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González-Ramos Z, Zuriguel-Pérez E, Albacar-Riobóo N, Casadó-Marín L. The emotional responses of women when terminating a pregnancy for medical reasons: A scoping review. Midwifery 2021; 103:103095. [PMID: 34320417 DOI: 10.1016/j.midw.2021.103095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND In most countries of the world the only basis for considering a termination of pregnancy is for medical reasons. Depending on the circumstances and determinants of each case, the emotional responses to this event vary greatly. The aim of this study is to map the emotional responses of women when their pregnancy is terminated for medical reasons. METHODS A scoping review was carried out. This covered all types of qualitative and quantitative studies published in English or Spanish since 2014 which included first-person accounts of women's emotional responses when they had a termination. A bibliographic search was made of four databases (CINAHL, Cochrane Library, PsycINFO and Pubmed) along with an additional manual search and backward and forward citation chaining of the studies included. The data were reported in narrative form and the results grouped according to the descriptive characteristics of the study and the emotions involved. FINDINGS The review process resulted in the inclusion of thirty-four studies. nineteen of these followed a qualitative approach and fifteen used quantitative methodology, with six of them being intervention studies. The emotions found ranged from anxiety and depression to guilt and thankfulness, so various authors stressed the need to improve training for health professionals to provide information, advice and support to the women during the entire process of the termination of pregnancy for medical reasons. CONCLUSIONS The available studies cannot be compared given the variety of designs. The predominant emotions underlying the termination for medical reasons were stress, anxiety and depression. Future research should be carried out using samples of participants covering all causes of termination for medical reasons in a particular context so that an intervention can be designed to help lessen the impact of the process on women's mental health.
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Affiliation(s)
- Zuleika González-Ramos
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain; Hospital Vall d'Hebron. Passeig de la Vall d'Hebron, 119-129, Postal Code 08035 Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain; Hospital Vall d'Hebron. Passeig de la Vall d'Hebron, 119-129, Postal Code 08035 Barcelona, Spain
| | - Núria Albacar-Riobóo
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain
| | - Lina Casadó-Marín
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain
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Stafford L, Sinclair M, Gerber K, Collins L, Newman L, Saunders C, Ives A, Mason KD, Peate M, Lippey J, Umstad MP, Shanahan K, Little R. Cancer during pregnancy: A qualitative study of healthcare experiences of Australian women. Eur J Cancer Care (Engl) 2021; 30:e13425. [PMID: 33569843 DOI: 10.1111/ecc.13425] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To identify features enhancing the quality of healthcare experiences for women with gestational cancer, and explore the impact of the heterogeneous Australian healthcare system on those experiences. METHODS Semi-structured, qualitative interviews were conducted with women diagnosed with any cancer during pregnancy in the last five years. Recruitment occurred during 2018-2019 via social media and professional, clinical and community networks. Questions related to women's experiences of their healthcare, wellbeing and psychosocial needs. Interviews were analysed thematically. RESULTS Study participants (n = 23) received treatment in the private sector (n = 10), public sector (n = 8), or both (n = 5). Five interview themes were found: Control over healthcare; Trust in clinicians, hospitals and systems; Coordination of care; An uncommon diagnosis; Holistic, future-oriented care. Women were most likely to have had a positive healthcare experience when (a)care was well-coordinated and adjusted to meet their unique needs/challenges, and (b)women perceived their care went beyond their immediate medical needs and encompassed future psychosocial wellbeing, including preparation for postpartum challenges. CONCLUSION Existing 'usual care' in the public and/or private sector for both the pregnancy and the cancer is insufficient to meet these women's needs. Prioritising psychological wellbeing including psychosocial needs, and communication and planning around fertility and postnatal challenges are essential for this population.
