Experience of women with breast cancer undergoing chemotherapy: a systematic review of qualitative research.

Abstract

Chemotherapy exerts adverse effects on physical, psychological and social functioning in women with breast cancer, which may trigger adaptive activities. For a better understanding of the experience of symptoms associated with chemotherapy and the development of targeted interventions, this study aimed to (a) explore the patient experience of chemotherapy, (b) identify patients' strategies to cope with the side effects and distress and (c) explore the link between their experience and coping strategies. Qualitative studies were included if they explored the experience or coping strategies of women with breast cancer receiving chemotherapy. Instruments from the Joanna Briggs Institute were used to critically appraise the methodological quality, extract data and aggregate findings from the included studies. Twelve studies presenting findings from 184 women with breast cancer who had received chemotherapy were included in this review. Three synthesized findings were identified from 8 categories based on 91 original findings: (1) Women living with chemotherapy experienced various stressful side effects, and their lives were changed. (2) Supportive care to address needs is essential to help women get through this difficult time. (3) They engaged in numerous types of coping strategies to deal with side effects and adapt to this difficult journey. Moreover, the link between experience of chemotherapy and coping strategies is based on the Lazarus' stress and coping theory. Although the experience of women with breast cancer undergoing chemotherapy is individualized, we concluded that the distressing experience related to chemotherapy as a stimulus was viewed as a stressor that demands coping or adaptation. Based on the Lazarus stress and coping theory, the ability of a woman to appraise how chemotherapy changed her life and how she appraises her resources to cope with chemotherapy are essential. The results highlight that pre-chemotherapy care programmes, information support systems, social support groups and individual effective coping strategies are helpful in reducing treatment-related distress levels and enhance self-care effects at home.