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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Reviews
Full Version
Sexual Health Needs of Women with Breast Cancer: A Rapid Review
Correspondence Address :
Dr. Mozhdeh Sarmadikia,
Postgraduate Student, Department of Consultation in Midwifery, Student Research Committee, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of
Medical Sciences, Sari, Iran.
E-mail: tombelina9@gmail.com
Introduction: The number of women diagnosed with breast cancer has been rising globally over the past few decades. Upon hearing of a breast cancer diagnosis, women face many challenges including emotional distress, body image issues and sexual dysfunction. Regarding the importance of sexuality for breast cancer patients, this paper aims to validate the sexual health needs of women with breast cancer.
Aim: To assess the sexual health needs of women with breast cancer and a need for further research.
Materials and Methods: This research is a rapid review conducted in Iran, in April 2020. Databases of PubMed, Cochrane Library, Scopus and Web of Science as well as the Iranian Scientific Information Database (SID), were searched with mentioned keywords, “Female Breast Cancer”, “Sex Counselling”, “Female Sexual Dysfunction” and “Sexual Health Needs”.
Results: This review included 16 studies with one randomised clinical trial, four cross-sectional, four review articles, three qualitative articles, three mixed-method studies and one cohort. This study highlights four major sexuality-related information needs of women with breast cancer including: informational need about sexual activity; informational need about fertility-preserving options before starting breast cancer treatment; informational need about prosthesis or breast reconstruction surgery, and informational need about physical changes caused by breast cancer treatments.
Conclusion: This review highlight the importance of sexual health needs for female breast cancer patients. However, little attention has been received from women’s health professionals and researchers and further research on sexuality and breast cancer is recommended to affirm these research findings.
Carcinoma, Needs assessment, Sex counselling, Sex dysfunction
Breast cancer incidence has been steadily increasing over the last few decades due to the dramatic changes in women’s lifestyle including changes in their diet and daily routine (1),(2). According to the world cancer statistics, in 2018, the global incidence rate of female breast cancer was about 2.1 million or 24% of all cancer cases worldwide (3). Also, in Iran, the breast cancer rate is reported about 13776 cases or 27% of all types of cancer nationwide (4).
Breast cancer is associated with many physical, psychosocial, economical and sexual complications which have a long-term negative impact on the quality of life in women with breast cancer (5),(6). According to the World Health Organisation (WHO), “Sexual Health” is not just the absence of sexual dysfunction or sexual disorder, but it is a combination of a person’s physical, emotional, mental and socio-cultural health and well-being (7). Based on the Maslow's hierarchy of needs, the sexual need is one of the basic physiological needs for human survival and as important as other biological requirements such as food, drink and sleep (8). Since the number of breast cancer survivors is higher than the survivors of other types of cancer, therefore, paying attention to the needs of women with breast cancer should be prioritised by the women’s health professionals worldwide (9),(10),(11). Women with breast cancer face many physical and psychological health problems that may affect their sexual desire and sexual activities (12),(13). A mixed-method study on sexual dysfunction following the diagnosis and treatment of breast cancer in Chinese women by Wang F et al., (2013) found that women with breast cancer complain about the decreased sexual activity frequency, loss of libido, menopausal symptoms, and changes in body image as well as misconceptions about sex. Also, they found out that women need sexual health counselling before and after breast cancer treatment (14). Furthermore, the results of a cross-sectional study by Leila M et al., (2016) on sexual activity after breast cancer showed a significant difference between sexual satisfaction in breast cancer patients and women without breast cancer (p=0.0003) (15).
Overall, after reviewing the existing national and international literature, we found that, so far, few researchers have addressed the sexual needs of women with breast cancer. Therefore, this rapid-review study was conducted to assess the sexual needs in women with breast cancer.
Rationale for a Rapid Review: A rapid review is a type of research that can be conducted in a short period of time by simplifying the process of a systematic review study (16). The present study is part of a research project in partial fulfilment of a master’s degree in midwifery by course and was approved by the University’s Human Ethics Committee with a reference number of IR.MAZUMS.REC.1399.513. Regarding the time limit for completion of a master’s degree program, a rapid review approach was selected as the sui type of knowledge synthesis for this research.
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used for the methodological steps for this rapid review study (Table/Fig 1) (17).
