Coping with breast cancer: between diagnosis and surgery

AIM: This paper is a report of a descriptive study of coping strategies used by women between diagnosis of breast cancer and surgery. BACKGROUND: Although research has suggested that the initial phase of breast cancer is important in the overall process of coping, there have been few qualitative studies conducted in the period between diagnosis and surgery to describe women's experiences and coping efforts in the midst of stress. METHOD: Individual interviews were conducted with 21 women with newly diagnosed breast cancer who were awaiting surgery. Data were collected from February 2006 to February 2007 at a Norwegian university hospital. Transcripts were analysed using methods of qualitative content analysis. FINDINGS: Prominent themes about coping between diagnosis and surgery were: step-by-step, pushing away, business as usual, enjoying life, dealing with emotions, preparing for the worst and positive focus. The women were highly aware of the threat of death, but at the same time hopeful and optimistic. In general, they wanted to be treated as usual. Pity and compassion could increase their feelings of fear and vulnerability. Emotions were dealt with either by openness or by holding back. CONCLUSION: Avoiding being overwhelmed by emotional reactions was a major goal for the women. Their coping strategies displayed similar patterns but diverged on some points. In general they needed to manage the situation in their own way. By being aware of women's individual needs and different coping strategies, nurses and other healthcare professionals can improve support to women in this vulnerable situation.