RESUMEN

Little is known about the experience of nurses in Africa caring for cancer patients. This study was undertaken to provide a straightforward description of the experiences of South African nurses caring for patients in acute cancer care settings. Purposive sampling selected 20 nurses with whom there were in-depth interviews. Most of the participants were female registered oncology nurses with more than five years' experience. Three themes were identified: defining the cancer nursing experience, the challenges experienced in caring for cancer patients, and challenges imposed by the healthcare system. Most of the participants believed they were called by God to care for cancer patients. However, the challenges they experienced led to guilt feelings and believing the care they provided was insufficient. They were subjected to workplace violence, missed the support from senior nursing management, and displayed signs of burnout. Addressing these challenges could limit their emotional distress and prevent burnout.

RESUMEN

BACKGROUND: Most people with cancer experience pain caused by the disease and treatment. AIMS: To describe the experience of cancer pain of South African patients. METHODS: A qualitative descriptive design was used; 20 (n=20) participants were purposively selected and in-depth interviews were conducted. Inductive content analysis was used to analyse the data. FINDINGS: Two themes and five subthemes were identified. The themes were pain as a unique multi-dimensional experience, and that the unmet needs of the patient can influence their experience of pain. CONCLUSION: The participants experienced total pain. Emotional pain, enhanced by loneliness and unmet information needs was experienced, and this was felt by participants as the worst kind of pain. Pain was mediated by means of medication that did not work well for all, support, compassionate care and hope that God would cure them and take the pain away. RECOMMENDATION: A person-centred approach to pain management is needed, especially in diverse countries, such as South Africa, to better understand the complexity and influence of culture, language and education on the pain experience and to guide individual pain management.

Asunto(s)

RESUMEN

BACKGROUND: Prostate cancer is one of the leading causes of death in Zimbabwe. However, screening for prostate cancer is opportunistic as population-based screening is not available. OBJECTIVES: This study aimed to describe the knowledge, attitudes and practices of men living in Harare, Zimbabwe relating to prostate cancer. METHOD: A door-to-door survey took place in Mufakose, Harare. Each household was included, and men, 40 years and older, were convenience sampled until realisation of the calculated sample size of 269 (n = 269). A researcher-administered questionnaire collected the data, analysis was performed with descriptive statistics, and Chi-square tested statistically significant differences between the variables. RESULTS: The majority of the sample (53.2; n = 143) was between 40 years old and 49 years old. Most (74.5%; n = 201) did not know what prostate cancer was, but the total sample (100%; n = 269) indicated that prostate cancer could lead to death. Only 50.6% (n = 136) were of the opinion that men should be screened; most (87.7%; n = 236) had never been screened. A Chi-square test of independence found a statistically significant difference between educational level and having had prostate cancer screening, χ2 (1) = 47.881, p 0.000. CONCLUSION: As confirmed by other studies, the respondents had limited knowledge of prostate cancer, but had a positive attitude towards the disease, as most were willing to go for screening. There had been only a small percentage screened previously, and less than half returned to learn the results.Contribution: The study emphasises the role of primary health clinics as it could be an ideal setting to teach men about prostate cancer and its screening, and provide screening services in Zimbabwe.

Asunto(s)

RESUMEN

There is a growing recognition that oncology nurses are vitally important for an effective cancer control system. Although there is variation among countries, oncology nursing is being recognized as a specialty practice and seen as a priority for development in cancer control plans in many settings. Ministries of Health in many countries are beginning to acknowledge the role nurses play in achieving successful cancer control outcomes. Additionally, the need for access to relevant education for oncology nursing practice is being recognized by nursing and policy leaders. The purpose of this paper is to highlight the growth and development of oncology nursing in Africa. Several vignettes are presented by nurse leaders in cancer care from several African countries. Their descriptions offer brief illustrations regarding the leadership nurses are providing in cancer control education, clinical practice, and research in their respective countries. The illustrations offer insight into the urgent need, and the potential, for future development of oncology nursing as a specialty given the many challenges nurses face across the African continent. The illustrations may also provide encouragement and ideas for nurses in countries where there is little current development of the specialty about how to proceed to mobilize efforts aimed toward its growth.

