating compassionate relationships with equanimity between nurses, patients and relatives: a grounded theory approach. (Doctor of philosophy). Southern Cross University, Lismore, New South Wales.2007
Downloads
Published
How to Cite
Issue
Section
License
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
