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In 2018, we conducted a survey among a convenience sample of men (n = 205) living in a resource-poor, semi-urban community in South Africa. We aimed to describe what they know about cancer by asking questions about cancer-related knowledge and understanding, and health-seeking behavior. We also investigated possible relationships between the variables. We used a researcher-administered questionnaire to collect the data and descriptive statistics and quantitative content analyses for the analysis. Chi-square was used to examine the relationships. The mean age of the sample was 35 years, and 49.8% (n = 102) attended 11 or 12 years of school. One-third (32.7%; n = 67) indicated they knew what cancer was, but only 28.8% (n = 59) gave an explanation: “very dangerous/a killer/worse than HIV” were the most common explanations. Only 24.9% (n = 51) were able to identify a possible warning sign, and “feeling very sick” was the most common. However, more than 60% considered six of the seven warning signs of cancer as serious. When suspecting they might have cancer, most (77%; n = 159) indicated they would tell the preferred person within 1 week, while 5.9% (n = 12) would tell “nobody.” Although the majority (52.2%; n = 107) felt their partners and families motivated them to seek healthcare when sick, 28.3% (n = 58) needed permission to consult a professional. Educating the community about cancer in a culturally sensitive manner, irrespective of their educational level and perceived knowledge of cancer, could improve knowledge and understanding and lead to seeking healthcare timely.

Objectives: Globally, breast cancer is the commonest cancer in women. Empirical literature indicate that it is the second cause of cancer-related mortality in high-resource regions, while it is the most common cause of cancer-related deaths among women in poor-resource regions. This study presents the suitability of the health belief model (HBM) as a framework for carrying out a comprehensive assessment of women with late-stage breast cancer in Nigeria. Materials and Methods: This qualitative study employed interpretive description as its methodological approach, while the HBM was the conceptual framework. Two institutional review boards granted approval to conduct the study. Thirty women with advanced breast cancer were recruited for the study using purposeful sampling techniques. Components of the original HBM were identified to carry out the investigation. Data analysis was inductive. Results: Findings indicated that the participants viewed breast cancer as a definite threat- both as a spiritual attack – an arrow shot by the enemy, and as a killer disease. Many of their perceptions appeared to be culturally based, while others were based on their individual experiences. They perceived some benefits to both traditional and medical treatment options. Conclusions: Interventions that address people’s cultural and individual perceptions enables a comprehensive assessment of the patients with breast cancer, which can improve the treatment outcomes and survival rates of disease.

To describe the experiences of girls who have undergone FGM/C, so that efforts toward ending this practice can be scaled up using evidence-based interventions. Method: A qualitative descriptive des...

Aim and objectives To describe the FGM/C experiences of young women living in Nigeria. Background Globally, several activities have been targeted at ending female genital mutilation/cutting (FGM/C). However, the practice is ongoing, especially in countries such as Nigeria, which is reported to be having a population boom. Therefore, there is a need to investigate the FGM/C experiences of young women in such countries so that efforts towards ending it can be accelerated using evidence-based, community-led interventions. Design A qualitative descriptive design. Methods The study took place in two states of south-eastern Nigeria with a high prevalence of FGM/C. The snowball sampling method was used to recruit 22 women, aged 20-40, who had undergone FGM/C. Participant's experiences were explored through semi-structured interviews, and the qualitative content analysis was used for data analysis. The consolidated checklist for reporting of qualitative studies guided the reporting of this study. Findings Three themes and seven subthemes emerged from the data. The themes were as follows: cultural issues, life as a circumcised woman and the future with FGM/C. Half of the participants could not recall their experiences on the day of their circumcision, as they were circumcised at infancy. However, those who were older when circumcised experienced it as a painful, traumatic experience forced upon them. Some of the participants experienced sexual and childbirth problems due to this procedure, and this was of great concern to them. Conclusion Female genital mutilation/cutting was a traumatic experience forced on the participants. They felt helpless as they could not choose and had to do the "right thing." Despite the trauma and complications caused by the cutting, some still supported the continuation of the practice. Relevance to clinical practice Understanding the experiences of genitally mutilated women could assist healthcare practitioners in rendering quality, and contextualised services to these women.