Asunto(s)

RESUMEN

AIM: The aim of this study was to describe the research output of African's nurses in the field of palliative care from January 1, 2012 to December 31, 2021. METHODS: A scoping review was conducted. The key words Africa and nursing in combination with palliative care, end of life, terminal care, hospice, and supportive care were used to search the databases Cumulative Index to Nursing and Allied Health Literature, PsychINFO, PubMed, Scopus, and Web of Science. Only studies authored by a nurse with an African affiliation focusing on issues related to advanced cancer were included. The data were captured onto an extraction sheet and analyzed by means of descriptive statistics and content analyses. RESULTS: Of the 522 articles identified, only 16 met the inclusion criteria. The work originated from eight African countries was primarily qualitative and focused on the family and caregivers. Pain was the only symptom investigated. CONCLUSIONS: Studies focusing on symptoms, psychosocial, spiritual, end of life care as well as studies testing nursing interventions are urgently needed. Interregional research could also assist with building the current evidence.

RESUMEN

Psychosocial care is considered an important component of quality cancer care. Individuals treated for cancer can experience biologic or physical, emotional, spiritual, and practical consequences (eg, financial), which have an impact on their quality of living. With the establishment of cancer centers in Africa, there is growing advocacy regarding the need for psychosocial care, given the level of unmet supportive care needs and high emotional distress reported for patients. Nurses are in an ideal position to provide psychosocial care to patients with cancer and their families but must possess relevant knowledge and skills to do so. Across Africa, nurses are challenged in gaining the necessary education for psychosocial cancer care as programs vary in the amount of psychosocial content offered. This perspective article presents competencies regarding psychosocial care for nurses caring for patients with cancer in Africa. The competencies were adapted by expert consensus from existing evidenced-based competencies for oncology nurses. They are offered as a potential basis for educational program planning and curriculum development for cancer nursing in Africa. Recommendations are offered regarding use of these competencies by nursing and cancer program leaders to enhance the quality of care for African patients with cancer and their family members. The strategies emphasize building capacity of nurses to engage in effective delivery of psychosocial care for individuals with cancer and their family members.

Asunto(s)

RESUMEN

In 2018, we conducted a survey among a convenience sample of men (n = 205) living in a resource-poor, semi-urban community in South Africa. We aimed to describe what they know about cancer by asking questions about cancer-related knowledge and understanding, and health-seeking behavior. We also investigated possible relationships between the variables. We used a researcher-administered questionnaire to collect the data and descriptive statistics and quantitative content analyses for the analysis. Chi-square was used to examine the relationships. The mean age of the sample was 35 years, and 49.8% (n = 102) attended 11 or 12 years of school. One-third (32.7%; n = 67) indicated they knew what cancer was, but only 28.8% (n = 59) gave an explanation: "very dangerous/a killer/worse than HIV" were the most common explanations. Only 24.9% (n = 51) were able to identify a possible warning sign, and "feeling very sick" was the most common. However, more than 60% considered six of the seven warning signs of cancer as serious. When suspecting they might have cancer, most (77%; n = 159) indicated they would tell the preferred person within 1 week, while 5.9% (n = 12) would tell "nobody." Although the majority (52.2%; n = 107) felt their partners and families motivated them to seek healthcare when sick, 28.3% (n = 58) needed permission to consult a professional. Educating the community about cancer in a culturally sensitive manner, irrespective of their educational level and perceived knowledge of cancer, could improve knowledge and understanding and lead to seeking healthcare timely.

Asunto(s)

RESUMEN

BACKGROUND: The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES: To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS: Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS: Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION: Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE: Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

Asunto(s)

RESUMEN

BACKGROUND: Cervical cancer is the fourth most common cancer in women worldwide. However, developing countries bear 85% of the burden, with Africa sharing the highest incidence with Melanesia. OBJECTIVES: The aims of this study were to explore the experiences of women living with cervical cancer in Africa and to inform others of the extent of the work done in this field of study by synthesizing the findings of qualitative research. METHODS: The work of Sandelowski and Barroso guided the study, and 6 databases were searched to identify relevant studies using the key words Africa, cervical cancer, and experiences. RESULTS: A total of 13 studies (n = 13) met the inclusion criteria, and their findings were synthesized. The studies originated primarily from South Africa and focused on the period from diagnosis to 1 year after completing curative treatment. One overarching core theme living a life of suffering, 2 main themes, architects of suffering and mediators of suffering, and 9 subthemes were identified. CONCLUSION: Women living with cervical cancer in Africa live a life of suffering, which starts when they experience the first symptom of cervical cancer and continues well after completing treatment. The facilitators of suffering outweighed the mediators and could not be guaranteed, as it did not relieve the suffering of all. IMPLICATIONS FOR PRACTICE: Nurses practicing in Africa should be acutely aware of cervical cancer and do their utmost within their limited resources to prevent and detect the disease in its earliest stage. Religious and support interventions could be used to lessen the suffering of these women.

