Abstract
Background: Women with breast cancer in Iran face challenges requiring support. Yet the provision of support may have changed during the coronavirus disease 2019 (COVID-19) pandemic.
Objective: The aim of the present study was to explore the perceptions of women with breast cancer about the support they received during the COVID-19 pandemic.
Methods: This study was qualitative in nature. Semi-structured interviews were conducted with Iranian women with breast cancer. The interviews were transcribed verbatim and analysed via conventional content analysis.
Results: Participants (n = 33) were Iranian women aged 29-58 years. All women included were married and were working in the role of a housewife. Women's perceptions of breast cancer during the COVID-19 pandemic of support were identified under two main categories; Constructive support and Lack of support. Sub-categories related to constructive support included receiving support from family, peers, and nurses. Sub-categories related to lack of support included a perceived lack of spousal and sociocultural support.
Conclusion: Anti-stigma interventions (AS interventions) are suggested to increase both spousal and sociocultural support in this context. Further studies may usefully be conducted with the participation of Iranian women's family members in order to gain a deeper understanding of the support received and required by Iranian women with breast cancer during the COVID-19 pandemic and beyond.
Graphical Abstract
[1]
Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2021, 71(3), 209-249.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[2]
Farhood, B.; Geraily, G.; Alizadeh, A. Incidence and mortality of various cancers in Iran and compare to other countries: A review article. Iran. J. Public Health, 2018, 47(3), 309-316.
[PMID: 29845017]
[PMID: 29845017]
[3]
Chao, Y.H.; Wang, S.Y.; Sheu, S.J. Integrative review of breast cancer survivors’ transition experience and transitional care: dialog with transition theory perspectives. Breast Cancer, 2020, 27(5), 810-818.
[http://dx.doi.org/10.1007/s12282-020-01097-w] [PMID: 32372320]
[http://dx.doi.org/10.1007/s12282-020-01097-w] [PMID: 32372320]
[4]
Lu, H.; Xie, J.; Gerido, L.H.; Cheng, Y.; Chen, Y.; Sun, L. Information needs of breast cancer patients: Theory-generating meta-synthesis. J. Med. Internet Res., 2020, 22(7), e17907.
[http://dx.doi.org/10.2196/17907] [PMID: 32720899]
[http://dx.doi.org/10.2196/17907] [PMID: 32720899]
[5]
Schifferdecker, K.E.; Vaclavik, D.; Wernli, K.J.; Buist, D.S.M.; Kerlikowske, K.; Sprague, B.L.; Henderson, L.M.; Johnson, D.; Budesky, J.; Jackson-Nefertiti, G.; Miglioretti, D.L.; Tosteson, A.N.A. Women’s considerations and experiences for breast cancer screening and surveillance during the COVID-19 pandemic in the United States: A focus group study. Prev. Med., 2021, 151, 106542.
[http://dx.doi.org/10.1016/j.ypmed.2021.106542] [PMID: 34217409]
[http://dx.doi.org/10.1016/j.ypmed.2021.106542] [PMID: 34217409]
[6]
Mulita, F.; Vailas, M.; Tchabashvili, L.; Liolis, E.; Iliopoulos, F.; Drakos, N.; Maroulis, I. The impact of the COVID-19 outbreak on emergency surgery: A Greek emergency department experience. Prz. Gastroenterol., 2021, 16(1), 95.
[http://dx.doi.org/10.5114/pg.2021.104739] [PMID: 33986894]
[http://dx.doi.org/10.5114/pg.2021.104739] [PMID: 33986894]
[7]
Mulita, F.; Sotiropoulou, M.; Vailas, M. A multifaceted virus. Non-reducible and strangulated effects of COVID-19. J. Trauma Acute Care Surg., 2021, 91(1), e34.
[http://dx.doi.org/10.1097/TA.0000000000003219] [PMID: 33797481]
[http://dx.doi.org/10.1097/TA.0000000000003219] [PMID: 33797481]
[8]
Elghazawy, H.; Bakkach, J.; Zaghloul, M.S.; Abusanad, A.; Hussein, M.M.; Alorabi, M.; eldin, N.B.;; Helal, T.; Zaghloul, T.M.; Venkatesulu, B.P.; Elghazaly, H.; Al-Sukhun, S. Implementation of breast cancer continuum of care in low- and middle-income countries during the COVID-19 pandemic. Future Oncol., 2020, 16(31), 2551-2567.