Cervical cancer is the second most common cancer in South African women, but the most common cancer in Black women. Despite cervical cancer screening being available, most women present with late stage disease requiring the standard curative treatment of radiotherapy, with or without chemotherapy. Cervical cancer and its treatment have various side effects, which have a negative influence on sexual function. Our study aimed at describing the sexual function of women treated for cervical cancer at an academic hospital, in the third (M3), sixth (M6) and twelfth months (M12) after completing treatment. A cross sectional design, convenience sampling and calculated sample size (n = 147) were used. Structured interviews were conducted to collect the data, and the Female Sexual Function Index (FSFI) served as data collection instrument. Kruskal Wallis H and Chi-square tests were used to determine the relationships between the variables. The data were collected between July and August 2015. The majority of the women (94.6%; n = 139) experienced sexual dysfunction, which persisted over time. The most affected domain was arousal, whilst satisfaction was the least affected. Pain experienced during sexual activity persisted as time progressed. Age, educational level, the type of treatment received and having had sexual counselling before treatment commenced did not influence sexual function. Our study provided evidence that the majority of women treated for cervical cancer live with long lasting sexual dysfunction affecting all sexual function domains. Although sexual dysfunction reached the highest level in the third month after treatment, there was little improvement over time.

Malawi has the highest incidence of cervical cancer in the world. Due to various challenges the country faces in terms of cervical cancer control, women have a poor chance to survive this disease. The purpose of our study was to describe the knowledge and practices of cervical cancer and its screening as well as the educational preferences of women living in a rural community in the Chiradzulu District. We conducted a survey among women between the ages 30 and 45, used convenience sampling, a calculated sample size (n = 282) and structured interviews to collect the data. A questionnaire adapted from a previous study served as data collection instrument. The data were analysed in Microsoft Excel and chi-square (p

Objective: The objective of this study was to describe the perspectives and experiences of South African nurses caring for patients receiving palliative chemotherapy. Methods: A qualitative descriptive design was used and purposive sampling allowed us to select 11 nurses practising in a private ambulatory cancer care center in Port Elizabeth. In-depth interviews, guided by three broad themes were conducted and analyzed using qualitative content analyses. Data saturation determined the sample size. Results: Two themes emerged from the data – the patients cling to hope and the positive influence of palliative chemotherapy. The participants believed that patients consenting to palliative chemotherapy were clinging to false hope. They were also of the opinion that family members pressurize patients to consent to treatment. The participants experienced palliative chemotherapy positively, especially when an improvement in the patients’ quality of life or pain relief was evident. Fatigue was highlighted as the major side effect, but it did not temper the participants’ positive attitudes toward the treatment. Conclusions: Although the participants believed that patients cling to hope and consent to palliative chemotherapy because they hope to be cured, they experienced the treatment as positive. For them, the improvement in pain and quality of life outweighed the side effects the patients experienced. The positive attitude patients upheld while receiving this treatment encouraged them. Nurses should gain more knowledge about the meaning, people living with advanced cancer, attach to hope to prevent them from interpreting patients’ hope as denial and false.

Objective: Cancer patients in Africa face unique challenges such as poverty, access to health care and under-resourced health-care systems. Although quality of life (QoL) of cancer patients has been well researched, the perspectives of cancer patients living in Africa are unknown. The objective was to explore what constitutes QoL for cancer patients accessing public health care in South Africa. Methods: A qualitative exploratory design was used, and data were gathered by means of in-depth interviews. Purposive sampling selected the participants, and the sample size was determined by saturation (n = 22). The data were analyzed using Patton's method of content analysis. Results: The participants were aged between 20 and 79 years, with an average of 50 years. Most were female and represented seven cultural groups. Four themes that influence QoL arose from the data: psychosocial-, physical-, spiritual and financial factors. Conclusions: QoL remains a complex phenomenon, enhanced and diminished by various individual factors. Poverty was a major issue and influenced the physical aspects of QoL, as the participants had to be strong enough to work and earn a living. Support from family, friends, and church members enhanced QoL, as well as religion and religious practices. Measuring QoL would be the next step to enable nurses to implement measures to improve QoL. Whether existing QoL instruments would be suitable for this patient population is not known and should be investigated before implementation.

Cervical cancer is the second most common cancer in South African women, but the most common cancer in Black women. Despite having a national cervical cancer screening programme, most women present with advanced disease. Men play a role in cervical cancer as the HPV, the major cause of cervical cancer, is sexually transmitted. The purpose of our study was to describe the knowledge men, living in Muldersdrift, had about cervical cancer, cervical cancer screening and the cervical cancer screening programme and how they preferred to be taught about these health issues. We used a survey design and convenience sampling to select 101 men older than 18 years (n = 101). A pretested self-developed questionnaire was used as the data collection instrument, and the data were analyzed using the SPSS version 22-computer program and quantitative content analyses. The Fischer's exact test measured associations between variables (p = 0.05). The ages of the sample (n = 101) ranged from 18 to 92 years; most were from the Zulu cultural group, unemployed and unmarried. The majority (66.3%, n = 67) had not heard of cervical cancer, the cervical cancer screening programme (60.4%, n = 61) or the Pap smear (67.3%, n = 68). Age and educational level did not influence having ever heard of these health issues. HPV infection was the most well-known risk factor, and the very late symptoms of cervical cancer were the least known. Most men preferred to be educated in a group, which provided a practical, feasible and cost effective way of educating men living in this community about these health issues.

