Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer Patients.

AIM: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. MATERIALS AND METHODS: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). RESULTS: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. CONCLUSION: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.

Antenatal depression: prevalence and risk factors in a hospital based Turkish sample.

OBJECTIVE: To assess the prevalence and associated risk factors for antenatal depression. METHODS: From April to September 2011, a total of 651 pregnant women who had no chronic diseases, were at low risk for obstetric complications and who had no diagnosed depression before pregnancy were recruited for interview at Merkez Efendi Hospital, Maternal and Child out-patient department in western Turkey. The evaluation of depression was scored according to the Beck Depression Inventory. Statistical analysis was carried out using Chi-square, Fisher exact, t test and stepwise multiple regression analyses. RESULT: Of the total, 71 (10.9%) women scored > or = 17 on the inventory. Low level of education, unplanned pregnancy, lack of social support and pregnancy-related physical symptoms were found to be the most important risk factors for antenatal depression. CONCLUSION: Early identification and treatment of antenatal depression may improve pregnancy outcomes, and healthcare providers need to be sensitive to the risk factors for depression and strengthen the women's skills in coping with stress to improve their emotional health.

Planned and unplanned pregnancy: effects on health practice and depression during pregnancy.

AIM: The aim of the study was to explore the prevalence and characteristics of women with unplanned pregnancy (UP) and to examine the associations between pregnancy planning status and women's health practice and depression during pregnancy in Manisa, Turkey. MATERIAL AND METHODS: The study was conducted with pregnant women (n=550) who attended a state hospital for antenatal care in Manisa, Turkey. Health practices of women during pregnancy were assessed with the Health Practices Questionnaire (HPQ II) and depression was measured by the Beck Depression Inventory (BDI). RESULTS: Of the 550 pregnancies, 149 (27.1%) were unplanned. Women whose pregnancies were planned were likely to be younger, more educated, employed, to perceive more social support and to be more satisfied in marriage life than women whose pregnancies were unplanned. The number of pregnancies, births and children was higher in women whose pregnancies were unplanned. Women with UP had significantly lower HPQ scores (mean 118.4, SD=13.5) than women with planned pregnancies (mean 124.0, SD=14.1). Women with UP also had a significantly higher score for BDI (mean 10.3, SD 6.9 vs mean 8.1, SD 5.8). CONCLUSIONS: Women with UP had engaged in fewer healthy practices and experienced more depressive symptoms during pregnancy. Health-care providers should screen for UP at an early stage and offer health education programs to help women to develop positive health practices and to improve their emotional health.

A survey of the awareness, use and attitudes of women towards Down syndrome screening.

AIMS AND OBJECTIVES: To determine awareness, use and attitudes of Turkish women towards prenatal screening tests (PST) for Down syndrome (DS). BACKGROUND: The technology of screening and diagnosing congenital diseases and abnormalities of foetuses has rapidly developed in the past few decades and prenatal screening for DS in early pregnancy is a valued component representing a cost-effective public health intervention in modern developed countries. DESIGN: Cross-sectional and descriptive study. METHODS: The study was carried out in 518 women in the early postpartum period at the Maternity and Children's Hospital between 1 September 2010 and 1 March 2011 using a questionnaire developed by the researchers. RESULTS: Awareness about the first- and second-trimester PST [nuchal translucency (NT), triple test] was 21·6 and 59·7%, whereas use of them was 13·7 and 44·8%, respectively. Women who had lower education, were unemployed, had a patriarchal family type, had a low income status, were unmarried, had consanguineous marriage and did not have a private doctor were less aware and had less use of NT and/or triple test. Women who did not have a genetic disease in their family, were multiparous, had an unplanned pregnancy and did not receive antenatal care were less aware and had less use of the triple test. In case, the foetus was diagnosed as DS, women made the following decisions: continuing the pregnancy, terminating the pregnancy, leaving the decision to the doctor and being not sure 34·9, 12·0, 29·9 and 23·2%, respectively. CONCLUSION: Women's knowledge about and attitudes towards PST are important. This study shows that Turkish women have limited knowledge about and use of PST. Therefore, health professionals play a significant role in improving patients' information about PST. They should dedicate more time to discussions with women, provide appropriate and understandable information tailored to women's socio-economical level and should emphasise the indications, purposes and limitations of PST. RELEVANCE TO CLINICAL PRACTICE: Discovering women's opinions and knowledge about PST will help healthcare providers determine their information needs.

Health-promoting lifestyle behaviour for cancer prevention: a survey of Turkish university students.

BACKGROUND: Health risks associated with unhealthy behaviours in adolescent and university students contribute to the development of health problems in later life. During the past twenty years, there has been a dramatic increase in public, private, and professional interest in preventing disability and death through changes in lifestyle and participation in screening programs. The aim of the study was to evaluate university students' health-promoting lifestyle behaviour for cancer prevention. METHOD: This study was carried out on university students who had education in sports, health and social areas in Celal Bayar University, Manisa, Turkey. The health-promoting lifestyles of university students were measured with the "health-promoting lifestyle profile (HPLP)" The survey was conducted from March 2011 to July 2011 and the study sample consisted of 1007 university students. T-test, ANOVA and multiple regression analyses were used for statistical analyses. RESULTS: In the univariate analyses, the overall HPLP score was significantly related to students' school, sex, age, school grades, their status of received health education lessons, place of birth, longest place of residence, current place of residence, health insurance, family income, alcohol use, their status in sports, and self-perceived health status. Healthier behaviour was found in those students whose parents had higher secondary degrees, and in students who had no siblings. In the multiple regression model, healthier behaviour was observed in Physical Education and Sports students, fourth-year students, those who exercised regularly, had a good self-perceived health status, who lived with their family, and who had received health education lessons. CONCLUSION: In general, in order to ensure cancer prevention and a healthy life style, social, cultural and sportive activities should be encouraged and educational programmes supporting these goals should be designed and applied in all stages of life from childhood through adulthood.

Fertility preferences, contraceptive behaviors and unmet needs: a gap between urban and suburban parts of a city.

OBJECTIVES: To explore the differences in unwanted fertility in different parts of a city. METHODS: Data were obtained from the 1999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 ever-married women aged 15-49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows. RESULTS: Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9-3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in urban women (8.3%; p < 0.001). The induced abortion rate is higher in urban women (14.8 per 1000 pregnancies) than in gecekondu women (7.1 per 1000 pregnancies; OR 2.1; 95% CI 1.4-3.1; p < 0.001). CONCLUSIONS: There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.