Stress management for breast cancer survivor in South Sulawesi Province Indonesia
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Farid" "apellidos" => "Lewa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911121002016?idApp=WGSE" "url" => "/02139111/00000035000000S2/v1_202112201615/S0213911121002016/v1_202112201615/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "titulo" => "Stress management for breast cancer survivor in South Sulawesi Province Indonesia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S183" "paginaFinal" => "S185" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => " Azriful, Fatmawaty Mallapiang, Nildawati, Syamsul Alam, Rini Jusriani, Masyitha Muis" "autores" => array:6 [ 0 => array:3 [ "apellidos" => "Azriful" "email" => array:2 [ 0 => "azriful@uin-alauddin.ac.id" 1 => "pmc@agri.unhas.ac.id" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Fatmawaty" "apellidos" => "Mallapiang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:2 [ "apellidos" => "Nildawati" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Syamsul" "apellidos" => "Alam" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Rini" "apellidos" => "Jusriani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Masyitha" "apellidos" => "Muis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Islam Negeri, Alauddin, Makassar 92113, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Occupational Safety and Health, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cancer is the second leading cause of death globally with 9.6 million deaths in 2018. Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, cervical and thyroid cancers are the most common in women.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> The mortality rate from breast cancer in developing countries is much higher than in developed countries.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The uncontrolled increase in cancer cases is due to many factors, such as lifestyle, diet, reproductive changes, smoking behavior, physical activity and the influence of urbanization and economic development.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">4–8</span></a> This cancer mortality rate ranks third after death from cardiovascular disease. The incidence of cancer can be estimated to reach 26 million people in 2030 and 17 million of them will die from cancer.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a> In Indonesia, cancer is still a serious health problem, breast cancer was ranked second (1.7 million or 11.9%) after lung cancer (1.8 million or 13%). This figure shows that breast cancer ranks first in cancer cases experienced by women.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a> The national incidence of cancer shows an increase from 1.4% 2013 to 1.8% in 2018.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The psychological impact experienced by each person varies depending on the severity (stage), the type of treatment being undertaken and the characteristics of each patient. About 30.0% of cancer sufferers experience adjustment problems and 20% were diagnosed as having depression Eight psychological effects that are often felt by breast cancer patients, namely in the form of helplessness, anxiety, shame, decreased self-esteem, stress and anger.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">12</span></a> Psychological problems that arise due to breast cancer are anxiety, depression and stress.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">13</span></a> The results of the research by Sitepu and Wahyuni, (2018) explained that patients with cancer experience stress as much as 28.8%, patients feel stressful. ena haunted by the image of death, fear of the impact of treatment, stress will arise when a person knows for sure that he has breast cancer even though it is still in a very early stage. Stress can affect nerves and hormone secretion, resulting in decreased chemotherapy efficacy and decreased antibody production.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">14</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The stress experienced is manifested directly through physiological and psychological changes. If stress symptoms are not handled properly in breast cancer sufferers, stress can continue and enter a depressive disorder. Depression is a common mental disorder characterized by feelings of sadness, depression, loss of interest, pleasure, decreased energy, feelings of guilt or feelings of inferiority, sleep disturbances and difficulty concentrating.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> Stress management program for breast cancer survivors is needed to deal with stress and train breast cancer sufferers’ skills in coping with stress so that it can improve the quality of life for breast cancer survivors.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study used a phenomenological qualitative method. Phenomenological qualitative research aims to describe the general meaning of a number of individuals to various life experiences related to a concept or a phenomenon.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">16</span></a> Phenomenology focuses more on the concept of a certain phenomenon and the form of its study to see and understand the meaning of an individual experience related to certain phenomena or events.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">17</span></a> Phenomenology as a study to provide an overview of the meaning of the experiences of several individuals regarding a particular concept.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The location of this research is in South Sulawesi Indoensia. This research was conducted from February to Mei 2021, with a total of 10 informants. Data collection techniques used interview techniques to informants who are breast cancer survivors who live in South Sulawesi Province. Data analysis was performed using qualitative data analysis which was developed or better known as interactive analysis (<span class="elsevierStyleItalic">interactive models of analysis</span>). This interactive analysis consists of three main components, namely data reduction, data presentation, and drawing conclusions which are carried out in an interactive form with the data collection process as a cycle.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Result</span><p id="par0035" class="elsevierStylePara elsevierViewall">The results of the interviews conducted by the informants were related to how they felt when they first heard the doctor's diagnosis, the strategies they took to control stress, how the informants carried out their daily life activities, what made them remain optimistic and how fellow survivors were able to control stress during treatment.</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 1. The feeling when I first heard the doctor's diagnosis</span><span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">apos;I was shocked and didn’t believe it and felt like dyingapos; (Inf. 001, 40 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0010"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">apos;Of course it is very depressed, why should I and refuse to accept the realityapos; (Inf. 002, 40 years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0015"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">apos;It has been mentally prepared and ready to accept whatever the doctor's diagnosis isapos; (Inf. 003, 44 Years).</p></span></p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 2. Strategies used to control stress</span><span class="elsevierStyleDisplayedQuote" id="dsq0020"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">apos;Meeting survivors, reading lots of books, hearing stories from fellow survivorsapos; (Inf. 005, 40 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0025"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">apos;Strengthen yourself, surrender and keep thinking positively, and that death is certain (Inf. 007, 44 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0030"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">apos;After mastectomy (breast removal), sad and really depressed, bought books about the remembrance of cancer healing apos; (Inf. 009, 41 Years).