Information Sources and Search Strategy: The present paper is a rapid-review study conducted in Iran in April 2020. The public health databases such as PubMed, Cochrane Library, Scopus, Web of Science and Google Scholar, as well as the Iranian Scientific Information Database (SID), were searched. The key terms used for the search were including “Female Breast Cancer”, “Sex Counselling”, “Female Sexual Dysfunction” and “Sexual Health Needs”. We also checked the reference lists of the articles manually for relevant studies. All the research process and procedures such as searching titles and abstracts as well as screening the full-text papers and data analysis were conducted by the student and two experienced researchers independently.
Inclusion and Exclusion criteria: All research articles concerning sexual health needs in women with breast cancer that have been published since 1990, published in English and Persian languages were included and studies in other languages were excluded.
Study selection screening: Firstly, after careful screening of 1082 articles’ title and abstract, 1060 of them were excluded because of not being related to the title and abstract of this manuscript. Secondly, we carefully screened the remaining articles’ full-text and we excluded six more articles because of not being related to the full-text of this manuscript. Finally, 16 articles were selected including one randomised clinical trial study (12), four cross-sectional (15),(18),(19),(20), four review articles (21),(22),(23),(24) three qualitative articles (25),(26),(27), three mixed-method studies (14),(28),(29), one cohort (30) and the title, abstract and full-text related to this manuscript has been shown in (Table/Fig 2).
Study Quality Assessment: The assessment of methodological quality for the eligible articles was performed by using the 22-item STROBE checklist (31),(32). The 32-item COREQ checklist for eligible qualitative studies (33),(34), the 5-item MMAT checklist for eligible mixed-method studies (35), the 27-item PRISMA checklist for eligible systematic review papers (36) and finally 25-item CONSORT checklist for the randomised clinical trial studies (37).
Based on the STROBE checklist with minimum and maximum scores of 0-44, the eligible studies with less than 15.5 score categorised as the low-quality studies, articles with 15.5-29.5 scores were classified as the mid-quality articles and studies with 30-44 scores ranked as the high-quality articles (31). In MMAT checklist for mixed-method's studies 5 is high score that means studies with 5 score have high quality (35).
In this current study, the selected articles were as follows: seven high-quality studies including one randomised clinical trial (12), three mixed-method (14),(28),(29) and three qualitative research papers (25),(26),(27), as well as, nine mid-quality studies (four cross-sectional studies (15),(18),(19),(20) and four review articles (21),(22),(23),(24) plus one cohort (30).
The main findings of this rapid-review study can be summarised as follows: 1) Women need more information about sexual desire and sexual activity during and after breast cancer treatment, 2) Women of reproductive age need more information about fertility-preserving options before starting breast cancer treatment, 3) Women need more information on a prosthesis or breast reconstruction surgery options and alternatives, and 4) women need more information about temporary and long-term physical changes caused by breast cancer treatments.
Women need more information about sexual desire and sexual activity during and after breast cancer treatment: the two mixed-method studies (14),(28) on the misconceptions of sexuality in women with breast cancer found that some women believe that having sexual activity after chemotherapy is not safe for themselves and their partners due to the side effects of chemotherapy. They also believe that sexual activity stimulates the secretion of their sex hormone, oestrogen, which may increase the risk of breast cancer recurrence. All these sexuality misconceptions influence quality of life in women with breast cancer. Some women also decline reconstruction surgery after mastectomy due to their self-perceived stigma around breast implants and breast augmentation. They believe these types of procedures are luxury plastic surgery that is suitable for younger women. They also believe breast reconstruction surgery after mastectomy increases the risk of breast cancer recurrence significantly (14),(28).
Women of reproductive age need more information about fertility-preserving options before starting breast cancer treatment: results of three review studies (21),(22),(23) and one cohort study (30) about fertility in women with breast cancer have shown that future fertility status is one of the main concerns in women of reproductive age. These women are worried about being infertile because of chemotherapy and other cancer treatments. Since hot flashes are most commonly due to menopause, women may have become more concerned with the onset of hot flashes after starting chemotherapy and they need more information accordingly. For instance, women need more evidenced-base information from their healthcare providers around hormonal therapies as well as ovarian tissue or egg freezing options before starting any breast cancer treatment and procedures (21),(22),(23),(30).
Women need more information on a prosthesis or breast reconstruction surgery options and alternatives: one mixed-method study and one qualitative study (19),(21),(22),(25),(27),(28) concerning breast reconstruction surgery found that women with breast cancer need the breast reconstruction surgery after mastectomy for many reasons including regaining a sense of feminity, improving symmetry and beauty of breasts, forgetting the disease, enhancing marital relationship by recovering sexual attractiveness. Some women report that they feel unattractive to their sexual partners during sexual activity due to the loss of their breasts. That's why they feel that their physical attractiveness has reduced, their self-confidence has increased and their marital relationship has improved after a breast implant surgery. Also, some women have stated that the scar tissues left by surgery make them nervous, while breast reconstruction surgery helps them to feel attractive again. Some women were reluctant to use external prosthesis every day because they are not comfortable, while others prefer to use an external prosthesis rather than going under a major surgery. Some of them also are not able to make any decision regarding having breast reconstruction surgery due to the social stigma surrounding breast implant surgery (19),(21),(22),(25),(27),(28).