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Affiliation(s)
- Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Michelle Sinclair
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia
| | - Katrin Gerber
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.,Melbourne Ageing Research Collaboration, National Ageing Research Institute, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Leah Collins
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia
| | - Louise Newman
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Christobel Saunders
- Medical School, The University of Western Australia, Perth, WA, Australia.,Fiona Stanley and St John of God Subiaco Hospitals, Subiaco, WA, Australia
| | - Angela Ives
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Kylie D Mason
- Parkville Integrated Haematology Service, Victorian Comprehensive Cancer Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia
| | - Jocelyn Lippey
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia.,Department of Surgery, St. Vincent's Hospital, Fitzroy, VIC, Australia.,Department of Surgery, The Northern Hospital, Epping, VIC, Australia
| | - Mark P Umstad
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia.,Department of Maternal-Fetal Medicine, The Royal Women's Hospital, Parkville, VIC, Australia
| | - Kerry Shanahan
- Breast Service, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Ruth Little
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia
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Leung V, Bryant C, Stafford L. Psychological aspects of gestational cancer: A systematic review. Psychooncology 2020; 29:1734-1745. [PMID: 32779263 DOI: 10.1002/pon.5502] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Gestational cancer is defined as any type of cancer diagnosed during pregnancy or within 12 months of delivery. To date, existing studies on the psychological aspects of this type of cancer have not been evaluated for methodological quality. The aim of this systematic review was to identify the psychological aspects of gestational cancer. METHODS Five journal databases were searched to identify peer-reviewed articles reporting upon the psychological aspects of women with gestational cancer. Studies published from journal inception to December 2019 were included, and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. The Mixed-Method Appraisal Bias Tool was used, to assess the methodological quality of the studies. A narrative description was developed for the psychological outcomes reported in quantitative studies. Qualitative data was synthesized using thematic analysis. RESULTS Five papers were eligible for inclusion (two qualitative and three quantitative studies). Factors that contributed to women's psychological distress during gestational cancer included disease characteristics, sociodemographic factors, the baby's health, pregnancy-related factors and cognitive emotion regulation. Four main themes emerged from the qualitative studies; concerns about the baby's health, lost opportunities, "not fitting in," and healthcare decision-making. CONCLUSIONS These findings suggest that (a) women with gestational cancer experience psychological distress that is associated with concerns about their babies' health, and (b) their healthcare experiences are affected by communication within multidisciplinary care teams.
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Affiliation(s)
- Vivien Leung
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Lesley Stafford
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Women's Mental Health, The Royal Women's Hospital, Parkville, Victoria, Australia
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McKenzie F, Zietsman A, Galukande M, Anele A, Adisa C, Parham G, Pinder L, Cubasch H, Joffe M, Kidaaga F, Lukande R, Offiah AU, Egejuru RO, Shibemba A, Schuz J, Anderson BO, dos Santos Silva I, McCormack V. Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer - disparities in outcomes (ABC-DO) study. Int J Cancer 2018; 142:1568-1579. [PMID: 29197068 PMCID: PMC5838525 DOI: 10.1002/ijc.31187] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 01/25/2023]
Abstract
Breast cancer (BC) survival rates in sub-Saharan Africa (SSA) are low in part due to advanced stage at diagnosis. As one component of a study of the entire journey of SSA women with BC, we aimed to identify shared and setting-specific drivers of advanced stage BC. Women newly diagnosed in the multicountry African Breast Cancer-Disparities in Outcomes (ABC-DO) study completed a baseline interview and their stage information was extracted from medical records. Ordinal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for advanced stage (I, II, III, IV) in relation to individual woman-level, referral and biological factors. A total of 1795 women were included from Nigeria, Uganda, Zambia, and the multiracial populations of Namibia and South Africa, 1091 of whom (61%) were stage III/IV. Stage was lower in women with greater BC knowledge (OR 0.77 (95% CI: 0.70, 0.85) per point on a 6 point scale). More advanced stage was associated with being black (4.00 (2.79, 5.74)), having attended
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Affiliation(s)
- Fiona McKenzie
- Section of Environment and RadiationInternational Agency for Research on CancerLyonFrance
| | | | | | | | | | | | | | - Herbert Cubasch
- University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalJohannesburgSouth Africa
| | - Maureen Joffe
- University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalJohannesburgSouth Africa
| | | | | | | | | | | | - Joachim Schuz
- Section of Environment and RadiationInternational Agency for Research on CancerLyonFrance
| | | | - Isabel dos Santos Silva
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Valerie McCormack
- Section of Environment and RadiationInternational Agency for Research on CancerLyonFrance
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