80 Systematic literature review on the psychological concerns of indian women undergoing breast cancer treatment

Abstract

Background Psychological symptoms are common in women diagnosed with breast cancer. The cancer care experiences of women varies across diverse cultural backgrounds. Given that breast cancer is becoming the most common cancer among women in India, recognition of psychological distress during treatment is important to enable the physician to offer support that is culturally sensitive. Aims To determine the psychological concerns of Indian women in relation to breast cancer treatment. Method Medline, Embase, CINAHL and PsychInfo were searched (to February 2017) using terms relating to Indian women with breast cancer and psychological concerns. The EBSCO host discovery science was searched for papers from Indian journals inaccessible from other databases. Two reviewers were involved in all stages of study selection against inclusion criteria. Any discrepancy was finalised after discussion with a third researcher. Included papers were appraised for their quality and data extracted using a standard proforma. Results Out of 550 titles, 17 studies met the inclusion criteria. 13 were observational and four were qualitative studies. The observational studies found five psychological outcomes related to breast cancer and its treatment; anxiety/depression, quality of life, concerns and coping, body image and stigma and information needs. Thematic synthesis of qualitative papers revealed four major themes; cultural context of disease experiences, information seeking, role of women and women’s individual response to disease. Overall, a major cultural impact of Indian family life and the role of women, the role of religion and a particular impact of hair loss for these women within these contexts was seen in women living in India and elsewhere in the world. Conclusion This literature review highlights the cultural impact on the experience of Indian women with breast cancer living in India and around the world; culture travels. This is important for clinicians looking after patients from diverse cultural backgrounds.