Breast cancer is the most common cancer in women particularly in developing countries like Nigeria, with high mortality, and economic costs. Worldwide, it is predicted that more than one million women are diagnosed with breast cancer, and more than 400,000 will die from the disease every year. A comparative integrative review of the literature from Nigeria and Canada showed that in Canada, there is positive association between wide spread education, early detection, the disease stage at diagnosis, and survival rates. In Nigeria, presentation with the advanced stage of the disease makes survival very low. The primary factors responsible for the late presentations are lack of awareness, misconceptions about breast cancer causes, and treatment outcomes. It is recommended that guidelines and policies about breast cancer early detection, care strategies, and ongoing management pathways be produced, disseminated, and adopted. The guidelines will assist practitioners and patients in making informed decisions and choices about the most appropriate health care for their specific clinical situations. The implementation of evidence-based guidelines will most likely help to improve care processes, the quality of clinical decisions and patient treatment outcome. Keywords: Breast cancer, awareness, early detection of cancer, cancer care, Nigeria, Canada

Background Cervical cancer is the fourth most common cancer in women worldwide. However, developing countries bear 85% of the burden, with Africa sharing the highest incidence with Melanesia. Objectives The aims of this study were to explore the experiences of women living with cervical cancer in Africa and to inform others of the extent of the work done in this field of study by synthesizing the findings of qualitative research. Methods The work of Sandelowski and Barroso guided the study, and 6 databases were searched to identify relevant studies using the key words Africa, cervical cancer, and experiences. Results A total of 13 studies (n = 13) met the inclusion criteria, and their findings were synthesized. The studies originated primarily from South Africa and focused on the period from diagnosis to 1 year after completing curative treatment. One overarching core theme living a life of suffering, 2 main themes, architects of suffering and mediators of suffering, and 9 subthemes were identified. Conclusion Women living with cervical cancer in Africa live a life of suffering, which starts when they experience the first symptom of cervical cancer and continues well after completing treatment. The facilitators of suffering outweighed the mediators and could not be guaranteed, as it did not relieve the suffering of all. Implications for practice Nurses practicing in Africa should be acutely aware of cervical cancer and do their utmost within their limited resources to prevent and detect the disease in its earliest stage. Religious and support interventions could be used to lessen the suffering of these women.

BACKGROUND The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

Background Despite concerted efforts to curb Female Genital Mutilation/Cutting (FGM/C), it is still a contributor to the high morbidity and mortality rates among females in Africa. Purpose To describe the publication output on FGM/C conducted in Africa over a period of 10 years and identify trends and gaps to guide future research. Method A scoping review on FGM/C in Africa was conducted. The keyword ‘Africa’ in combination with the terms ‘female genital mutilation,’ ‘female genital cutting’ and ‘female circumcision,’ were used to search the databases PubMed, CINAHL, Web of Science and Scopus. Reference lists of tracked articles were used to track other relevant articles. Only peer-reviewed works published between 1 January 2007 and 31 December 2016 were included. The data were captured onto an extraction sheet, while content analysis was used to categorize the findings of the studies and group the categories into themes. Results Of the 401 articles identified for possible inclusion, only 28 articles met the inclusion requirements. Most of the studies (n = 17; 60.7%) were quantitative and focused on prevalence, attitudes, perpetrators, and health consequences of FGM/C. Two themes and six sub-themes arose from the data. The themes were the practice of FGM/C and the attempts to end FGM/C. Conclusions FGM/C is still widely practiced in Africa and there may have been an increase in early-age FGM/C in some communities. Studies investigating the experiences of all the role players involved in this practice and how to prevent it were absent. Understanding these phenomena could guide efforts to curb this harmful practice.