[http://dx.doi.org/10.2217/fon-2020-0574] [PMID: 32715776]
[http://dx.doi.org/10.2217/fon-2020-0574] [PMID: 32715776]
[9]
Chan, J.J.; Sim, Y.; Ow, S.G.W.; Lim, J.S.J.; Kusumawidjaja, G.; Zhuang, Q.; Wong, R.X.; Wong, F.Y.; Tan, V.K.M.; Tan, T.J.Y. The impact of COVID-19 on and recommendations for breast cancer care: The Singapore experience. Endocr. Relat. Cancer, 2020, 27(9), R307-R327.
[http://dx.doi.org/10.1530/ERC-20-0157] [PMID: 32544879]
[http://dx.doi.org/10.1530/ERC-20-0157] [PMID: 32544879]
[10]
Armoogum, J.; Harcourt, D.; Foster, C.; Llewellyn, A.; McCabe, C.S. The experience of persistent pain in adult cancer survivors: A qualitative evidence synthesis. Eur. J. Cancer Care, 2020, 29(1), e13192.
[http://dx.doi.org/10.1111/ecc.13192] [PMID: 31762169]
[http://dx.doi.org/10.1111/ecc.13192] [PMID: 31762169]
[11]
Seven, M.; Bagcivan, G.; Pasalak, S.I.; Oz, G.; Aydin, Y.; Selcukbiricik, F. Experiences of breast cancer survivors during the COVID-19 pandemic: A qualitative study. Support. Care Cancer, 2021, 29(11), 6481-6493.
[http://dx.doi.org/10.1007/s00520-021-06243-4] [PMID: 33905013]
[http://dx.doi.org/10.1007/s00520-021-06243-4] [PMID: 33905013]
[12]
Daniel, S.; Venkateswaran, C.; Hutchinson, A.; Johnson, M.J. ‘I don’t talk about my distress to others; I feel that I have to suffer my problems...’ Voices of Indian women with breast cancer: A qualitative interview study. Support. Care Cancer, 2021, 29(5), 2591-2600.
[http://dx.doi.org/10.1007/s00520-020-05756-8] [PMID: 32955655]
[http://dx.doi.org/10.1007/s00520-020-05756-8] [PMID: 32955655]
[13]
Lavallée, J.F.; Abdin, S.; Faulkner, J.; Husted, M. Barriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment: A qualitative metasynthesis. Psychooncology, 2019, 28(3), 468-476.
[http://dx.doi.org/10.1002/pon.4980] [PMID: 30657225]
[http://dx.doi.org/10.1002/pon.4980] [PMID: 30657225]
[14]
Phoosuwan, N.; Lundberg, P.C. Psychological distress and health-related quality of life among women with breast cancer: A descriptive cross-sectional study. Support. Care Cancer, 2022, 30(4), 3177-3186.
[http://dx.doi.org/10.1007/s00520-021-06763-z] [PMID: 34950961]
[http://dx.doi.org/10.1007/s00520-021-06763-z] [PMID: 34950961]
[15]
Flores, N.J.; Mathew, M.J.; Fortson, L.S.; Abernethy, A.D.; Ashing, K.T. The influence of culture, social, and religious support on well-being in breast cancer survivorship. Cureus, 2021, 13(3), e14158.
[http://dx.doi.org/10.7759/cureus.14158] [PMID: 33936871]
[http://dx.doi.org/10.7759/cureus.14158] [PMID: 33936871]
[16]
Elo, S.; Kyngäs, H. The qualitative content analysis process. J. Adv. Nurs., 2008, 62(1), 107-115.
[http://dx.doi.org/10.1111/j.1365-2648.2007.04569.x] [PMID: 18352969]
[http://dx.doi.org/10.1111/j.1365-2648.2007.04569.x] [PMID: 18352969]
[17]
Lincoln, Y.S.; Guba, E.G. Naturalistic Inquiry; Sage Publications Inc: London; Sage: Newbury Park, CA, 1985.
[http://dx.doi.org/10.1016/0147-1767(85)90062-8]
[http://dx.doi.org/10.1016/0147-1767(85)90062-8]
[18]
Liow, K.H.F.; Ng, T.R.P.; Choo, C.H.; Koh, S.S.L.; Shorey, S. The experiences and support needs of women with gestational breast cancer in Singapore. Cancer Nurs., 2022, 45(1), E263-E269.
[http://dx.doi.org/10.1097/NCC.0000000000000912] [PMID: 33252405]
[http://dx.doi.org/10.1097/NCC.0000000000000912] [PMID: 33252405]
[19]
Adejoh, S.O.; Olorunlana, A.; Adejayan, A. Patients’ experiences of family members’ reactions to diagnosis of breast cancer and support in the management of breast cancer in Lagos, Nigeria. Palliat. Support. Care, 2021, 19(5), 592-597.
