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Exploring the psychosocial morbidity of women undergoing chemotherapy for breast cancer in a post-war setting: experiences of Northern Sri Lankan women

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Abstract

Purpose

A breast cancer diagnosis leads to considerable internal conflict and social disruption. Coping with breast cancer may be especially challenging where psychosocial services are not integrated to cancer care. This exploratory descriptive qualitative study delves into breast cancer–associated psychosocial morbidity among women diagnosed with breast cancer at a cancer centre in post-war northern Sri Lanka.

Methods

Fifteen women with non-metastatic breast cancer and treated with curative intent, who were undergoing or had completed adjuvant chemotherapy, were included in the study. Data were gathered through semi-structured interviews and thematically analysed.

Results

Aside from the immediate effects of chemotherapy, participants grappled with concerns of body image, social stigma, and dependency while straddling anxieties about the fate of their families and expenses on cancer care. Demonstrating remarkable strength and resilience, however, they drew on their families and communities for support in the absence of a formal system of psychosocial care. These women’s narratives shed light on certain universal aspects of the breast cancer experience as well as its specificity in a region devastated by war, where cancer care is delivered with minimal resources.

Conclusion

The findings underscore the need to invest in integrating psychosocial services to chronic illness care in low- and middle-income settings.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

Our sincere thanks go to the James Cook University, Townsville, Australia, for funding this project. We are grateful to Dr. Anusha Yoganathan and Mrs. K. Yoganathan for their support to carry out this project.

Funding

The cost involved in the translation of interviews was funded by the James Cook University, Townsville, Queensland, Australia. Two of the co-authors are attached to this University.

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All authors have contributed significantly towards this paper.

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Correspondence to Chrishanthi I. Rajasooriyar.

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Ethics approval

Ethical approval for the study was obtained from the Ethics Review Committee of the Faculty of Medicine, University of Jaffna, Sri Lanka, Ref. No. J/ERC/15/62/NDR/0121.

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Informed consent was obtained from all participants.

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Informed consent for publication was obtained from all participants.

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The authors declare no competing interests.

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Rajasooriyar, C.I., Kumar, R., Sriskandarajah, M.H. et al. Exploring the psychosocial morbidity of women undergoing chemotherapy for breast cancer in a post-war setting: experiences of Northern Sri Lankan women. Support Care Cancer 29, 7403–7409 (2021). https://doi.org/10.1007/s00520-021-06296-5

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