The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Sampling Strategy
2.3. Semi-Structured Interviews and Topic Guide
2.4. Data Analysis
2.5. Ethical Approval
3. Results
3.1. Characteristics of the Participants
3.2. Findings
3.2.1. Self-Interaction
“When I was told that I … [had] cancer, I accept[ed] it normally because it is the act of God that I should obey. I … [had] faith that every disease God has created has a treatment and cure for it. I accepted it normally”.(Participant #8, 35 years old)
“One of my relatives told me that her uncle was diagnosed with cancer, and he was in a bad psychological state. I advised her that he needs to accept it because … [his] psychological state is an important factor which will help [him] to overcome the disease because the therapy … is strong”.(Participant #10, 38 years old)
“After the diagnosis, my self-confidence went down. I was not accepting my appearance as a person. During the treatment period itself, I was very, very strong. After finishing all the treatments, I felt that I was broken and I became an introvert[ed] person”.(Participant #1, 36 years old)
“I felt that, to be honest, the disease created positives … I felt that I became stronger and I used to focus on small details that I no longer focus on and I became more spontaneous. I started to care about myself more without forcing myself to do things I’m not comfortable [with] … for others. I only do what only makes me comfortable and I feel also that I became more confident”.(Participant #3, 40 years old)
“I noticed that I have changed, this disease [makes] me strong and it solidifies my personality. I was more dependent on my husband but I started to depend more on myself; now I drop the kids by myself to school. I became more [in]dependent”.(Participant #7, 33 years old)
3.2.2. Interaction with Children
“I did not want to let them [my children] feel that there is a difference in our relationship: before and after the diagnosis, it was totally the same. But, deep inside me, I was trying to get closer without letting them notice that”.(Participant #1, 36 years old)
“I became closer to them [my children], I feel that the therapy time made me be closer to them … I have already started the therapy but I … [haven’t] told them. They … [are] aware that I go to the hospital but they don’t know what I [am] doing there”.(Participant #10, 38 years old)
“Even … when I was doing the chemotherapy session[s], I wasn’t going back to my home with my kids. To avoid them seeing me tired … I used to go to my parents’, where I stay for a whole week, and I also used to take the immunity injections in my parents’ house to avoid the [children] seeing me”.(Participant #5, 24 years old)
“It was a shock for me … I had [a lot of] fear, especially [because] I do have kids and I was concerned about them. The dominant feeling was distraction, I was too distracted. I did not know what [would] happen to me as I know nothing about this disease. All … [that] I knew is anyone having cancer will die from it”.(Participant #1, 36 years old)
“I was thinking about my kids and how hard [it would be] to pass away and leave them behind; it was difficult”.(Participant #10, 38 years old)
“My younger daughter once knocked [on] the bathroom door while she was in hurry, and … [during that] time, I [had] started the chemotherapy [and so] I was wearing [a] cap to cover my hair all the time, even in the house. I opened the door while I was not wearing the cap and she was in shock, to the level that she … [was unable to] urinate”.(Participant #2, 27 years old)
“They [the children] understood it more when they saw the condition of [my] hair later and they started to wonder why you don’t have hair. I was answering that I am sick and [taking] medications and it will be growing back after I finish from the therapy. They [the children] noticed and I had no choice [other] than telling them, and it grew back after I was done from the therapy”.(Participant #4, 31 years old)
3.2.3. Interaction with Spouses
“He [my husband] accepted me as I am. He used to say that I see you [as] the same woman as before and I don’t see that anything has changed [about] you at all”.(Participant #1, 36 years old)
“My husband is, during the therapy session, he tried to change the environment. We travelled a lot during that time, and I noticed a very positive impact on my psychological state”.(Participant #4, 31 years old)
“We [my husband and I] became much closer to each other. We used to have more arguments before; we became better and closer”.(Participant #10, 38 years old)
“Honestly, I was feeling, deep inside myself, that all what I wanted from my husband is divorce. With all the medications I was taking and the therapy, I was really exhausted, especially in [terms of] the intimacy [side of the] relationship because of the dryness … I used to cry and think about divorce … I felt that I am out of the mood … I was worried to put pressure on him, but I passed that period”.(Participant #6, 40 years old)
“In my relationship with my husband, sometimes I feel that I am now different than other women because I eradicated the breast. Sometimes I feel that I am less than the others. But, at the same time, I feel lucky that I survived all of that and I am doing well in my work”.(Participant #2, 27 years old)
3.2.4. Interaction with Family