Background Cervical cancer mainly occurs among women from the developing world, and women face unique challenges in terms of their disease and treatment. Most women present with advanced cervical cancer and receive the standard curative treatment with external beam radiotherapy and brachytherapy with or without chemotherapy. Objectives To describe the quality of life (QOL) of women treated for cervical cancer during treatment (M0), at 6 months after completing treatment (M6) and at 12 months after treatment (M12). Methods A cross-sectional design, calculated sample size (n = 153) and convenience sampling were used. Data were collected through structured interviews, and the EORTC QLQ-C30 and EORTC QLQ CX24 served as data collection instruments. Descriptive statistics were used to analyse the data, and the Kruskal-Wallis H test was used to compare the mean responses across the groups (p ≤ 0.05). Results The mean age of the respondents was 50.6 years (standard deviation [SD] 11.9). The global health status improved significantly in contrast with the functional scores. Financial difficulties were rampant, especially during the treatment phase. Insomnia and urinary frequency were the most cumbersome problems and remained so even after treatment. Conclusions Despite an improvement in the global health, cervical cancer and its treatment had a negative influence on the QOL in all domains of lives of these women. Assessing the QOL of patients during treatment and follow-up visits would allow nurses to develop interventions to address distressing problems timeously. In addition, Africa's nurses should assess social functioning and develop programmes to prevent social dysfunction.

Objective To describe the experiences of South African patients living with head and neck cancer. Methods We used a qualitative descriptive design and conducted unstructured interviews with 18 (n = 18) purposive selected participants. Data saturation determined the sample size. Qualitative content analysis was used to analyse the data. Results The majority of the sample were Black males; on average, 50.8 years (SD ± 13.6) old. Two themes and eight subthemes arose from the data. The themes were living with the consequences of the illness and treatment, and coping with a changed life. The lives the participants knew before becoming sick changed and became a living hell; pain was a major problem as was eating and for some, communicating. The participants were stigmatised, ridiculed and rejected which added to their suffering. Receiving support from family and friends and their faith in God assisted them to cope with their changed lives. Conclusion Our study poses various challenges to clinical practice. Pain management is of the utmost importance; the nutritional status of these patients should be monitored and best practices in terms of management applied. Raising awareness of cancer and its complications could improve knowledge and decrease blame, stigmatisation and rejection and improve patient outcomes.

Objective: The objective of this study was to describe the experiences of Zambian nurses caring for women with advanced breast cancer. Methods: We used a qualitative descriptive design and purposive sampling. Seventeen in-depth interviews were conducted with registered nurses practicing in the Cancer Diseases Hospital and the University Teaching Hospital, Lusaka, Zambia, and analyzed using thematic analyses. Results: Two themes emerged from the data - caring for women with advanced breast cancer is challenging and the good outweighs the bad. The majority of the participants agreed that caring for women with advanced breast cancer and witnessing their suffering were challenging. Not having formal education and training in oncology nursing was disempowering, and one of the various frustrations participants experienced. The work environment, learning opportunities, positive patient outcomes, and the opportunity to establish good nurse–patient experiences were positive experiences. Conclusions: Although negative experiences seemed to be overwhelming, participants reported some meaningful experiences while caring for women with advanced breast cancer. The lack of formal oncology nursing education and training was a major factor contributing to their negative experiences and perceived as the key to rendering the quality of care patients deserved. Ways to fulfill the educational needs of nurses should be explored and instituted, and nurses should be remunerated according to their levels of practice.

Background This study is the first review of African cancer nursing research as only 1 review focusing on South Africa was conducted in the past decade. Objective The aim of this study was to identify, summarize, and synthesize the findings from previous independent studies conducted by nurses in Africa. Methods The terms cancer nursing and oncology nursing and Africa were used to search PubMed, CINAHL, Web of Science, SA e-publications, and Scopus. Studies reporting research conducted in an African setting, coauthored by a nurse affiliated with an African institution and published between January 1, 2005, and December 31, 2014, in English were included. A data extraction sheet captured the data. Results A potential 536 articles for possible inclusion were identified. Fifty met the inclusion requirements. Cancer in women (78%; n = 39) and prevention and early detection (62%; n = 31) were most commonly investigated. The work was primarily quantitative and collected data on some knowledge aspect from women in the community. Most of the studies (96%; n = 48) did not meet the criteria of high-quality work. Conclusions Africa's nurses have improved their research output in the field of cancer nursing considerably. Research focusing on the most prevalent cancers, the treatment, the patient living with cancer, the family, extended family, and community is lacking, as is work focusing on pain and other symptoms. Implications for nursing practice Nurses in practice should assist nurse researchers to address the identified knowledge gaps to develop cancer nursing science and practice tailored to meet the unique needs of Africa.