[http://dx.doi.org/10.1017/S147895152000070X] [PMID: 32830624]
[http://dx.doi.org/10.1017/S147895152000070X] [PMID: 32830624]
[20]
Wienand, I.; Rakic, M.; Eckstein, S.; Escher, M.; Pacurari, N.; Zwahlen, S.; Elger, B. The variety of hope: Findings in palliative care patients’ medical records. Spirit. Care, 2018, 7(2), 181-185.
[http://dx.doi.org/10.1515/spircare-2017-0039]
[http://dx.doi.org/10.1515/spircare-2017-0039]
[21]
Liu, J.; Hunter, S.; Zhu, J.; Lee, R.L.T.; Chan, S.W.C. Decision-making experience related to mastectomy among women with breast cancer. Cancer Nurs., 2021, 44(6), E670-E686.
[http://dx.doi.org/10.1097/NCC.0000000000000981] [PMID: 34294647]
[http://dx.doi.org/10.1097/NCC.0000000000000981] [PMID: 34294647]
[22]
Browall, M.; Mijwel, S.; Rundqvist, H.; Wengström, Y. Physical activity during and after adjuvant treatment for breast cancer: An integrative review of women’s experiences. Integr. Cancer Ther., 2018, 17(1), 16-30.
[http://dx.doi.org/10.1177/1534735416683807] [PMID: 28008778]
[http://dx.doi.org/10.1177/1534735416683807] [PMID: 28008778]
[23]
Geng, Z.; Wang, J.; Zhang, Y.; Wu, F.; Yuan, C. Physical activity in the context of advanced breast cancer: An integrative review. J. Adv. Nurs., 2021, 77(5), 2119-2143.
[http://dx.doi.org/10.1111/jan.14709] [PMID: 33314310]
[http://dx.doi.org/10.1111/jan.14709] [PMID: 33314310]
[24]
Vanni, G.; Materazzo, M.; Pellicciaro, M.; Ingallinella, S.; Rho, M.; Santori, F.; Cotesta, M.; Caspi, J.; Makarova, A.; Pistolese, C.A.; Buonomo, O.C. Breast cancer and COVID-19: The effect of fear on patients’ decision-making process. In Vivo, 2020, 34(Suppl. 3), 1651-1659.
[http://dx.doi.org/10.21873/invivo.11957] [PMID: 32503825]
[http://dx.doi.org/10.21873/invivo.11957] [PMID: 32503825]
[25]
Rogers, CC; Pope, S; Whitfield, F; Cohn, WF; Valdez, RS The lived experience during the peri-diagnostic period of breast cancer: A scoping review.Patient Educ. Couns., 2021, S0738-3991(21), 00416-X.
[http://dx.doi.org/10.1016/j.pec.2021.06.017]
[http://dx.doi.org/10.1016/j.pec.2021.06.017]
[26]
Jin, R.; Xie, T.; Zhang, L.; Gong, N.; Zhang, J. Stigma and its influencing factors among breast cancer survivors in China: A cross-sectional study. Eur. J. Oncol. Nurs., 2021, 52, 101972.
[http://dx.doi.org/10.1016/j.ejon.2021.101972] [PMID: 33991869]
[http://dx.doi.org/10.1016/j.ejon.2021.101972] [PMID: 33991869]
[27]
Luo, Z.; Chen, C.; Xu, W.; Wang, P.; Wang, Y. A qualitative study on the experience of empowerment from the perspectives of breast cancer survivors. Nurs. Open, 2021, 8(5), 2429-2438.
[http://dx.doi.org/10.1002/nop2.1000] [PMID: 34313022]
[http://dx.doi.org/10.1002/nop2.1000] [PMID: 34313022]
[28]
Wright, J.D.; Kroenke, C.H.; Kwan, M.L.; Kushi, L.H. “I had to make them feel at ease”: Narrative accounts of how women with breast cancer navigate social support. Qual. Health Res., 2021, 31(6), 1056-1068.
[http://dx.doi.org/10.1177/1049732321989999] [PMID: 33645335]
[http://dx.doi.org/10.1177/1049732321989999] [PMID: 33645335]
[29]
Mokhtari, L.; Markani, A.K.; Khalkhali, H.R.; Feizi, A. The perceived social support by Iranian women with breast cancer: A qualitative study. Support. Care Cancer, 2022, 30(1), 941-949.
[http://dx.doi.org/10.1007/s00520-021-06478-1] [PMID: 34417884]
[http://dx.doi.org/10.1007/s00520-021-06478-1] [PMID: 34417884]