“My sister told them [my family] about my diagnosis and the reactions were different: some of them were crying, and there was someone who fainted … I was telling them that definitely this will be having a benefit for me and we don’t know where it is yet. My mother was more than crying, she collapsed, my father was only in tears and my sister … fainted. I was talking to her but she wasn’t responding … I left them and stayed alone in my room. I started to think about everything, and I … cried”.(Participant #10, 38 years old)
“He [my brother] didn’t collapse, it was totally the opposite—he was strong while I collapsed and I was in tears, but at the end of that meeting I decided to accept [my diagnosis], so I can proceed to the treatment”.(Participant #3, 40 years old)
“My sister-in-law took me to another room because I collapsed, and I was in tears wondering why it was me who got this disease. I didn’t want that to happen because I still want to live, because [I had] the idea that all people who have cancer are going to die soon”.(Participant #6, 40 years old)
“My father was trying not to let me feel that I was alone or anything has changed. This [is] what made me feel that I was strong enough to live a normal life, they [my family] didn’t let me feel that I was sick”.(Participant #2, 27 years old)
“They [my family] never let me feel anything unusual and they were supporting me”.(Participant #6, 40 years old)
“… My family, my relatives, and my tribe, I was supported financially by all of them. For moral support, my family supported me and they took care of my kids to the level that I was not worried about them when it comes to their education and rear [upbringing]. I left a newborn who was two months at that time; my mother raised him until he is two years”.(Participant #1, 36 years old)
“I loved their [my family’s] support, and it was what I needed the most because I felt like I am living my last days and I will eventually die. I felt that I needed my sister to take care of me because it was only a matter of time and I will not be able to take care of myself and I will be bedridden”.(Participant #2, 27 years old)
“The best thing was the support I received from the whole family. Although we were always gathering [before the diagnosis], we weren’t close this much to each other”.(Participant #10, 38 years old)
“I was very close with my parents; I do love them a lot and they feel the same, but this connection became stronger after the diagnosis”.(Participant #2, 27 years old)
3.2.5. Interaction with Friends
“Even my social life wasn’t affected. My colleagues were visiting me and telling me that if I don’t want to meet people, I can isolate myself because of the disease but I didn’t want to create this atmosphere for myself. It was totally the opposite for me”.(Participant #2, 27 years old)
“My colleagues stood by my side during my therapy journey, they were supporting me and showing that in different forms. Some of them used to bring me natural honey, herbs, and frankincense. They were more than colleagues; I felt that they are my sisters. My colleagues told my close friend once that they can’t visit me often and they were worried that I’ll feel bad about it”.(Participant #7, 33 years old)
“It [my relationship with my friends] was slightly affected. I was the one who started to withdraw but I started to go back to the norm, and I want to because this withdrawal made me feel uncomfortable and I was mentally exhausted at that time. … I truly want to go back to the old days, now I am much better than before, I started also to go out”.(Participant #1, 36 years old)
“I had to tell the general manger to keep them aware that I will be [away on] a long leave [of absence from work] and my colleagues knew about it later. They didn’t … dare … to ask me [directly], but they were checking on me from [one] time to another”.(Participant #3, 40 years old)
3.2.6. Interaction with Society
“When I was diagnosed with this cancer, I stipulated that no one knows about it outside the range of family. I didn’t [want] anyone to know about it because I don’t want to be distracted during the therapy period and there is [are] people who look at [these] things negatively. It was only in the range of my siblings and their spouses, no one … [else] knows about it”.(Participant #3, 40 years old)
“I became an introvert after the chemo doses, I didn’t want to talk to anyone to avoid being asked about my disease”.(Participant #7, 33 years old)
“I want it to be confidential and I didn’t want anyone to know or be aware of my situation as I know how the community reacts with it and they give you sometimes a negative message”.(Participant #5, 24 years old)
“What really exhausts me is the hair fall, including the eyebrows and the lashes: whenever I go to shopping malls, I feel that people are having a wandering eye to me, which I don’t like. This was the most difficult to me and the therapy wasn’t difficult as much as the hair loss”.(Participant #4, 31 years old)
“I wished if I had the chance to meet people who doesn’t have the courage to complete the chemotherapy journey to push them forward, I was telling myself that I wanted to go for the day care unit to achieve this after I finish from the chemotherapy; I wanted to share hope to others”.(Participant #11, 37 years old)
“I also receive messages and calls from people who are recently diagnosed with the disease, and I motivate and push them forward to start the treatment here in the hospital without travelling abroad for it because it is available here”.(Participant #7, 33 years old)
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Breast Cancer. Available online: https://www.who.int/news-room/fact-sheets/detail/breast-cancer (accessed on 17 October 2022).
