Perception of Cancer Patients and Their Attendants during Pandemic of COVID-19: An Experience from Tertiary Care Center, Pakistan

Introduction: Cancer patients have concerns about treatment during COVID-19 pandemic virus as well as its impact on their health. This survey was conducted to ascertain perception of cancer patients and their attendants during this pandemic. Methods & Results: This cross-sectional study was conducted at Oncology OPD of SIUT, from May 2020 to July 2020 on cancer patients along with their attendants. Among 306 patients, 68.9% received chemotherapy. In response of each question, 1st one belonged to patients and 2nd was related to attendants. Only positive answers are reported here. For increasing gap of chemotherapy during the pandemic COVID-19, 58.3% vs 38.4% agreed with doctor recommendation. For start of single agent chemotherapy instead of combination regimen, 41% vs 19% agreed. For hospitalization 41.5%, vs 47.7% depicted inclination towards admission whereas for mental health questions, 63.7% vs 51.3% were neither afraid nor had psychological issues 79.7% vs 25.8% respectively. About COVID-19 testing, 66% vs 22.5% wanted to be tested. If results turned out positive, 82.2% vs 24.7% would go in isolation. Conclusion: This study provides evidence of perception of cancer patients with their attendants from resource restrained country. Our study confirms that for disease like cancer, fear of the illness is always more paramount than any infection.

Fear of breast cancer among young Spanish women: Factor structure and psychometric properties of the Champion breast cancer fear scale

Heightened fear of breast cancer (FBC) has been linked to increased distress following breast cancer diagnosis and to avoidance of mammography screening. To our knowledge, however, no studies have examined the nature of FBC exclusively among young females, even though they are overrepresented in media stories of breast cancer. Given that no instruments are available to assess FBC in the Spanish language, we sought to 1) evaluate the psychometric properties and factor structure of the Champion Breast Cancer Fear Scale (CBCFS), and 2) offer preliminary data on the nature of FBC among young women. Participants (N = 442, mean age = 21.17, range 17–35) completed the translated CBCFS (CBCFS-es) and the Spanish version of the Short Health Anxiety Inventory. The CBCFS-es demonstrated good concurrent validity, internal consistency, and test-retest reliability. Confirmatory factor analysis showed adequate fit to a one-factor solution. The majority of participants reported considerably high levels of FBC, as 25.34% and 59.73% of them scored above the moderate- and high-FBC cut-offs, respectively. Moreover, FBC could not be explained by general concerns regarding health and illness, given that levels of health anxiety were low. Implications for health education, research, and clinical practice are discussed.

Association of Sociodemographic Factors, Breast Cancer Fear, and Perceived Self-Efficacy With Breast Cancer Screening Behaviors Among Middle-Aged Nigerian Women

Introduction: Breast cancer (BC) is a major public health problem among women. However, BC screening uptake is abysmally low among Nigerian women. This study evaluated the association of BC fear and perceived self-efficacy with BC screening (clinical breast exam [CBE] and mammography) among middle-aged Nigerian women. Methods: A community-based cross-sectional study was conducted among middle-aged women in Enugu State, southeast Nigeria. The data were collected between September 2019 and February 2020. The BC screening uptake, fear, and self-efficacy were assessed using the validated Breast Cancer Screening Questionnaire (BCSQ), Champion Breast Cancer Fear Scale (CBCFS), and Champion’s Mammography Self-Efficacy Scale (CMSES). Data were analyzed using frequencies and percentages, chi-square test, and univariate analysis of variance. Bivariate and multivariable logistic regression models were used to examine independent associations between selected sociodemographic factors, cancer fear, perceived self-efficacy, and BC screening. Results: The mean age of the participants was 55.3 years (SD: 5.75). More than half of the women (51%) reported having a BC screening in the past 12 months. However, only 12.5% and 16.9% reported having a CBE or mammogram in the past 12 months. The prevalence of a high, moderate, and low level of fear was 68%, 22.3%, and 9.8%, respectively. The prevalence of a high, moderate, and low self-efficacy level was 50.6%, 37.5%, and 12.0%, respectively. The multivariable logistics regression analysis showed that women aged 50-59 years and 60-64 years were 3.5 times (adjusted odds ratio [AOR] = 3.50, 95% confidence interval [CI]: 2.07-5.89, P < .0001), and 5.92 times (AOR = 5.92 95% CI: 2.63-13.35, P < .0001), respectively, more likely to perform mammogram than those aged 40-49 years. Women with a high level of self-efficacy were 2.68 times (AOR = 2.68, 95% CI: 1.15-6.26, P < .0001) more likely to use mammographic screening than those with low self-efficacy. Although not statistically significant, women with a moderate level of BC fear were 0.56 times less likely to use mammogram than women with a low level of BC fear. Conclusion: A low proportion of women underwent CBE or mammography. Women had a high level of BC fear and a moderate level of self-efficacy for BC screening. The findings emphasize the need for health educational and psychosocial interventions that improve self-efficacy and promote regular BC screening among middle-aged women.

Health Orientation and Fear of Cancer: Implications for Counseling and Integrated Care

The mental health counseling profession’s focus on wellness and prevention puts counselors at an advantage in the developing fields of integrated care and cancer care. To integrate counselors further into the cancer care world, this study investigated how factors related to prevention and wellness (e.g., health orientation and fear of cancer) relate to topics that counselors are adept at addressing, such as optimism, social support, and resilience. Results indicated that health orientation predicted fear of cancer, but that psychosocial variables (i.e., optimism and social support) either had no relationship with cancer fear or were not significant moderators (i.e., resiliency) of the relationship between health orientation and fear of cancer. In particular, health anxiety was the best predictor of cancer fear. Implications for counselors and future research are discussed.