The objective of this study was to present a descriptive summary of the experiences of women treated with high dose rate brachytherapy for cervical cancer. A qualitative descriptive design was used and 16 women treated at an academic hospital in Gauteng were purposively selected. Qualitative interviews were conducted and thematic analysis was used to analyse the data, from which two themes arose: the treatment experience and experiencing emotional distress. Being treated with brachytherapy was a negative experience causing fear, pain and humiliation. The participants feared the procedure, before receiving the first treatment and even after having had one. Pain was a major problem, as the preventative medication participants received did not protect them from experiencing pain. Having to open and hang their legs was a humiliating experience aggravated by the presence of observers and the rotation of doctors. Their belief in God comforted them and gave them courage to endure the treatment, whilst caring sta...

The purpose of our exploratory qualitative study was to study the experiences of patients and their families when transitioning from palliative care with anticancer treatment to palliative care without anticancer treatment. A total of 22 qualitative interviews were conducted, 11 with patients and 11 with their families, and analyzed using Tesch’s approach. Four themes arose from the patient data, and 3 themes from the family data. Our study highlights the shock and severe suffering of the patients and their families. Both the patients and families experienced various losses, such as the care they received from the health care professionals, while they were receiving treatment. They also had to cope with high symptom burdens, including uncontrolled pain. Some patients and family members were able to accept their own or their family member’s impending death, whereas others hoped for the miracle of cure.

Evidence-based guidance for the delivery of palliative care in Africa is rare. Identifying the palliative care needs of this community could contribute evidence to guide the services provided, and could add to the body of knowledge of palliative care in Africa. Using a retrospective chart review research method, the researchers aimed to describe the palliative care needs of people using a nurse-led palliative care service situated in a newly established, underserved, informal settlement in Tshwane, Gauteng, South Africa. A quantitative inductive content analysis method was used to analyse the data. The sample realised at 48 (n = 48). The ages of patients ranged from 21 to 78 with the median age 47. Nearly half (45.9%) of the patients were functionally illiterate. The records reflected 85 different medical diagnoses and some patients suffered more than one illness. The most common diagnosis was HIV/AIDS (54.2%). Furthermore, records revealed 379 health problems, ranging from 1 to 17 per patient, with an average of 8.1. Most problems were physical symptoms (50.3%; n = 195), while 38.8 per cent (n = 147) were psychosocial problems and 9.8 per cent (n = 37) were spiritual problems. The need for pain relief (89.6%; n = 43) was the greatest, followed by the need for emotional support. Patients suffering from various medical diagnoses used the services of the palliative care clinic. Patients’ care needs revolved around relief from total pain. Therefore, nurses should become aware of the suffering of palliative patients living in resource-poor communities, and through meticulous assessment, identify their main care needs.

Objective:Quality of life (QoL) is a multidimensional, subjective, and highly individual phenomenon. The current study speaks to the QoL domains identified by palliative patients living in Africa. The need to identify these domains has been recognized but seemed to still be lacking. This study filled this knowledge gap by providing the domains and by giving directions in terms of the assessment of QoL in palliative patients living in resource-restricted communities in South Africa.Method:We followed a multi-method approach and conducted a literature review to identify and describe the multidimensional QoL instruments used in African palliative care. A secondary analysis design and open-coding method was employed to identify the domains influencing the QoL of palliative patients living in a resource-restricted South African community, after which we compared these domains to the domains assessed by the identified QoL instruments.Results:We found that two multidimensional QoL of life instruments—the Missoula–Vitas Quality of Life Index (MVQoLI) and the Functional Assessments of Chronic Illness Therapy–Palliative Care (FACIT–Pal)—have been used in African palliative care and have identified various domains, grouped as four themes: physical concerns, psychosocial issues, financial restraints, and existential issues. The patient-identified QoL domains were to a great extent not assessed by the MVQoLI and FACIT–Pal.Significance of Results:Our study highlights the complexity of QoL and QoL assessment. A more accurate representation of the QoL of palliative patients living in resource-restricted communities might be obtained by using individualized measures or exploring what QoL means to these patients and selecting QoL instruments accordingly.

Objective: The late effects of cervical cancer and its treatment are well known. However, qualitative research describing how women experience these effects seems to be unavailable. The purpose of our study was to describe how women experienced the late effects of cervical cancer treatment.Design: A qualitative descriptive design was used.Subjects and setting: Purposive sampling was employed to select the participants treated at an academic hospital in Gauteng. Sixteen in-depth interviews were conducted. Data saturation determined the sample size. Thematic analysis was used to analyse the data.Results: The average age of the sample was 44.1 years, and half of the participants had stage IIB cancer. Most were treated with external beam radiation in combination with brachytherapy. Five themes arose from the data, namely experiencing the physical consequences of the treatment, struggling with the socio-economic implications of the treatment, living with the sexual consequences of the treatment, spirit...