</p></span></p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 3. How to survive daily activities and life</span><span class="elsevierStyleDisplayedQuote" id="dsq0035"><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">apos;There are mothers who always give advice, fix dzikir, wake up midnight prayers, do dhuha prayers, I think that these are signs that all ages of God's health have been regulatedapos; (Inf. 001, 40 Year).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0040"><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">apos;Stay as usual, assuming that nothing happenedapos; (Inf. 008, 44 Years).</p></span></p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 4. What keeps you optimistic about recovering from this disease</span><span class="elsevierStyleDisplayedQuote" id="dsq0045"><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">apos;That everything has to be lived, Meeting survivors, reading lots of books, hearing stories from fellow survivors apos; (Inf. 004, 44 Year).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0050"><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">apos;Many provide support and from the experiences of previous survivorsapos; (Inf. 006, 41 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0055"><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">apos;Actually, just follow the medically suggested treatment, follow the doctor's advice, adjust the dietapos; (Inf. 007, 41 Years).</p></span></p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 5. How do fellow survivors be able to control stress while the treatment is taking place</span><span class="elsevierStyleDisplayedQuote" id="dsq0060"><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">apos;Very good fellow survivors, cancer members 230 support people from the survivors are very supportive and provide experiences - experiences of the survivorsapos; (Inf. 001, 40 years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0065"><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">apos;We have a group of fellow survivors and that's where we often share and encourage each otherapos; (Inf. 008, 44 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0070"><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">apos;It was necessary to meet fellow survivors, because I shared experiences with each other and I was included in the survivor groupapos; (Inf. 004, 44 Years).</p></span></p><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Theme 6. How is family support in helping to deal with stress?</span><span class="elsevierStyleDisplayedQuote" id="dsq0075"><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">apos;The first thing I know is my husband, my husband is very surprised, but my husband is very supprot and I am strong inapos; (Inf. 010, 40 Years).</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0080"><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">apos;Until the current treatment, my hair has fallen out, but my husband always gives motivationapos; (Inf. 002, 40 years).</p></span></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Based on the results of interviews, breast cancer sufferers experience stress and depression when they first find out the diagnosis from a doctor. However, they carry out strategic in order to get rid of excessive anxiety such as reading books, dzikir, meeting fellow survivors, and still trying to sincerely undergo all series of treatments. Support from family and fellow survivors greatly contributes to efforts to prevent stress and depression, fellow survivors have communities and groups to provide information and education as well as sharing related to breast cancer.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Stress conditions often occur when undergoing treatment so that cancer patients experience pressure and the depression they feel causes the patient to perceive depression more severely.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">18</span></a> Sukma's research (2018) shows that breast cancer patients with depression levels found that age (36–45 years) experienced more depression.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">19</span></a> Sources of coping, optimism and various support are needed to deal with stress and depression experienced by breast cancer patients undergoing chemotherapy.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">20,21</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Other studies have shown that patients who are first diagnosed with cancer may experience several psychological disorders including stress, depression, anger, and even poor self-acceptance. Coping strategies and support from the environment are several factors that can reduce the level of stress experienced by cancer patients.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">22</span></a> Research conducted by Hopman & Rijken (2015) shows that cancer patients have different perceptions of death, each individual knowing that cancer has very unpleasant and even frightening effects, ranging from physical deterioration to the fact that the disease can cause death.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">23</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The psychological burden felt heavier by breast cancer sufferers after being convicted of breast cancer. Breast cancer sufferers maintain good social relations with the surrounding community by continuing to participate in community activities. An uncomfortable environment that does not provide a sense of security for breast cancer sufferers increases the sufferer's stress. The financial shortage for medical expenses adds to the burden for breast cancer sufferers. Social support is obtained by breast cancer sufferers from their closest people such as younger siblings, children and husbands. The support of the closest people makes the sufferer stronger in living and has better hopes for the future.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">24</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="par0090" class="elsevierStylePara elsevierViewall">The feelings experienced by breast cancer survivors when they were first diagnosed were feelings of sadness, anxiety, fear, disappointment, hopelessness, loss of self-confidence, shame, stress and depression which caused the patient to want to commit suicide. Support and motivation from family, work environment, friends, relatives, fellow breast cancer survivors and treating doctors are needed to deal with stress and depression.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1632454" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1456606" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Result" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-06-28" "fechaAceptado" => "2021-07-30" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1456606" "palabras" => array:3 [ 0 => "Breast cancer" 1 => "Stress management" 2 => "Survivors" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cancer is still a health problem serious. Based on the Ministry of Health's report, cancer is the second leading cause of death in the world by 13% after cardiovascular disease. Approximately 30% of cancer patients had adjustment problems and 20% were diagnosed with depression.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A qualitative design with an ethnographic and phenomenological approach with a total of 10 participants.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Result</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Based on the results of the interview, breast cancer sufferers experience stress and depression when they first find out the diagnosis from the doctor. However, they carry out strategic in order to get rid of excessive anxiety such as reading books, dzikir, meeting fellow survivors, and still trying to sincerely undergo all series of treatments.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Support from family, work environment, friends, relatives, fellow breast cancer survivors and treating doctors and fellow survivors greatly contributes to efforts to prevent stress and depression, fellow survivors have communities and groups to provide information and education as well as sharing related to breast cancer.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd International Nursing, Health Science Students & Health Care Professionals Conference. 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