Comparing the quality of life of women suffering from breast cancer receiving palliative care and ordinary care

Introduction: Breast cancer is the most prevalent cancer and leading cause of women’s mortality due to malignancy. Treatment increases the survival however it is associated with poor quality of life and bringing the patients toward palliative care. Objectives: This study was conducted to compare the quality of life in patients with breast cancer receiving palliative care and ordinary care. Patients and Methods: This descriptive-analytical study was carried out in Tehran hospitals (February to August 2017). The sample consisted of 220 breast cancer women who had completed the therapy four weeks prior to the study. The European Organization for Research and Treatment of Cancer quality of life Questionnaire (EORTC QLQ-C30), its supplementary breast cancer questionnaire (QLQ-BR23) and International Physical Activity Questionnaire (IPAQ) were applied to assess the quality of life of patients who received palliative care (n=110) and ordinary care (n=110). Descriptive and inferential statistics (t test and Mann-Whitney U test) were applied to analyze the data through SPSS 21. Results: The palliative care group demonstrated higher quality of life compared to the ordinary care group. Scores in functioning and global health were higher in the palliative care group than the ordinary care group. The palliative care group also had higher scores in sexual functioning, body image, future perspective, physical activity and lower scores in symptom scales, arm symptoms and hair loss than the ordinary care group (P<0.001). Conclusion: Palliative care provides more desired quality of life than ordinary care in breast cancer women and can be effective to improve the quality of life in these patients.

Designing a Process Model of Home Care Service Delivery in Iran: A Mixed Methods Study

Background:

Considering the position of home health care in the current world, the objective of this study was to design an applied model of providing home care services in Iran.

Methods:

The mixed methods approach was employed in three stages in Iran from Feb 2015 to Sep 2016. During the first phase, the qualitative method of content analysis was used. Data were collected by conducting 26 individual interviews and holding one focus group session involving 7 people. Data analysis was based on Graneheim and Lundman’s approach to content analysis.

In the second phase of the study, a literature review was carried out and at the end of this stage, a preliminary model was designed. The model was standardized in the third phase using the Delphi method with 23 participants in two rounds.

Results:

In the first and second stages of the study, various categories emerged including patient referral, agreement, determination of the needed level of care, care plans designing, provision of comprehensive services, documentation, service monitoring, inter-professional cooperation, issuance of death certificates at home, ethical considerations, and the evaluation of services. Then, in the Delphi phase, 20 (95.2%) of the experts confirmed the structure and content of the model and its applicability.

Conclusion:

The designed model can be helpful in organizing the provision of integrated and comprehensive health services to clients at home, which can be effective in improving the clients’ health and enhancing their self-care and autonomy.

Exploration of the administrative aspects of the delivery of home health care services: a qualitative study

BACKGROUND

Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task.

OBJECTIVES

The purpose of this study was to explore the administrative aspects of the delivery of home health care services.

METHODS

This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method.

RESULTS

23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories.

CONCLUSION

Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

Effects of progressive muscle relaxation, guided imagery and deep diaphragmatic breathing on quality of life in elderly with breast or prostate cancer

BACKGROUND AND OBJECTIVES

Due to the increasing number of elderly and an increase in the number of cases of cancer by age, cancer is a common problem in the elderly. For elderly patients with cancer, the disease and its treatment can have long-term negative effects on their quality of life (QoL). The purpose of this study was to evaluate the effect of progressive muscle relaxation, body image and deep diaphragmatic breathing on the QoL in the elderly with cancer.

MATERIALS AND METHODS

This study was a randomized controlled trial in which 50 elderly patients with breast or prostate cancer were randomized into study and control groups. Progressive muscle relaxation, guided imagery, and deep diaphragmatic breathing were given to the study group, but not to the control group. The effect of the progressive muscle relaxation, guided imagery and deep diaphragmatic breathing was measured at three different time points. European Organization for Research and Treatment of Cancer and QoL Questionnaire-Core questionnaires was completed before, after and 6 weeks after the intervention for the patients in both groups simultaneously. The data were analyzed by SPSS.

RESULTS

There was statistically significant improvement in QoL (P < 0.001) and physical functioning (P < 0.001) after progressive muscle relaxation, guided imagery and deep diaphragmatic breathing intervention.

CONCLUSIONS

The findings indicated that concurrent application of progressive muscle relaxation, guided imagery, and deep diaphragmatic breathing would improve QoL in the elderly with breast or prostate cancer.

Exploring the Barriers of Home Care Services in Iran: A Qualitative Study

With increasing chronic diseases, the use of home care is rising in the world. Home care in Iran has many challenges and to improve that, we should identify the challenges and barriers of home care. The aim of this study was to identify and explore the barriers of home care in Iran. This is a qualitative study with content analysis approach that was conducted in Iran in 2015. Fourteen key informants comprising health policymakers, faculty members, nurses, and physicians as well as patients and families engaged in home care purposefully participated in this study. Data was obtained using face-to-face semistructured interviews. A focus group discussion was also used to complete the findings. Graneheim and Lundman's approach was used for analysis of data and Lincoln and Guba's criteria were used to confirm the trustworthiness of study's findings. The data were divided into three main categories and eight subcategories. Main categories included treatment-based approach in the healthcare system, cultural dimensions, and the lack of adequate infrastructure. A position for home care in the healthcare system, considering cultural dimensions in Iranian society and providing an appropriate infrastructure, can be beneficial to improve the situation of home care services in Iran.