Breast cancer is the most common cancer in women worldwide and the second most common cancer in women treated at the Cancer Diseases Hospital in Zambia. Unfortunately most women present with advanced disease, too late to be cured. The purpose of the study was to describe the experiences of Zambian women living with advanced breast cancer. We used a descriptive qualitative design and purposive sampling to select the participants. Ten in depth interviews were conducted and thematic analyses analysed the data. Data saturation determined the sample size. The average age of the participants was 48.2 years and most (7 of 10) had Stage IV breast cancer. Four themes arose from the data: experiencing the signs and symptoms of breast cancer, learning about the diagnosis and treatment, undergoing the treatment and living with advanced breast cancer. The study has shown that living with advanced breast cancer comprises severe suffering which started before diagnosis with the inability to recognise the signs. In addition, participants experienced various losses such as femininity, physical strength and appearance, roles and support which changed the lives they had lived before becoming ill. They battled through the chemotherapy and feared stigmatisation, yet receiving treatment and care brought hope. 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license

Cervical cancer is a major health problem in South Africa. Despite having a national, population-based screening program, screening coverage is as low as 13%. Based on the role men could play in increasing cervical cancer screening and the low level of knowledge, men living in the study setting had about this health issue, we developed and pilot tested an educational program aimed at empowering men to teach their female partners and family members about cervical cancer and motivate them to be screened. The study setting was Ward 23 in Muldersdrift, a semi-urban, resource poor area situated northeast of Johannesburg. We used an intervention research design to assess the outcomes of our educational program. The primary outcome was screening uptake, with knowledge the secondary outcome. Statistics and face-to-face and telephone interviews, guided by questionnaires, were used to collect the data which were analyzed by means of descriptive statistics and content analysis. A total of 120 men (n = 120) participated in the educational program and 100 (n = 100) completed the post-test questionnaire. Only 30 women (n = 30) reported for screening. The men’s knowledge improved after the education program but did not guarantee that they would educate women about cervical cancer as only 55% (n = 66) indicated they taught a female family member or their partner. Cultural restrictions were the most common reason presented for not teaching women about this health issue. Ways of supporting men to overcome cultural barriers prohibiting them from discussing matters related to sexuality should be explored, before refining and replicating the intervention.

In a project to investigate the chemistry of South African Plectranthus species, from the dichloromethane extract of the aerial parts of Plectranthus venteri, we isolated two known natural product acetophenones, namely 2-hydroxy-3,4,5,6-tetramethoxy-acetophenone (1) and 2-hydroxy-4,5,6-trimethoxy-acetophenone (2). Structures were assigned using NMR spectroscopy and HRTOFESIMS. Compound 1 was previously synthesised as a precursor to the polymethoxylated flavone nobiletin. The acetophenones exhibited remarkable inhibitory activities against the transfer of the IncW plasmid R7K in a bacterial plasmid transfer inhibition assay.

ObjectiveCervical cancer is the most common cancer in Zambian women, and approximately 28% of all patients with cancer seen at the Cancer Diseases Hospital in Lusaka experience this disease. Our objective was to gain insight into the knowledge, understanding, and experiences of women treated for cervical cancer at the specific hospital.MethodsWe selected a qualitative research design and descriptive phenomenological approach for the study. Twenty-one (n = 21) semistructured interviews directed by an interview schedule were conducted. We used Patton’s open coding steps and a template analyses style guided by the 4 themes of the interview schedule to analyze the data.ResultsMost participants indicated that they did not know and understand anything of cervical cancer. They believed they were bewitched and consulted traditional healers and used traditional medicine. Most described that they experienced symptoms for extended periods of time before they were diagnosed. They described how the offensive vaginal bleeding and watery discharge they experienced led to isolation, rejection, and humiliation. The participants said they did not understand how they would be treated and treatment was described as a terrible experience.ConclusionsThe women’s lived experiences of cervical cancer tell of severe suffering. They knew and understood very little about this disease. Their suffering became so unbearable that some wanted to end their lives. They were subjected to the opinions of others who knew equally as little but were quite willing to speak out, judge, and reject. Most battled through the treatment and the distressing adverse effects because it was their only hope to become better.RecommendationsZambian women must be empowered with knowledge and skills to protect themselves against cervical cancer. Suggestions for improving outcomes include changing high-risk behavior, taking advantage of screening opportunities, recognizing the signs of cervical cancer, and seeking health care without delay.

