Body image alteration in women with breast cancer: A concept analysis using an evolutionary method.

Objective: Women with breast cancer experience changes in body image, a key predictor of overall quality of life. Body image alteration has been recognized in scholarly circles and is actively being researched on; however, a comprehensive conceptualization of body image alteration from an oncological perspective is insufficient. Therefore, this study aimed to analyze the concept of body image alteration in women within the context of breast cancer based on Rodgers' evolutionary method. Methods: A literature search using a combination of the keywords "breast neoplasms" and "body image" was conducted via PubMed, CINAHL, EMbase, PsycInfo, KISS, and RISS. Peer-reviewed journal articles related to body image alteration in women with breast cancer, published from 2001 to 2020, were included in this study. Results: Three critical attributes of body image alteration were identified: "dismantling the existing body image," "transitioning to the altered body," and "re-integrating a new body image." Antecedents included "breast cancer and its treatment," "awakening to the sociocultural norms of a feminine body," and "triggering events for reflecting on one's body." The consequences were "psychological well-being or distress," "strengthening or breakdown of intimate relationships," "enhancement or impairment of social functioning," and "adherence or resistance to breast cancer treatment." Conclusions: This study provides comprehensive conceptualizations that encompass individual, interpersonal, and sociocultural components and cover both negative and positive changes in body image from a long-term perspective. This may offer a useful framework that can be used to develop effective interventions for body image improvement and accelerate further research.

The effects of P6 acupressure and nurse-provided counseling on chemotherapy-induced nausea and vomiting in patients with breast cancer.

PURPOSE/OBJECTIVES: To evaluate the effects of pericardium 6 (P6) acupressure and nurse-provided counseling on chemotherapy-induced nausea and vomiting (CINV) in patients with breast cancer. DESIGN: Randomized, controlled trial. SETTING: A university cancer center in Seoul, South Korea. SAMPLE: 120 women who were beginning their second cycle of adjuvant chemotherapy after definitive surgery for breast cancer and who had more than mild levels of nausea and vomiting with the first cycle of chemotherapy. METHODS: Participants were assigned randomly into four groups: control (placebo on SI3), counseling only, P6 acupressure only, and P6 acupressure plus nurse-provided counseling. The experiences of upper-gastrointestinal distress were measured by the Rhodes Index of Nausea, Vomiting, and Retching for acute (day 1) and delayed (day 2 to day 5) CINV. MAIN RESEARCH VARIABLES: Nausea, retching, vomiting, P6 acupressure, and counseling. FINDINGS: No significant differences were found in the demographic and disease-related variables among the four groups. The levels of CINV were significantly different among the groups from day 2 to day 5. The CINV differences were attributed mainly to the difference between the control group and the group with P6 acupressure plus nurse-provided counseling. The effects of acupressure were proven from day 2 to day 5, and the effects of nurse-provided counseling were proven on day 4 and were close to significance level on day 5. CONCLUSIONS: Synergic effects of P6 acupressure with nurse-provided counseling appeared to be effective in reducing CINV in patients with breast cancer. IMPLICATIONS FOR NURSING: P6 acupressure combined with counseling by nurses is a safe and easy-to-apply tool in CINV management in practice.

The sociocultural context of breast cancer screening among Korean immigrant women.

Korean immigrant women, who compose 1 of 6 major subpopulations in Asian Americans in the United States, are reported to have far lower rates of breast cancer screening than do women in general. Despite the sporadically reported cognitive, affective, and environmental constraints to the screening practices, to date, no research has been conducted to investigate the sociocultural contexts within which women in this population seek help for breast health. The purpose of this study is to explore and interpret the sociocultural processes of breast cancer screening among Korean immigrant women using the grounded theory method. Twenty Korean immigrant women, aged between 20 and 81 years, participated in a set of 2 consecutive qualitative interviews conducted in the Korean language. The qualitative data were transcribed and analyzed using the constant comparison technique. "Balancing relationships within a discordant world" is the core concept of the process of breast cancer screening among Korean immigrant women. There are sociocultural discord in perceptions of breast cancer and screening procedures between Asian ways of thinking and Western biomedical premises. The elicited situation-specific theory sheds light on what Western healthcare professionals have missed and what they should consider in caring for culturally diverse populations.

Korean immigrant women's meanings of breast, breast cancer, and breast cancer screenings.

PURPOSE: Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW. METHODS: Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes. RESULTS: The cultural schema of the meaning of breast is "mother who is breast-feeding her baby," with two themes of "balance in size," and "shyness." Regarding breast cancer, three themes, i.e., "indifference," "fear," and "uncertainty" are emerged. "Lack of information about screening modalities" is the overarching schema with reference to breast cancer screenings. CONCLUSIONS: The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.

The model of cultural competence through an evolutionary concept analysis.

Becoming a culturally competent health professional is a demanding prerequisite in this multicultural society. Cultural competence is explored and abstracted as a conceptual framework through a concept analysis using the evolutionary method. Its model is constructed from a systemic, comprehensive literature review and analysis. Taking into account how cultural competence is viewed by other disciplines (medicine, psychology, education, and social work), a comprehensive definition, antecedents, and consequences of cultural competence in nursing are described and diagrammed. Additionally, two model cases and future implications are discussed. The broader American society is composed of a mosaic of discrete cultural groups existing within the context of their values and identities. Those distinct cultures affect each patient's ways of thinking and his or her perceptions on health care and health behaviors. The proposed model of cultural competence provides a theoretical guide for developing strategies to achieve culturally competent care in nursing practice and research.