- Forouzanfar, M.H.; Foreman, K.J.; Delossantos, A.M.; Lozano, R.; Lopez, A.D.; Murray, C.J.L.; Naghavi, M. Breast and cervical cancer in 187 countries between 1980 and 2010: A systematic analysis. Lancet 2011, 378, 1461–1484. [Google Scholar] [CrossRef] [PubMed]
- Al-Lawati, N.A.; Al-Bahrani, B.J.; Al-Raisi, S.S.; Al-Lawati, J.A. Twenty-year trends of cancer incidence in Omanis, 1996–2015. Oman Med. J. 2019, 34, 361–387. [Google Scholar] [PubMed]
- Al-Lawati, J.A.; Al-Zakwani, I.; Fadhil, I.; Al-Bahrani, B.J. Cancer incidence in Oman (1996–2015). Oman Med. J. 2019, 34, 271–273. [Google Scholar] [CrossRef] [PubMed]
- Siegel, R.L.; Miller, K.D.; Jemal, A. Cancer statistics, 2020. CA Cancer J. Clin. 2020, 70, 7–30. [Google Scholar] [CrossRef]
- Al-Azri, M.; Al-Awisi, H.; Al-Rasbi, S.; El-Shafie, K.; Al-Hinai, M.; Al-Habsi, H.; Al-Moundhri, M. Psychosocial impact of breast cancer diagnosis among Omani women. Oman Med. J. 2014, 29, 437–444. [Google Scholar] [CrossRef]
- Al-Azri, M.; Al-Awisi, H.; Al-Moundhri, M. Coping with a diagnosis of breast cancer-literature review and implications for developing countries. Breast J. 2009, 15, 615–622. [Google Scholar] [CrossRef]
- Kent, E.E.; Parry, C.; Montoya, M.J.; Sender, L.S.; Morris, R.A.; Anton-Culver, H. “You’re too young for this”: Adolescent and young adults’ perspectives on cancer survivorship. J. Psychosoc. Oncol. 2012, 30, 260–279. [Google Scholar] [CrossRef] [PubMed]
- Die Trill, M. Anxiety and sleep disorders in cancer patients. EJC Suppl. 2013, 11, 216–224. [Google Scholar] [CrossRef]
- Al-Riyami, A.; Abdulhadi, N.N.; Al-Azri, M. Understanding the perceptions of Omani women regarding life after a breast cancer diagnosis. Sultan Qaboos Univ. Med. J. 2020, 20, e360–e367. [Google Scholar] [CrossRef]
- Li, J.; Humphreys, K.; Eriksson, M.; Dar, H.; Brandberg, Y.; Hall, P.; Czene, K. Worse quality of life in young and recently diagnosed breast cancer survivors compared with female survivors of other cancers: A cross-sectional study. Int. J. Cancer 2016, 139, 2415–2425. [Google Scholar] [CrossRef]
- Faccio, F.; Renzi, C.; Giudice, A.V.; Pravettoni, G. Family resilience in the oncology setting: Development of an integrative framework. Front. Psychol. 2018, 9, 666. [Google Scholar] [CrossRef] [PubMed]
- Jones, R.A.; Taylor, A.G.; Bourguignon, C.; Steeves, R.; Fraser, G.; Lippert, M.; Theodorescu, D.; Mathews, H.; Kilbridge, K.L. Family interactions among African American prostate cancer survivors. Fam. Community Health 2008, 31, 213–220. [Google Scholar] [CrossRef] [PubMed]
- Ungar, M. Varied patterns of family resilience in challenging contexts. J. Marital Fam. Ther. 2016, 42, 19–31. [Google Scholar] [CrossRef] [PubMed]
- Chan, M.F.; Al-Dhawyani, A.M.; Al Hinai, K.; Al-Azri, M. A cluster analysis to explore the burden of primary caregivers of children with cancer in Oman. J. Spec. Pediatr. Nurs. 2022, 27, e12389. [Google Scholar] [CrossRef]
- Breast Cancer Program. Available online: https://cccrc.gov.om/breast-cancer-program/ (accessed on 29 January 2024).
