الفهرس 
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Abstract
Breast cancer is detected as a lump in one or both breast. It starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get it, too. Cells in nearly any part of the body can become cancer and can spread to other areas of the body.
Concerns which are defined by Francis as statements made by nursing students or their informants which indicate an opinion ,knowledge, attitudes, practice when caring for patients with breast cancer .
Concerns are felt by nursing students derived from new situation in an oncology area as nursing students during their clinical rotations are exposed to patients with different diagnosis which might be stressful for them. Concerns may arise due to dealing with breast cancer patients related to fear from radiation and its complications and meeting patients other health needs related to their condition.
The current study aimed to determine the concerns of the nursing students caring for patients with breast cancer.
Descriptive research design was utilized for the conduction of this study.
The study was conducted at the Technical Health Institute in Moharam Beck in Alex. This health institute offers a two years program for nursing students who have received a high School Diploma, Secondary school or a nursing school diploma.
Two tools were used for data collection:
Tool (I): Socio demographic and personal data questionnaire:
It included items related to nursing students such as age, sex, level of education.
Tool (II): Concerns of Nursing Students caring for patients with breast cancer structured interview schedule:
This tool was adapted from the tool developed by Luang , Bova ,Finnie Rogers and Williams et al (2005) . It is composed of 31-items designed to determine the concerns of nursing students about caring for patients with breast cancer. The statements are closed ended and the possible answer was (Yes) or (No).
After having the official approval and testing tool for validity and reliability, a pilot study was conducted. Written informed nursing students’ consent was obtained after explanation of the study aim. Then, the data collection started. The subjects of the study comprised 100 nursing students from Technical Health Institute in Alexandria Moharam Beck. Age from 18 p to 20 years old , Caring for patients with breast cancer on different stages of treatments as mastectomy , chemotherapy and radiotherapy, able to communicate effectively and willing to participate in the study.
The interview time ranged between 30-45minutes. The data were collected over period of three months and ten days; starting on 6th of Jan 2017and ending on the 16th of March 2017.
The results of the study revealed that
- Age of the studied subjects ranged from 19 to less than 20 years with the mean and standard deviation of 25 ± 10.14 years. The age group of 18 represented (24%) of all studied subjects and the age group of 19 represented the major subjects ( 57%) and age group of 20 represented minor subjects (19 %) of all study subjects.
- The educational level of subjects varied between first and second academic year, first academic year represented (46%) while second academic year represented ( 54%).
- Result showed that (14%) were resident in urban areas while( 86%) lived in rural areas.
- Results showed that ( 79%) were single and (21%)were married.
-Few of them about (7%) had a family history of breast cancer while most of them about ( 93%) did not.
- About (78%) attended lectures about breast cancer while (22%) did not attend lectures about breast cancer.
-The present study revealed that the knowledge of the Nursing Students from The Technical Health Institute about predisposing factors regarding breast cancer such as smoking, obesity, alcohol consumption and fat diet are unsatisfactory.
- Variation in the knowledge of the students across the two academic years was observed as regards the different items of study. Second academic year nursing students being more oriented towards knowledge about risk factors regarding breast cancer while first academic year nursing students being less oriented towards the previous items as found by their low scores on these items, because second year nursing students have more experience and lectures about the breast cancer disease and provided care for patients with breast cancer than first year nursing students.
-As regards, nursing student’s awareness about breast cancer risk factors, the present findings revealed that majority of the nursing students agreed that smoking is a risk factor for breast cancer. While about half of them agreed that alcohol is another risk factor leading to breast cancer while a minority attributed weight gain to be a risk factor.
-Concerning the relationship between knowledge regarding risk factors that may lead to breast cancer with socio demographic data and personal characteristics of studied nursing students, the current study illustrated that there was statistically significance positive correlation between nursing student’s knowledge level and their previous dealing and caring for patients with breast cancer.
-Moreover, this study also showed that majority of nursing student’s identify many signs and symptoms of breast cancer disease as presence of a lump, mass in the breast, swelling and discharge from the breast and their answer about signs and symptoms were right. Variation in the knowledge of the students across the two academic years was observed as regards the different items studied.
- In addition, the current study revealed that there was statistically significance relation between knowledge regarding signs and symptoms of breast cancer disease with academic year. This could be explained by the fact that second year students received lectures and information about breast cancer in the first year and continued their advanced lectures in the second year ,while first year nursing students did not receive enough lectures and information about breast cancer.
-The current study showed that age, academic year, family history and previous dealing and caring for patients with breast cancer significantly increased nursing student’s knowledge about breast cancer. And therefore had a positive influence on breast cancer knowledge level. In this study concerns about inadequate clinical experiences were expressed by some respondents who did not take care of patients with breast cancer, but some were also hopeful they would have the opportunity before graduation. However, they believed that they had learned sufficient general knowledge to care for such patients upon graduation.
- Moreover, these results revealed that nursing students expressed favorable attitudes towards the idea of breast cancer cure and its treatment. It was observed that the highest favorable attitudes concerning breast cancer cure were expressed by second year nursing students.
- Furthermore, in this study the highest favorable attitudes concerning causes and treatment of breast cancer was expressed by second academic year nursing students. This may be due to the theoretical knowledge gained by those students in conjunction with their clinical experience.
- The current study showed statistically significance positive relation between attitudes of nursing students caring for patients with breast cancer and their academic year. The study of the attitudes of the nursing students toward breast cancer disease showed that most of the students of two academic years expressed favorable attitudes especially towards meaning of breast cancer and its advanced therapy.
- In respect to, the present study findings indicated the presence of some physical, psychological and spiritual concerns of nursing students caring for patients with breast cancer with number of similarities and number of differences of concerns about caring for patients with breast cancer.
-The present study revealed that, Nursing Students who provided complete care for patients with breast cancer were suffer many physical concerns as headache, loss of appetite, tachycardia, fatigue, insomnia. Thus the nature of viewing mastectomy patient’s manipulation exacerbates the autonomic nervous system leading to these symptoms.
-The present study showed statistically significant relation between physical concerns and academic year, family history, previous lectures about breast cancer and previous dealing and caring for patients with breast cancer.
- This study revealed that the majority of nursing students caring for patients with breast cancer suffered from one or more psychological problems as fear, anxiety, nervousness, irritability and tachycardia.
- This study showed that, there was statistically significance relation between psychological concerns with socio demographic data and personal characteristics of studied subjects as age, academic year, marital status and previous caring for patients with breast cancer.
- Spiritual concerns are one of the topics that nursing students tend to talk with the diagnosed patients. Studies found that spirituality, religion, and prayer are very important to the quality of life for some people who are diagnosed with breast cancer. Research has not shown that spirituality and prayer can cure cancer or any other disease, but they may be helpful addition to conventional medical care.
- In the present study almost all of the nursing students caring for patients with breast cancer reported that prayer can decrease the anxiety of patients with breast cancer disease and its complication because prayer gives them powerful spiritual force.
- The current study revealed that there was statistically significance relation between spiritual concerns of nursing students caring for patients with breast cancer with their socio demographic data and personal characteristics as marital status and previous dealing and caring for patients with breast cancer.
- In essence, oncology nursing students are a unique group of nursing students that face challenges such as physical, psychological and spiritual challenges and concerns related to dealing and caring for patients with breast cancer during every stage of treatments. This study revealed that nursing students who had more knowledge and experience about breast cancer disease and were caring for those patients in different stages of treatments as mastectomy, chemotherapy and radiotherapy express more concern, while nursing students who had inadequate knowledge and experience about breast cancer patients and did not provide care for them express less concern.