Background Prostate cancer is a global health problem strongly linked to the Western lifestyle and its health risks. South Africa, like many African countries, has no population-based screening for this disease. Objective The purpose of this study was to develop and pilot test an intervention focused on the prevention and detection of prostate cancer in a resource-poor community in Tshwane, South Africa. Intervention Personal invitations for screening were extended to 122 men 40 years or older. Those presenting for screening received health education on prostate cancer and were screened using digital rectal examination and a prostate-specific antigen (PSA) test. Follow-up appointments were also arranged. Results Only 53.3% (n = 65) of the invitees reported for screening, with 38 (58.5%) returning to the clinic to learn the results of the PSA test. Knowledge of prostate cancer improved significantly after the intervention. Abnormal findings were detected in 6.2% (n = 4) of the participants, and elevations in PSA levels, in 12.3% (n = 8). Conclusions Disappointing results in terms of screening uptake and the number of men lost to follow-up were achieved. The strategies to improve knowledge were successful and resulted in a significant increase in knowledge of prostate cancer. Implications for nursing practice The success of a cancer prevention and detection service is determined by participation and screening uptake. The reasons for not accepting the screening invitation and not returning to learn the findings of the PSA test should be explored. Preventative strategies should be developed and tested as part of a second pilot study testing the refined intervention.

Objective:Research on women's experiences of cervical cancer as a health problem focuses primarily on cervical screening, while their experiences of cervical cancer as a disease seem to be underresearched. This study addresses this understudied area and aims to yield insight into the experiences of underprivileged women confronted with this disease.Method:Our study was qualitative, exploratory, and contextual with descriptive and interpretive elements. The context of the study was a radiation oncology department at an academic hospital in the Gauteng Province of South Africa. The target population was all patients diagnosed with cervical cancer referred for treatment at the specific hospital. Convenience sampling selected participants typical of the population. Nineteen open-ended unstructured interviews were conducted after demographic data were collected. One question was posed: “Please tell me what made you think there was something wrong with you?” Thematic analyses were used to analyze the data.Results:The average age of participants was 47.2 years, with a youngest participant of 29 and oldest of 70. Three themes arose from the data: experiencing the symptoms of cervical cancer, hearing the bad news, and what remained unsaid.Significance of Results:Being confronted with cervical cancer is a traumatic experience. Women suffer unexplained, severe, humiliating vaginal bleeding and unrelieved pain. They have to face a dual healthcare system: on the one hand, unaffordable effective private healthcare and, on the other, the free-of-cost public healthcare that failed them. The bad news of their cervical cancer is most commonly broken in a kind and sympathetic manner, yet misunderstandings and a need for additional information prevail after the bad news conversation. Having to inform their families of their cancer adds to their suffering.

Spouses are the primary source of support for married patients and patients suffering from gynaecological cancers and play a major role in the positive, or negative, management of the disease and treatment. The purpose of the study was to explore the experiences of life partner support among hospitalised women receiving treatment for cervical cancer at an academic hospital in Tshwane, South Africa. An exploratory, qualitative study was conducted using a convenience sampling method. Seventeen (n = 17) women were interviewed. The data were analysed using open coding and a template analysis style. The support women treated for cervical cancer received from their life partner varied. Some were fully supported while others received limited support and some were even abandoned. Both the women and their life partners were challenged in terms of giving and receiving support. How the support they received from their life partners influenced their quality of life is not known and should be the next exploratory step before designing and testing a support intervention to maximise the outcomes for these patients.

An exploratory qualitative research approach was selected for this study aiming to explore how people living with breast cancer related lymphedema experience this complication. Unstructured interviews were conducted with nine purposively selected participants. Living with breast cancer related lymphedema was not easy. Participants were not informed of the possibility of developing lymphedema and felt let down by the medical professionals they consulted. They had to face the physical, psychological and practical consequences without the continuous support of a knowledgeable therapist. Managing the lymphedema was a challenge as they could not afford the necessary treatment and theself-care items. In addition, treatment failure resulted in them feeling exploited and using various treatment options. Nurses should maintain a high level of suspicion of breastcancer related lymphedema, assess patients for lymphedema and refer them to a therapist specifically trained in the management of this debilitating condition.Hierdie studie ondersoek die belewenis van mense met borskanker verwante limfedeem.‘n Kwalitatiewe eksploratiewe navorsingsontwerp is gekies en ongestruktureerde onderhoude is met nege doelgerig gekose persone gevoer. Limfedeem kompliseer die lewe en die proefpersone het die nie maklik gevind om daarmee saam te leef nie. Hulle is nie ingelig oor die moonlikhied om limfedeem te ontwikkel nie en was van mening dat hulle deur die medici wat hulle behandel het in die steek gelaat is. Die proefpersone moes die fisiese, psigologiese en praktiese gevolge van limfedeem sonder die bystand van ‘n kundige terapeut te bowe kom. Die hantering van die limfedeem was ‘n uitdaging aangesien hulle nie die behandeling en self-sorg artikels kon bekostig nie. Die slegte resultate van behandeling het tot gevolg gehad dat die proefpersone uitgebuit gevoel het en ook verskillende behandelingsopsies gevolg het. Verpleegkundiges moet ‘n hoë vlak van bewustheid ten opsigte van limfedeem handhaaf, pasiënte hiervoor beraam en na ‘n terapeut wat in limfedeem spesialieer verwys.