- Palinkas, L.A.; Horwitz, S.M.; Green, C.A.; Wisdom, J.P.; Duan, N.; Hoagwood, K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm. Policy Ment. Health 2015, 42, 533–544. [Google Scholar] [CrossRef]
- Paluch-Shimon, S.; Pagani, O.; Partridge, A.H.; Bar-Meir, E.; Fallowfield, L.; Fenlon, D.; Friedman, E.; Gelmon, K.; Gentilini, O.; Geraghty, J.; et al. Second international consensus guidelines for breast cancer in young women (BCY2). Breast 2016, 26, 87–99. [Google Scholar] [CrossRef]
- Sandelowski, M. Whatever happened to qualitative description? Res. Nurs. Health 2000, 23, 334–340. [Google Scholar] [CrossRef]
- Patton, M.Q. Qualitative Research and Evaluation Methods, 3rd ed.; Sage Publications Inc.: Thousand Oaks, CA, USA, 2002. [Google Scholar]
- Al-Bahri, A.; Al-Moundhri, M.; Al-Mandhari, Z.; Al-Azri, M. The role of patients’ families in treatment decision-making among adult cancer patients in the Sultanate of Oman. Eur. J. Cancer Care 2018, 27, e12845. [Google Scholar] [CrossRef]
- Al-Azri, M.H.; Al-Awisi, H.; Al-Rasbi, S.; Al-Moundhri, M. Coping with a diagnosis of breast cancer among Omani women. J. Health Psychol. 2014, 19, 836–846. [Google Scholar] [CrossRef]
- Ritchie, J.; Spencer, L. Qualitative data analysis for applied policy research. In Analyzing Qualitative Data, Bryman, A., Burgess, R.G., Eds.; 1st ed.; Routledge: London, UK, 1994; pp. 173–194. [Google Scholar]
- Saunders, B.; Sim, J.; Kingstone, T.; Baker, S.; Waterfield, J.; Bartlam, B.; Burroughs, H.; Jinks, C. Saturation in qualitative research: Exploring its conceptualization and operationalization. Qual. Quant. 2018, 52, 1893–1907. [Google Scholar] [CrossRef]
- Michalczyk, J.; Dmochowska, J.; Aftyka, A.; Milanowska, J. Post-traumatic growth in women with breast cancer: Intensity and predictors. Int. J. Environ. Res. Public Health. 2022, 19, 6509. [Google Scholar] [CrossRef] [PubMed]
- Carlsson, T.; Kukkola, L.; Ljungman, L.; Hovén, E.; von Essen, L. Psychological distress in parents of children treated for cancer: An explorative study. PLoS ONE 2019, 14, e0218860. [Google Scholar] [CrossRef] [PubMed]
- Alexander, E.S.; O’Connor, M.; Halkett, G.K.B. The psychosocial effect of parental cancer: Qualitative interviews with patients’ dependent children. Children 2023, 10, 171. [Google Scholar] [CrossRef]
- Koçan, S.; Gürsoy, A. Body image of women with breast cancer after mastectomy: A qualitative research. J. Breast Health 2016, 12, 145–150. [Google Scholar] [CrossRef]
- Andrzejczak, E.; Markocka-Mączka, K.; Lewandowski, A. Partner relationships after mastectomy in women not offered breast reconstruction. Psychooncology 2013, 22, 1653–1657. [Google Scholar] [CrossRef]
- Feeney, B.C.; Collins, N.L. A new look at social support: A theoretical perspective on thriving through relationships. Pers. Soc. Psychol. Rev. 2015, 19, 113–147. [Google Scholar] [CrossRef]
- Antoni, M.H.; Moreno, P.I.; Penedo, F.J. Stress management interventions to facilitate psychological and physiological adaptation and optimal health outcomes in cancer patients and survivors. Annu. Rev. Psychol. 2023, 74, 423–455. [Google Scholar] [CrossRef]
- Driessen, H.P.A.; Busschbach, J.J.V.; van der Rijt, C.C.D.; Elfrink, E.J.; Raijmakers, N.J.H.; van Roij, J.; Rietjens, J.; Kranenburg, L.W. Unmet care needs of patients with advanced cancer and their relatives: Multicentre observational study. BMJ Support Palliat Care. 2023, 14, e1413–e1421. [Google Scholar] [CrossRef]
