Psychological distress in adult women of reproductive age at different stages after breast cancer diagnosis: A qualitative study

Abstract

Aim: To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis.

Design: Qualitative.

Methods: Eighty-one patients with breast cancer-related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1-, 3-, 6-, 9- and 12-month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted.

Results: Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post-diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1-, 3-, 6-, 9- and 12 months post-diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns.

Conclusion: Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns.

Implications for the profession and/or patient care: During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions.

Impact: To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence-based professional guidance on reproductive preservation techniques.

Reporting method: The study was reported using the consolidated criteria for reporting qualitative research guidelines.

Patient or public contribution: Patients contributed to data collection through interviews.

Keywords: breast cancer; cancer education; fertility; nursing research; psychological distress; qualitative research; social support.