Use of external breast prostheses, associated factors and relationship with selected quality of life aspects among post-mastectomy women in Sri Lanka: a cross-sectional study
摘要
Despite advancements, over 60% of women undergo mastectomy as primary treatment following breast cancer, which could impact their quality of life (QOL). In this regard, external breast prostheses (EBP) have shown potential to improve post-mastectomy QOL globally, but the evidence is limited in South Asia. This study assessed the use of EBP, factors associated with its current use and relationship with selected aspects of QOL among post-mastectomy women in Sri Lanka.
MethodsA cross-sectional study was conducted among 158 non-metastasized post-mastectomy breast cancer patients attending outpatient clinics at the National Cancer Institute, Maharagama. Following systematic random sampling, an interviewer-administered questionnaire collected data on socio-demographic characteristics, EBP use, perceived barriers and QOL aspects.
ResultsThe response rate was 94.9%. The current EBP use was 58.9% (n = 93), which was primarily intended to mimic natural breast tissue. More than 75% of them expressed satisfaction with its application at work, social events and outdoor shopping. Higher monthly income and educational status, non-urban living, non-Buddhists, being employed and ≥ 18 months since surgery were associated with current EBP use, however, younger age (18–60 years) (adjusted odds ratio = 2.4; 95% CI: 1.2, 4.9) and being single (adjusted OR = 3.2; 95% CI: 1.1, 9.5) were the only factors significantly associated with their current EBP use after adjusting for confounders.
The EBP non-users consisted of 59 (37.3%) who had never used EBP and six (3.8%) who had used previously but now discontinued. Barriers to ever use of EBP included a lack of awareness (78.0%) and accessibility (61.0%), socio-cultural inappropriateness (55.9%), and feeling embarrassed (45.8%) and stigmatised (44.1%) to use. Compared with non-users, current EBP users reported higher satisfaction with the individual QOL aspects (p<0.01).
ConclusionsEBP use, driven by younger age and being single, was relatively high in post-mastectomy patients, while continued use was significantly associated with improved QOL in some critical aspects. The findings highlight the importance of incorporating informal EBP supply channels into rehabilitation programs to ensure sustainability, while concurrently addressing barriers among never/discontinued users through enhanced awareness and stigma reduction via patient-support groups.