Asunto(s)

RESUMEN

Malawi has the highest incidence of cervical cancer in the world. Due to various challenges the country faces in terms of cervical cancer control, women have a poor chance to survive this disease. The purpose of our study was to describe the knowledge and practices of cervical cancer and its screening as well as the educational preferences of women living in a rural community in the Chiradzulu District. We conducted a survey among women between the ages 30 and 45, used convenience sampling, a calculated sample size (n = 282) and structured interviews to collect the data. A questionnaire adapted from a previous study served as data collection instrument. The data were analysed in Microsoft Excel and chi-square (p < .05) was used to investigate the relationships between the variables. Content analyses analysed the open-ended questions. The mean age of the sample was 36.1 (SD ± 5.1) and the highest percentage (37.4%; n = 98) belonged to the Yao ethnic group. The majority attended primary school (66.0%; n = 173), were married (74.4%; n = 195) and depended on a small business as source of income (55.7%; n = 146). Most of the women (93.4%; n = 247) had heard of cervical cancer and the visual inspection with acetic acid (VIA) screening programme (67.9%; n = 178) but only 22.9% (n = 60) indicated they had been screened. Lack of knowledge of the screening programme was the most common reason for not being screened. Having a demonstration of the VIA procedure was the most popular educational method (92.0%; n = 241) which gives a fresh approach to educational programmes aimed at preventing cervical cancer.

Asunto(s)

RESUMEN

BACKGROUND:  Cervical cancer mainly occurs among women from the developing world, and women face unique challenges in terms of their disease and treatment. Most women present with advanced cervical cancer and receive the standard curative treatment with external beam radiotherapy and brachytherapy with or without chemotherapy. OBJECTIVES:  To describe the quality of life (QOL) of women treated for cervical cancer during treatment (M0), at 6 months after completing treatment (M6) and at 12 months after treatment (M12). METHODS:  A cross-sectional design, calculated sample size (n = 153) and convenience sampling were used. Data were collected through structured interviews, and the EORTC QLQ-C30 and EORTC QLQ CX24 served as data collection instruments. Descriptive statistics were used to analyse the data, and the Kruskal-Wallis H test was used to compare the mean responses across the groups (p ≤ 0.05). RESULTS:  The mean age of the respondents was 50.6 years (standard deviation [SD] 11.9). The global health status improved significantly in contrast with the functional scores. Financial difficulties were rampant, especially during the treatment phase. Insomnia and urinary frequency were the most cumbersome problems and remained so even after treatment. CONCLUSIONS:  Despite an improvement in the global health, cervical cancer and its treatment had a negative influence on the QOL in all domains of lives of these women. Assessing the QOL of patients during treatment and follow-up visits would allow nurses to develop interventions to address distressing problems timeously. In addition, Africa's nurses should assess social functioning and develop programmes to prevent social dysfunction.

Asunto(s)

RESUMEN

Cervical cancer is the second most common cancer in South African women, but the most common cancer in Black women. Despite having a national cervical cancer screening programme, most women present with advanced disease. Men play a role in cervical cancer as the HPV, the major cause of cervical cancer, is sexually transmitted. The purpose of our study was to describe the knowledge men, living in Muldersdrift, had about cervical cancer, cervical cancer screening and the cervical cancer screening programme and how they preferred to be taught about these health issues. We used a survey design and convenience sampling to select 101 men older than 18 years (n = 101). A pretested self-developed questionnaire was used as the data collection instrument, and the data were analyzed using the SPSS version 22-computer program and quantitative content analyses. The Fischer's exact test measured associations between variables (p = 0.05). The ages of the sample (n = 101) ranged from 18 to 92 years; most were from the Zulu cultural group, unemployed and unmarried. The majority (66.3%, n = 67) had not heard of cervical cancer, the cervical cancer screening programme (60.4%, n = 61) or the Pap smear (67.3%, n = 68). Age and educational level did not influence having ever heard of these health issues. HPV infection was the most well-known risk factor, and the very late symptoms of cervical cancer were the least known. Most men preferred to be educated in a group, which provided a practical, feasible and cost effective way of educating men living in this community about these health issues.

