Public Health

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Browsing Public Health by Author "Ayda Ahmad Mohammad AL-Hadad"

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    Psychosocial Challenges, Coping Strategies and Access to Support for Women with Breast Cancer in the Gaza Strip
    (Al-Quds University, 2024-04-20) Ayda Ahmad Mohammad AL-Hadad; عايدة أحمد محمد الحداد
    Breast cancer represents 11.7% of all cancer cases worldwide and 18% in in the Gaza Strip. In addition to being a common bodily health problem, cancer is also associated with psychosocial problems such as depression, anxiety. Universally, there is growing evidence around the challenges and support for women with breast cancer. The study is conducted to explore key psychosocial and mental health challenges facing women with BC, appraise their coping strategies, and to ascertain formal and informal support accessible to them. Methods A cross sectional design was used, in which data have been triangulated, quantitatively and qualitatively. The quantitative part is conducted through an interviewed questionnaire with 330 women diagnosed with breast cancer and focused on exploring the challenges they are facing and the support provided to them. The qualitative part looked in-depth to the lived experiences of women with breast cancer, their perspectives were explored through four focus group discussions with 25 participants. Quantitative data was analyzed using the SPSS and open coding thematic analysis technique was used for analyzing qualitative materials. Findings Findings revealed that 35.6% of the participants were 51-60 years old, nearly half of them from Gaza City, 76% were married, 93.3% were housewives and 53.8% reported that their monthly household income is less than 1000 ILS. With regard to the staging of BC, nearly a quarter (24%) were stage I and 36.8% were stage II. As reported by women, 60% took more than 4 weeks to initiate treatment after confirming their diagnosis. Chemotherapy was received by 83% of women, surgery was done for 84%, hormonal therapy was received by 71%, while 68.4% of participants received radiotherapy. Participants scores on mental health scales show that anxiety was more prominent (76% with moderate and severe) than depression (29% moderate and severe) or stress (9% moderate or severe). When asked how BC affected them, 31% reported that cancer reduced their activity level and negatively affected their psychosocial status (26.7%).Findings show that among the five social support dimensions, positive social interaction was the most common dimension, while tangible support (provision of practical resources and material aid) was the least common. Women used different strategies to cope with their disease, the most frequent coping strategies were praying or meditating (75.5%), followed by trying to find comfort in religion or spiritual beliefs (55.2 %).Inferential analysis showed that younger women (less than 40 years), recently diagnosed (one year and less) and women diagnosed at stage of III and IV were facing more challenges than their counterparts from other groups in reporting higher scores of depression, anxiety and stress, and had higher scores of avoidant coping strategies when compared to other women. Women who had mastectomy, reported higher scores in the challenges they face, depression, anxiety and stress, and received more social and formal support compared to women who had breast conservative surgery, but these variances are not statistically significant.Conclusions and recommendations The study concluded numerous challenges that are facing women throughout their course of disease, which found to be adversely affecting their mental health outcomes and points out to the necessity of addressing these challenges. Breast cancer management is not only medical rather, it requires multi-modal interventions including intensive psychosocial support and social protection which needs to be integrated as a crucial component of care.