الصحة العامة

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Browsing الصحة العامة by Author "ابتسام أحمد عيسى الطيطي"

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    Supportive Care Services and Quality of Life of Breast Cancer Patients in Governmental Hospitals of the South-ern West Bank PHD
    (Al-Quds Univeersity, 2025-08-24) Ibtisam Ahmed Issa Al-Titi; ابتسام أحمد عيسى الطيطي
    Background: Supportive care and quality of life (QoL) are crucial for positive breast cancer (BC) outcomes. However, there is a widespread lack of fulfilment regarding informational, physical, and psychological needs, and routine QoL assessments are rarely integrated into practice in Palestine. Addressing these gaps is vital, as the sys-tematic assessment of SCNs not only clarifies patients’ needs but also serves as a sig-nificant predictor of QoL. Aim: This research aims to assess supportive care services for women with BC in gov-ernmental hospitals in the southern West Bank and to evaluate their effect on patients' QoL, while analysing the influence of other important determinants Method: This research was conducted in governmental hospitals in the southern West Bank and included several complementary sub-studies. The first data collection phase was carried out between August 2023 and July 2024 and involved a cross-sectional survey of 362 women with breast cancer, as well as the follow-up of newly diagnosed patients (n = 147) throughout their one-year treatment trajectory. The second phase of data collection took place between November 2024 and January 2025, approximately one year after treatment completion. Across these phases, SCNs, coping strategies, spiritual well-being (SWB), and satisfaction with services associations with QoL at diagnosis and treatment were examined. Data were gathered through face-to-face in-terviews using validated study tools. Statistical analysis included descriptive statis-tics, bivariate tests, correlations, and multivariable models, with a significance level set at p < 0.05. Results: Unmet SCNs were highly prevalent in this study. 61% of the total sample and 83.5% of newly diagnosed women reported at least one unmet SCN need. The most affected domains were health system and information (93–95%), physical and daily living (90–93%), and psychological (75–86%). Intensive treatments such as chemotherapy and surgery increased physical and psychological needs, while family and social support reduced them. QoL at diagnosis was modest (global health mean, µ= 45.8), with relatively higher physical (µ =67.1), cognitive (µ=62.8), and role func-tioning (µ=58.6), but low emotional (µ=49.2) and social functioning (µ=34.5). Com-mon symptoms included fatigue (µ=44.67), insomnia (µ=44.7), and pain (µ=39.8). Younger, educated, employed, and married women with family support had better outcomes, while advanced disease, comorbidities, pain medication, chemotherapy, and mastectomy predicted poorer scores. After one year, body image remained mod-est (µ=43.2), while sexual functioning (µ=34.5), sexual enjoyment (µ=34.7), and fu-ture perspective (23.4) were particularly poor. Patient satisfaction strongly influenced QoL. Better communication, skilled nursing, and clean facilities were linked with im-proved body image and sexual functioning, as well as fewer systemic side effects, while poor access predicted more side effects. Coping and family support were pro-tective: positive focus and diversion predicted higher QoL, whereas maladaptive cop-ing reduced functioning. SWB was moderate (µ=29.7), highest for Faith (µ=11.3) and Meaning (µ=11.0), and lowest for Peace (µ=7.4). Higher SWB was associated with better body image, sexual functioning, and fewer systemic, breast, and arm symp-toms. Conclusion: This is the first comprehensive evidence-based research that assesses the supportive care services and QoL of Palestinian women with BC. Findings revealed a high burden of unmet SCN needs, particularly in informational, physical, and psycho-logical domains, with newly diagnosed patients at greatest risk. QoL was modest at diagnosis and remained compromised one year after treatment, especially in body im-age, sexual functioning, and future perspective. In addition, family and social support, education, positive coping strategies, satisfaction with care, and higher SWB im-proved outcomes. Integrating supportive care, psychosocial services, and culturally sensitive spiritual support into oncology practice is crucial to addressing these gaps and improving women’s overall well-being in a resource-limited, conflict-affected set-ting.