Asunto(s)

RESUMEN

Cervical cancer is a major health problem in South Africa. Despite having a national, population-based screening program, screening coverage is as low as 13%. Based on the role men could play in increasing cervical cancer screening and the low level of knowledge, men living in the study setting had about this health issue, we developed and pilot tested an educational program aimed at empowering men to teach their female partners and family members about cervical cancer and motivate them to be screened. The study setting was Ward 23 in Muldersdrift, a semi-urban, resource poor area situated northeast of Johannesburg. We used an intervention research design to assess the outcomes of our educational program. The primary outcome was screening uptake, with knowledge the secondary outcome. Statistics and face-to-face and telephone interviews, guided by questionnaires, were used to collect the data which were analyzed by means of descriptive statistics and content analysis. A total of 120 men (n = 120) participated in the educational program and 100 (n = 100) completed the post-test questionnaire. Only 30 women (n = 30) reported for screening. The men's knowledge improved after the education program but did not guarantee that they would educate women about cervical cancer as only 55% (n = 66) indicated they taught a female family member or their partner. Cultural restrictions were the most common reason presented for not teaching women about this health issue. Ways of supporting men to overcome cultural barriers prohibiting them from discussing matters related to sexuality should be explored, before refining and replicating the intervention.

Asunto(s)

RESUMEN

Background: Cervical cancer mainly occurs among women from the developing world, and women face unique challenges in terms of their disease and treatment. Most women present with advanced cervical cancer and receive the standard curative treatment with external beam radiotherapy and brachytherapy with or without chemotherapy. Objectives: To describe the quality of life (QOL) of women treated for cervical cancer during treatment (M0), at 6 months after completing treatment (M6) and at 12 months after treatment (M12).Methods: A cross-sectional design, calculated sample size (n = 153) and convenience sampling were used. Data were collected through structured interviews, and the EORTC QLQ-C30 and EORTC QLQ CX24 served as data collection instruments. Descriptive statistics were used to analyse the data, and the Kruskal­Wallis H test was used to compare the mean responses across the groups (p ≤ 0.05).Results: The mean age of the respondents was 50.6 years (standard deviation [SD] 11.9). The global health status improved significantly in contrast with the functional scores. Financial difficulties were rampant, especially during the treatment phase. Insomnia and urinary frequency were the most cumbersome problems and remained so even after treatment.Conclusions: Despite an improvement in the global health, cervical cancer and its treatment had a negative influence on the QOL in all domains of lives of these women. Assessing the QOL of patients during treatment and follow-up visits would allow nurses to develop interventions to address distressing problems timeously. In addition, Africa's nurses should assess social functioning and develop programmes to prevent social dysfunction

Asunto(s)

RESUMEN

AIMS: To describe what motivates cancer patients, treated at a private cancer care centre in Port Elizabeth, South Africa, to undergo palliative chemotherapy and how the patients and their families experienced this treatment. METHODS: A descriptive qualitative design was used. Researchers conducted 22 in-depth interviews with 11 purposively selected patients and 11 family members nominated by the patients. Qualitative content analysis was used to analyse the data. FINDINGS: The patient participants consisted of two males and nine females between the ages 40 and 79, who had been diagnosed with various cancers. The family members consisted of six husbands, two wives and three sons, with ages ranging from 20 to 79. Three themes arose from the patient data and three from the family data. CONCLUSION: Hope informed the palliative treatment decision. Despite being told that the chemotherapy would not cure them, patients hoped for additional time and even a cure. The families supported the patient's decision and shared their hopes. The family members were aware of the side effects their loved ones were experiencing, but still experienced the treatment as positive. Giving and receiving support was important and religion, the families and staff and fellow patients at the cancer care centre were identified as sources of support.

Asunto(s)

RESUMEN

OBJECTIVE: Quality of life (QoL) is a multidimensional, subjective, and highly individual phenomenon. The current study speaks to the QoL domains identified by palliative patients living in Africa. The need to identify these domains has been recognized but seemed to still be lacking. This study filled this knowledge gap by providing the domains and by giving directions in terms of the assessment of QoL in palliative patients living in resource-restricted communities in South Africa. METHOD: We followed a multi-method approach and conducted a literature review to identify and describe the multidimensional QoL instruments used in African palliative care. A secondary analysis design and open-coding method was employed to identify the domains influencing the QoL of palliative patients living in a resource-restricted South African community, after which we compared these domains to the domains assessed by the identified QoL instruments. RESULTS: We found that two multidimensional QoL of life instruments-the Missoula-Vitas Quality of Life Index (MVQoLI) and the Functional Assessments of Chronic Illness Therapy-Palliative Care (FACIT-Pal)-have been used in African palliative care and have identified various domains, grouped as four themes: physical concerns, psychosocial issues, financial restraints, and existential issues. The patient-identified QoL domains were to a great extent not assessed by the MVQoLI and FACIT-Pal. SIGNIFICANCE OF RESULTS: Our study highlights the complexity of QoL and QoL assessment. A more accurate representation of the QoL of palliative patients living in resource-restricted communities might be obtained by using individualized measures or exploring what QoL means to these patients and selecting QoL instruments accordingly.

