Socio-Economic Status Inequity in Self Rated Health in Patients with Breast Cancer

Social, Economic, Technological, and Environmental Factors Affecting Cardiovascular Diseases: A Systematic Review and Thematic Analysis

Background

Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD.

Methods

Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data.

Results

A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster.

Conclusions

Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.

The Effect of E-Learning on Self-Efficacy and Sense of Coherence of Cancer Caregivers: Application of the Bandura and Antonovsky Social Cognitive Theory

AIM

Cancer is one of the most important chronic diseases which affects caregivers. Therefore, in this study, we decided to increase the self-efficacy and sense of coherence of caregivers by using virtual learning via mobile to increase the power of managing in such situations.

METHODS

This study is a clinical trial performed on 60 caregivers of cancer patients. Questionnaires of demographic information, Bandura self-efficacy, and Antonovsky's sense of coherence were completed for both intervention and control groups. Then, for the intervention group, a virtual educational intervention was performed daily for 1 month using the mobile phones, and for the control group, no intervention was performed.

RESULTS

The mean score of self-efficacy in the intervention group was (18.09±93.21) before and (135.12±11.14) after the intervention, which was statistically significant (P=0.001). While in the control group, this means was (84.71±18.55) before and (84.75±17.13) after the study, but this difference was not statistically significant (P=0.2). Also, the mean score of sense of coherence in the intervention group was (73.25±7.28) before and (89.11±7.11) after the intervention, which was statistically significant (P=0.001). While in the control group, this means was (76.42±7.45) before and (76.89±7.27) after the study, but this difference was not statistically significant (P=0.31).

CONCLUSION

Educational interventions, even virtually, can lead to improved self-efficacy and a sense of coherence in caregivers of cancer patients and can be used as one of the low-cost and effective methods in managing and controlling the disease.

Socioeconomic inequalities in metastasis, recurrence, stage and grade of breast cancer: a hospital-based retrospective cohort study

Introduction

This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC).

Methods

This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software.

Results

Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of > 80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), – 0.014 (– 0.034, – 0.001) and – 0.042 (– 0.061, – 0.002) for metastasis, recurrence, stage and grade of BC respectively.

Conclusions

Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.