Delayed Presentation of Self-discovered Breast Cancer Symptoms in Iranian Women: A Qualitative Study

Khakbazan, Zohreh,Taghipour, Ali,Roudsari, Robab Latifnejad,Mohammadi, Eesa,Omranipour, Ramesh Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.21

Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.

Appraisal of Breast Cancer Symptoms by Iranian Women: Entangled Cognitive, Emotional and Socio-Cultural Responses

Khakbazan, Zohreh,Roudsari, Robab Latifnejad,Taghipour, Ali,Mohammadi, Eesa,Pour, Ramesh Omrani Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study

Zohreh Khakbazan,Raziyeh Maasoumi,Zahra Rakhshaee,Saharnaz Nedjat 대한예방의학회 2020 Journal of Preventive Medicine and Public Health Vol.53 No.5

Objectives: An inadequate understanding of infertility can affect individuals’ self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health. Methods: In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach. Results: Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health. Conclusions: In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

Analysis and Control of a Modular MV-to-LV Rectifier based on a Cascaded Multilevel Converter

Iman-Eini, Hossein,Farhangi, Shahrokh,Khakbazan-Fard, Mahboubeh,Schanen, Jean-Luc The Korean Institute of Power Electronics 2009 JOURNAL OF POWER ELECTRONICS Vol.9 No.2

In this paper a modular high performance MV-to-LV rectifier based on a cascaded H-bridge rectifier is presented. The proposed rectifier can directly connect to the medium voltage levels and provide a low-voltage and highly-stable DC interface with the consumer applications. The input stage eliminates the necessity for heavy and bulky step-down transformers. It corrects the input power factor and maintains the voltage balance among the individual DC buses. The second stage includes the high frequency parallel-output DC/DC converters which prepares the galvanic isolation, regulates the output voltage, and attenuates the low frequency voltage ripple ($2f_{line}$) generated by the first stage. The parallel-output converters can work in interleaving mode and the active load-current sharing technique is utilized to balance the load power among them. The detailed analysis for modeling and control of the proposed structure is presented. The validity and performance of the proposed topology is verified by simulation and experimental results.

Analysis and Control of a Modular MV-to-LV Rectifier based on a Cascaded Multilevel Converter

Hossein Iman-Eini,Shahrokh Farhangi,Mahboubeh Khakbazan-Fard,Jean-Luc Schanen 전력전자학회 2009 JOURNAL OF POWER ELECTRONICS Vol.9 No.2

In this paper a modular high performance MV-to-LV rectifier based on a cascaded H-bridge rectifier is presented. The proposed rectifier can directly connect to the medium voltage levels and provide a low-voltage and highly-stable DC interface with the consumer applications. The input stage eliminates the necessity for heavy and bulky step-down transformers. It corrects the input power factor and maintains the voltage balance among the individual DC buses. The second stage includes the high frequency parallel-output DC/DC converters which prepares the galvanic isolation, regulates the output voltage, and attenuates the low frequency voltage ripple (2fline) generated by the first stage. The parallel-output converters can work in interleaving mode and the active load-current sharing technique is utilized to balance the load power among them. The detailed analysis for modeling and control of the proposed structure is presented. The validity and performance of the proposed topology is verified by simulation and experimental results.

A Fault-Tolerant Control Strategy for Cascaded H-Bridge Multilevel Rectifiers

Iman-Eini, Hossein,Farhangi, Shahrokh,Schanen, Jean-Luc,Khakbazan-Fard, Mahboubeh The Korean Institute of Power Electronics 2010 JOURNAL OF POWER ELECTRONICS Vol.10 No.1

Reliability is an important issue in cascaded H-bridge converters (CHB converters) because they use a high number of power semiconductors. A faulty power cell in a CHB converter can potentially lead to expensive downtime and great losses on the consumer side. With a fault-tolerant control strategy, operation can continue with the undamaged cells; thus increasing the reliability of the system. In this paper, the operating principles and the control method for a CHB multilevel rectifier are introduced. The influence of various faults on the CHB converter is investigated. The method of fault diagnosis and the bypassing of failed cells are explained. A fault-tolerant protection strategy is proposed to achieve redundancy in the CHB rectifier. The redundant H-bridge concept helps to deal with device failures and to increase system reliability. Simulation results verify the performance of the proposed strategy.

A Fault-Tolerant Control Strategy for Cascaded H-Bridge Multilevel Rectifiers

Hossein Iman-Eini,Shahrokh Farhangi,Jean-Luc Schanen,Mahboubeh Khakbazan-Fard 전력전자학회 2010 JOURNAL OF POWER ELECTRONICS Vol.10 No.1

Reliability is an important issue in cascaded H-bridge converters (CHB converters) because they use a high number of power semiconductors. A faulty power cell in a CHB converter can potentially lead to expensive downtime and great losses on the consumer side. With a fault-tolerant control strategy, operation can continue with the undamaged cells; thus increasing the reliability of the system. In this paper, the operating principles and the control method for a CHB multilevel rectifier are introduced. The influence of various faults on the CHB converter is investigated. The method of fault diagnosis and the bypassing of failed cells are explained. A fault-tolerant protection strategy is proposed to achieve redundancy in the CHB rectifier. The redundant H-bridge concept helps to deal with device failures and to increase system reliability. Simulation results verify the performance of the proposed strategy.