In South Africa, cervical cancer is the most common female cancer followed by breast cancer. Despite the high incidence of these cancers, population-based screening is limited to cervical screening available at primary health clinics. Cervical screening uptake is, however, low. In 2009 a new cancer prevention initiative was launched in a specific resource poor community in Tshwane, South Africa. The low cervical screening uptake as well as a potentially low breast screening uptake could have resulted in the failure of this initiative. The purpose of the study was to develop and pilot test an intervention to address this risk. A Community Health Worker was trained and tasked to raise awareness of cervical and breast cancer and motivate women to take up screening. The intervention was assessed in terms of three outcomes: screening uptake, awareness and the value of the Community Health Worker. Despite the fact that the Community Health Worker's role was valued, screening uptake was disappointing and the level of awareness remained low. Unfortunately this intervention failed and once again we are left with the challenge of improving screening uptake.

Objective:Quality of life is an ill-defined term, as it means different things to different people. Quality of life has been well researched, especially with respect to people with cancer, but not necessarily from the perspective of the patient, and also, not in Third World, resource-poor countries. The objective of this study was to explore quality of life from the perspective of palliative care patients managed at a palliative care clinic serving a resource-poor community in Tshwane, South Africa.Method:An exploratory, qualitative phenomenological study was conducted. The target population for this study was all patients managed at a palliative care clinic serving a resource-poor community in Tshwane. Self-report data were gathered by means of in-depth interviews. The data were analyzed using a template analysis style as well as content analysis using open coding. Data analysis was done concurrently with data gathering. Data saturation was reached after 10 interviews (n = 10).Results:Three themes arose from the data: factors that had a positive influence on quality of life, factors that had a negative influence on quality of life, and experience of quality of life. Work played the most important role in quality of life whereas only one participant linked symptom control with quality of life. Experiencing symptoms, rejection, and stigmatization had a negative influence on quality of life. Friends and religion played a significant role and added to quality of life.Significance of results:Life was a daily struggle for survival. Poverty was so overwhelming that quality of life was primarily measured in terms of the ability to buy food and other basic commodities.

Despite the fact that South African men are among the group having the highest risk of developing oral cancer there is currently no population-based primary and secondary prevention services for oral cancer in South Africa. This study aimed to develop an intervention focusing on the prevention and detection of oral cancer and pilot test the intervention in a semi-urban resource-poor community in Tshwane. The intervention was assessed in terms of screening uptake, knowledge and awareness of oral cancer and perception of the educational material developed for the intervention. Statistics were used to calculate screening uptake while a pre- and post-intervention design was used to determine knowledge and awareness and perception of the educational material. Sampling was purposive and all people reporting for oral screening were recruited for the study. The sample totalled 65 (n= 65) and the participation rate was 100%. Notwithstanding a favourable report on the flyer as motivator to take up oral screening the number of people especially those in the high-risk group who reported for screening was disappointing. However, the strategy used to improve knowledge and awareness was successful. Ways to improve screening uptake should be explored and tested to improve the current intervention.

During 2008–2009, only 4% of women targeted for cervical screening were screened in Tshwane, South Africa. The purpose of the study was to determine whether cervical screening uptake could be improved when breast and cervical screening are combined. An intervention research design was used. The intervention was assessed in terms of two outcomes, namely cervical screening uptake and the findings of the screening. The study was conducted in a resource poor environment in Tshwane. Convenience sampling was used to recruit the sample (n = 299) and a baseline survey was conducted before delivering the intervention. Only 14% of the sample (n = 299) reported having been screened for cervical cancer previously. The total sample (n = 299) were willing to have a clinical breast examination; however, only 65.4% of those eligible for cervical screening (n = 283) used the opportunity to be screened. The majority of the sample screened (n = 185) using acetic acid for visual inspection (VIA) were VIA negative; 12.4% were VIA positive and 4.4% were VIA positive, invasive cancer; the screening of 8.7% failed. Despite women’s lack of knowledge of cervical cancer and the screening thereof, combining cervical screening and breast screening lead to an increase in cervical screening uptake.