- Al-Azri, M.; Al-Bimani, K.; Al-Maqbali, A.A.; Al-Riyami, H.; Al-Shabnooti, A.K.; Panchatcharam, S.M.; Jaju, S. The unmet supportive care needs of Omani women diagnosed with breast cancer. Sultan Qaboos Univ. Med. J. 2022, 22, 515–524. [Google Scholar] [CrossRef]
- George, E.S.; Kecmanovic, M.; Meade, T.; Kolt, G.S. Psychological distress among carers and the moderating effects of social support. BMC Psychiatry 2020, 20, 1–9. [Google Scholar] [CrossRef] [PubMed]
- He, C.; Yang, T.; He, Y.; Guo, S.; Lin, Y.; Wu, C.; Gao, L.; Liu, X.; Wu, S.; Cao, B. Relationship between family functioning and self-transcendence in patients with breast cancer: A network analysis. Front. Public Health 2022, 10, 1028860. [Google Scholar] [CrossRef] [PubMed]
- Melguizo-Garín, A.; Benítez-Márquez, M.D.; Hombrados-Mendieta, I.; Martos-Méndez, M.J. Importance of Social Support of Parents of Children with Cancer: A Multicomponent Model Using Partial Least Squares-Path Modelling. Int. J. Environ. Res. Public Health 2023, 20, 1757. [Google Scholar] [CrossRef] [PubMed]
- Abu Khait, A.; Lazenby, M. Psychosocial-spiritual interventions among Muslims undergoing treatment for cancer: An integrative review. BMC Palliat. Care. 2021, 20, 51. [Google Scholar] [CrossRef] [PubMed]
- Al Naabi, M.; Al Zaabi, A. Quantitative Evaluation of Cancer Stigma among Non-Patient Population in Oman. Asian Pac J Cancer Prev. 2024, 25, 1223–1229. [Google Scholar] [CrossRef]
- Wang, C.; Qiu, X.; Yang, X.; Mao, J.; Li, Q. Factors influencing social isolation among cancer patients: A systematic review. Healthcare 2024, 12, 1042. [Google Scholar] [CrossRef]
Characteristic | N (%) |
---|---|
Age (years) | |
Range | 24–44 |
Mean ± SD | 35.0 ± 5.9 |
Median | 36 |
Marital status | |
Single | 4 (36.4) |
Married | 6 (54.5) |
Divorced/widowed | 1 (91) |
Education level | |
High school | 1 (9.1) |
College/university | 8 (72.7) |
Postgraduate | 2 (18.2) |
Employment status | |
Employed | 7 (63.6) |
Unemployed/housewife | 4 (36.4) |
Monthly family income (OMR) | |
≤1000 | 5 (45.5) |
1000–2000 | 5 (45.5) |
>2000 | 1 (9.1) |
Stage of BC at diagnosis | |
II | 4 (36.4) |
III | 2 (18.1) |
IV | 1 (9.1) |
Unknown | 4 (36.4) |
Interaction Domain | Type of Resilience | |
---|---|---|
Positive | Negative | |
Self |
|
|
Children |
|
|
Spouse |
|
|
Family |
|
|
Friends |
|
|
Society |
|
|
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Al-Azri, M.; AL-Kiyumi, Z.; Al-Bimani, K.; Al-Awaisi, H. The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach. Curr. Oncol. 2024, 31, 7979-7993. https://doi.org/10.3390/curroncol31120589
Al-Azri M, AL-Kiyumi Z, Al-Bimani K, Al-Awaisi H. The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach. Current Oncology. 2024; 31(12):7979-7993. https://doi.org/10.3390/curroncol31120589
Chicago/Turabian StyleAl-Azri, Mohammed, Zayana AL-Kiyumi, Khalid Al-Bimani, and Huda Al-Awaisi. 2024. "The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach" Current Oncology 31, no. 12: 7979-7993. https://doi.org/10.3390/curroncol31120589
APA StyleAl-Azri, M., AL-Kiyumi, Z., Al-Bimani, K., & Al-Awaisi, H. (2024). The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach. Current Oncology, 31(12), 7979-7993. https://doi.org/10.3390/curroncol31120589