Women need more information about temporary and long-term physical changes caused by breast cancer treatments: the findings of one mixed-method, two qualitative, one review, four cross-sectional and one randomized clinical trial studies (12),(14),(15),(18),(19),(20),(24),(26) have shown women complaining about the most common side-effects of breast cancer treatments including hot flushes, vaginal dryness, dyspareunia, obesity and dramatic body changes after mastectomy. These reported side-effects of breast cancer treatments can cause significant worry about their body image and sexual attractiveness which may affect their sexual activities. For instance, research has shown that women are too shy to discuss their sexual health problems with their health professionals. However, they need more information about temporary and long-term sexuality-related changes caused by breast cancer treatments to promote their quality of life (12),(14),(15),(18),(19),(20),(24),(26).
The studies conducted by Alianmoghaddam N et al., (21) to determine the status of breastfeeding, and fertility after mastectomy following breast cancer; Christinat A and Pagani O (22) concerning fertility status after breast cancer and Taleghani F et al., (27) about empowerment needs of women with breast cancer, all have highlighted the importance of an informed decision making before starting any treatment in women diagnosed with breast cancer. Also, they have shown that women should be aware of all kinds of cancer treatments and procedures as well as any sexual problems caused by those treatments before making any decision about their treatments. For instance, a Breast-Conserving Surgery (BCS) instead of mastectomy in the early stages of breast cancer may promote self-esteem and quality of life in women with breast cancer (21),(22),(27). Moreover, Ussher JM et al., in a study of information needs about sexual health in women with breast cancer and Albers LF et al., about sexuality-related information needs of breast cancer patients and their partners found that women are too embarrassed to talk directly to their doctor about uncomfortable topics such as sexual dysfunction and sexual needs. Therefore, providing educational materials to address the patients’ sexual health problems during the course of the disease may be a good option for women who feel embarrassed to talk directly with their health professionals (18),(29). Regarding the positive impact of midwifery-based counselling on sexual health in breast cancer patients, information regarding breast cancer and sexuality by a midwife may promote breast cancer patient’s sexual health (12).
Limitation(s)
Some limitations might have influenced the present findings including the exclusion of research papers in languages other than English and Persian at searching and screening process. Also, we had to use qualitative studies due to the limited numbers of papers that we found during the searching and screening process. Finally, this rapid review only highlights the importance of the information needs of women with breast cancer related to sexual health, while there are many unmet needs concerning sexual health in women with breast cancer that needs to be addressed by further research.
The number of women diagnosed with breast cancer has been steadily increasing globally. Consequently, many women with breast cancer complain about emotional distress, body image issues and sexual dysfunction before and after the breast cancer treatment. This rapid review study highlights some unmet sexual health needs of women with breast cancer including the need for information about sexual desire and sexual activity, fertility-preserving options before starting any breast cancer treatment, information on a prosthesis or breast reconstruction surgery options and alternatives and also women need information about temporary and long-term physical changes caused by breast cancer treatments. Although the findings of this study validate the importance of sexuality for women with breast cancer, little attention has been received from health professionals, researchers and policymakers. Therefore, further research on the sexual health needs of women with breast cancer is recommended to affirm these research findings.
The authors also would like to thank the human ethics committee and student research committee of Mazandaran Univerity of Medical Sciences for their support.
Author contributions: (ZH) approved the research proposal with some revisions, contributed to the data analysis, and finalised the first draft of the manuscript in the role of Supervisor. (MD) critically reviewed the data analysis and interpretation. (ML) and (AG) contributed to the revisions of the manuscript. (MS) has made a significant contribution to the conception and design of the study, data collection as well as drafting the manuscript in the role of research student, revision of the paper and finalised the revised manuscript. All the authors approved the final version of the manuscript.
DOI: 10.7860/JCDR/2022/53477.16583
Date of Submission: Nov 28, 2021
Date of Peer Review: Jan 19, 2022
Date of Acceptance: May 26, 2022
Date of Publishing: Jul 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Dec 01, 2021
• Manual Googling: Mar 24, 2022
• iThenticate Software: May 25, 2022 (11%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com