Asunto(s)

RESUMEN

Information is an important need in order for parents to be empowered to face their child's cancer condition. To explore the information needs of parents of children with cancer treated at an academic hospital in the Gauteng Province of South Africa, a descriptive phenomenological design was selected. The study setting was an academic hospital in Johannesburg and purposive sampling included 13 parents who spoke English and were willing to participate in the study. Qualitative interviews were conducted and thematic analyses were used to analyze the data. Four themes emerged from the data: the shock of the diagnosis, information needs about the disease and investigations, living with the treatment, and communication of the information. There was no consensus on which information was needed at specific points in time and parents had different opinions on how information should be made available to them. Continuous assessment allowing individualized information, according to the preference of the parents in the language of choice, could possibly meet their information needs.

Asunto(s)

RESUMEN

OBJECTIVE: Research on women's experiences of cervical cancer as a health problem focuses primarily on cervical screening, while their experiences of cervical cancer as a disease seem to be underresearched. This study addresses this understudied area and aims to yield insight into the experiences of underprivileged women confronted with this disease. METHOD: Our study was qualitative, exploratory, and contextual with descriptive and interpretive elements. The context of the study was a radiation oncology department at an academic hospital in the Gauteng Province of South Africa. The target population was all patients diagnosed with cervical cancer referred for treatment at the specific hospital. Convenience sampling selected participants typical of the population. Nineteen open-ended unstructured interviews were conducted after demographic data were collected. One question was posed: "Please tell me what made you think there was something wrong with you?" Thematic analyses were used to analyze the data. RESULTS: The average age of participants was 47.2 years, with a youngest participant of 29 and oldest of 70. Three themes arose from the data: experiencing the symptoms of cervical cancer, hearing the bad news, and what remained unsaid. SIGNIFICANCE OF RESULTS: Being confronted with cervical cancer is a traumatic experience. Women suffer unexplained, severe, humiliating vaginal bleeding and unrelieved pain. They have to face a dual healthcare system: on the one hand, unaffordable effective private healthcare and, on the other, the free-of-cost public healthcare that failed them. The bad news of their cervical cancer is most commonly broken in a kind and sympathetic manner, yet misunderstandings and a need for additional information prevail after the bad news conversation. Having to inform their families of their cancer adds to their suffering.

Asunto(s)

RESUMEN

BACKGROUND: Prostate cancer is a global health problem strongly linked to the Western lifestyle and its health risks. South Africa, like many African countries, has no population-based screening for this disease. OBJECTIVE: The purpose of this study was to develop and pilot test an intervention focused on the prevention and detection of prostate cancer in a resource-poor community in Tshwane, South Africa. INTERVENTION: Personal invitations for screening were extended to 122 men 40 years or older. Those presenting for screening received health education on prostate cancer and were screened using digital rectal examination and a prostate-specific antigen (PSA) test. Follow-up appointments were also arranged. RESULTS: Only 53.3% (n = 65) of the invitees reported for screening, with 38 (58.5%) returning to the clinic to learn the results of the PSA test. Knowledge of prostate cancer improved significantly after the intervention. Abnormal findings were detected in 6.2% (n = 4) of the participants, and elevations in PSA levels, in 12.3% (n = 8). CONCLUSIONS: Disappointing results in terms of screening uptake and the number of men lost to follow-up were achieved. The strategies to improve knowledge were successful and resulted in a significant increase in knowledge of prostate cancer. IMPLICATIONS FOR NURSING PRACTICE: The success of a cancer prevention and detection service is determined by participation and screening uptake. The reasons for not accepting the screening invitation and not returning to learn the findings of the PSA test should be explored. Preventative strategies should be developed and tested as part of a second pilot study testing the refined intervention.

Asunto(s)