Breast cancer, a formidable adversary, poses a unique challenge to women worldwide, surpassing even lung cancer as the leading cancer globally. The economic and emotional toll it takes on families and society is immense, with treatment costs adding an extra layer of burden. Researchers are now focused on finding ways to reduce the impact of breast cancer, aiming to alleviate the strain it places on individuals and communities.
Among breast cancer patients, approximately two-thirds are hormone receptor-positive, making them responsive to endocrine therapy. This treatment approach has proven effective, reducing recurrence and mortality rates significantly. However, a significant challenge arises as many patients struggle to adhere to their medication regimens, with some even discontinuing treatment prematurely. This non-adherence is influenced by various factors, including cognitive and psychosocial aspects, and it poses a critical barrier to successful treatment.
While quantitative research provides insights into the symptoms and their severity, it falls short in capturing the holistic patient experience. Standardized indicators fail to reveal the true impact of symptoms on patients' daily lives, emotional well-being, and sense of self. Furthermore, these methods often overlook the unique contextual factors, personal meanings, and individual differences that shape symptom perception. Existing research lacks a nuanced understanding of patients' unmet management needs, as quantitative methods struggle to explore the core issues from the patients' perspective.
This is where qualitative research steps in. By delving deep into patients' symptom experiences, qualitative methods reveal the unique significance of symptoms, analyze the background of management strategies, and identify unmet needs. It provides an indispensable foundation for developing truly patient-centered nursing interventions.
In this study, we aimed to explore the symptom experience and management needs of breast cancer patients undergoing endocrine therapy. Through qualitative interviews, we sought to address the limitations of current research and identify tailored intervention targets. Our findings revealed a complex web of challenges and needs, highlighting the urgent requirement for personalized and multi-level support.
The participants, a diverse group of breast cancer patients, shared their experiences and coping strategies. The data analysis revealed four overarching themes: substantial multidimensional disease burden, individual variations in symptom coping styles, diverse symptom management dilemmas, and personalized symptom management needs.
The disease burden extended beyond physical symptoms, encompassing psychological pressures that disrupted physical functioning and social engagement. Participants reported coexisting physical symptoms that exacerbated functional impairment, such as joint pain, debilitating fatigue, and hot flashes. These symptoms significantly impacted daily activities and occupational performance.
The psychological burden, driven by body image alterations and fear of recurrence, led to social withdrawal. Participants avoided interpersonal interactions to prevent unwanted attention and embarrassment. This social withdrawal manifested as physical isolation and emotional disengagement.
When it came to coping styles, patients demonstrated a range of approaches. Some adopted adaptive coping strategies, seeking information, communicating with clinicians, and implementing tailored lifestyle plans. Others exhibited defensive coping, enduring symptoms silently or relying heavily on medications and caregivers. A minority developed creative coping strategies, devising innovative solutions and adapting to their physical limitations.
The symptom management dilemmas faced by patients were multifaceted, spanning personal, social, and healthcare system barriers. Insufficient disease knowledge, limited self-advocacy, inadequate social support, and diminished self-management motivation were common challenges. Participants expressed a need for credible, individualized information, science-based lifestyle management plans, psychological support, and technology-enabled care.
The study's findings highlight the complex and interwoven nature of the challenges faced by breast cancer patients undergoing endocrine therapy. The regression of physiological functions and psychosocial withdrawal create a unique long-term therapeutic burden. To address this, a transformation in medical services is required, shifting from a standardized to a personalized paradigm. The management predicament lies in knowledge transfer mechanisms, doctor-patient interaction models, and social support systems.
To bridge these gaps, healthcare providers should integrate routine psychological screening into follow-up visits, utilize digital tools for symptom tracking, and deliver structured patient education programs tailored to different treatment phases. By doing so, we can better support breast cancer patients and improve their overall well-being and quality of life.
