The prevalence rate of deviations in body constitutions and related factors in follow-up stage breast cancer patients—A nationwide study
Introduction
Breast cancer is one of the most common malignancies in women worldwide,1 with an overall five-year survival rate of up to 90% in developed countries.1, 2 The related occurrence of a second malignancy and chronic disease is increasing among breast cancer survivors because of their prolonged lifespan.3, 4 Although many factors, including treatment methods and genetic factors, have been proposed as prognostic factors in breast cancer patients,5, 6 some studies have shown that healthy lifestyle behaviors could markedly increase the survival rate and decrease the recurrence rate of breast cancer survivors.7, 8 Suggestions for healthy lifestyle behaviors to prevent disease have become an important issue for the follow-up stages of breast cancer patients. Breast cancer patients’ compliance with healthy lifestyle behaviors is lacking.9 Enhancing patients’ motivation to change health behavior is the main goal for healthcare providers.
Traditional Chinese medicine (TCM) has been incorporated into the national health care system, and most medical fees are covered by National Health Insurance (NHI) in Taiwan. TCM is generally combined with Western medicine in the treatment course or recovery period of breast cancer patients.10, 11 According to a previous study, 81.5% of newly diagnosed breast cancer patients in Taiwan have used TCM at least once.12 A primary reason for the use of TCM was the belief that TCM could adjust the deviated body constitution, enhance the immune system, and prevent the recurrence of breast cancer.13 In addition, TCM theories note that any deviation in body constitution could influence patients’ health status and treatment outcome. The measurement of and regulation of an individual’s deviated body constitution might prevent or help treat a disease.14 Previous studies have shown that deviations in body constitution reduced the survival rate of cancer.15 The aggravated autonomic nervous system (ANS) function resulted in a poor prognosis for recovery from illness in cancer patients.16, 17 Adjustment of the deviation in body constitution could minimize the frequency of illness by regulating health-related factors, such as diet and food properties, exercise, sleep, emotion, and living environment.18, 19, 20, 21
This study combined the concepts of TCM body constitution and the beliefs of TCM therapies in breast cancer patients. We aimed to understand the prevalence and health-related lifestyle behavioral factors of deviations in body constitution in follow-up stage breast cancer patients and thereby stimulate patients’ motivation to adhere to healthy lifestyle behaviors. The exact distribution of deviations in body constitutions in follow-up stage breast cancer patients has not been studied thoroughly or frequently; therefore, our study applied a rigorous body constitution questionnaire (BCQ) to survey the prevalence rate of deviated body constitutions and to explore health–related lifestyle behavioral factors. The results could allow medical personnel to plan TCM health promotion programs to fit the demands of TCM and personal needs in follow-up breast cancer patients.
Section snippets
Participants
Initially, the sample size was estimated using G*Power: Statistical Power Analyses.22 Logistic regression was used to compute the required sample size. The α error probability was set to 0.05; the power was 0.95; and the odds ratio was set at 1.8. The calculated sample size was 245. According to the recovery and completion rates, a total of 450 eligible breast cancer patients were enrolled from the 37 branches of the Taiwan Breast Cancer Alliance (TBCA) from June to December 2012. The inclusion
Patient demographics and prevalence rate of deviations in body constitution
Questionnaires were sent to a total of 450 patients. Among the 358 respondents, forty-one patients were excluded from the study because of incomplete or improper completion of the questionnaires. Another six patients were excluded from the final analysis because of the presence of a distant metastasis. A total of 311 patients were included in the final data analysis. The results from Levene's test and the homogeneity test showed that all the missing data were homogeneous (all p > 0.05). The
Discussion
The significant findings of this study help establish empirical evidence of the prevalence and related factors of deviations in body constitutions in the follow-up stage of breast cancer patients. According to these findings, we provide recommendations for healthcare personnel to design a healthcare plan, including stress relief, lifestyle behavior adjustments, and correction of deviated body constitutions in breast cancer patients after their complete treatment to promote health and prevent
Conclusions
This study revealed the high prevalence of deviations in body constitutions in the follow-up stage of breast cancer patients. Physical exercise protects the body constitution. Stress and fried or salty foods are harmful factors of body constitutions. Based on this evidence, we sought to assess deviations in body constitution and to identify health promotion factors that might have more benefit for breast cancer patients. These findings provide additional evidence for medical personnel to
Declaration of conflict of interest
The authors declare that they have no competing interests.
Authors’ contributions
LL, SC, SM and YC were responsible for the study conception and design. SC and SM performed the data collection. SC and LL were responsible for the data analysis, interpretation and drafting of the manuscript. YC and LL made critical revisions to the paper for important intellectual content and supervised the study. All the authors read and approved the final manuscript.
Financial support
This work was supported by the Show Chwan Memorial Hospital [grant number RD101033].
Acknowledgment
We thank the TBCA and its members for participating in and assisting with this study.
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These authors contributed equally to this work.