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Treatment decision-making, family influences, and cultural influences of Chinese breast cancer survivors: a qualitative study using an expressive writing method

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Abstract

Purpose

Among Chinese breast cancer survivors, treatment decision-making is different than that in western countries. Among Chinese women, family often plays an important role during the treatment period, and Chinese-specific cultural factors have negative influences on their psychological conditions. The aim of the present study was to explore the treatment decision making, family influences, and cultural influences of Chinese breast cancer survivors.

Methods

This study used an expressive writing method to explore the experiences of breast cancer survivors who were diagnosed with stage 0 to III cancer. Participants were instructed to write 30 min per week over a period of 3 weeks. All writings were analyzed using a qualitative method.

Results

Three themes were identified: treatment decision making, family influences, and cultural influences. Treatment decision-making included the subthemes of preference for mastectomy, passive involvement, and active involvement. Family influences included the subthemes of financial burden, family expectations, and family support. Cultural influences included the subthemes of fatalism, barriers to expressing emotions, and stigma related to cancer.

Conclusions

Information on breast cancer treatment and survivorship should be provided to patients through multiple methods to improve their knowledge of breast cancer. Family support should be maintained to ensure patients’ confidence and courage during the treatment period. Necessary and appropriate psychological interventions that consider cultural influences should be administered.

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Funding

This research is supported by the Shandong Education Department (J17RA137), Science and Technology Development Plan of Weifang (2015WS009, 2018YX003), Health and Family Planning Commission of Shandong Province (2017WS852), and Natural Science Foundation of Shandong Province ( ZR2016GM05).

Author information

Author notes

  1. Lijuan Wang and Xiaotao Geng contributed equally to this work.

Authors and Affiliations

  1. Department of Intensive Care Unit, Weifang People’s Hospital, Weifang, Shandong, China

    Lijuan Wang

  2. School of Medicine, Shandong University, Jinan, Shandong, China

    Xiaotao Geng

  3. Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China

    Xiaotao Geng

  4. Department of Radiation Oncology, Weifang People’s Hospital, Weifang, Shandong, China

    Xiaotao Geng

  5. Department of Medical Nursing, Weifang Medical University, Weifang, Shandong, China

    Lili Ji

  6. Department of Psychology, Weifang Medical University, 7166 Baotong St, Weifang, 261053, Shandong, China

    Guohua Lu

  7. Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA

    Qian Lu

  8. Department of Psychology, University of Houston, Houston, TX, USA

    Qian Lu

Authors
  1. Lijuan Wang
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  2. Xiaotao Geng
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  3. Lili Ji
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  4. Guohua Lu
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  5. Qian Lu
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Corresponding author

Correspondence to Guohua Lu.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures in studies involving human participants were conducted in accordance with the ethical standards of the Southern Adelaide Clinical Human Research Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical

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Informed consent was obtained from all individual participants included in the study.

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Wang, L., Geng, X., Ji, L. et al. Treatment decision-making, family influences, and cultural influences of Chinese breast cancer survivors: a qualitative study using an expressive writing method. Support Care Cancer 28, 3259–3266 (2020). https://doi.org/10.1007/s00520-019-05161-w

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  • DOI: https://doi.org/10.1007/s00520-019-05161-w

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