Lived experience, coping skill, and quality of life among women with breast cancer in Iraq: a mixed methods study

• Main Author: Alsdfan, Rasha Mohammed Jumaah
• Format: Thesis
• Language: English
• Published: 2025
• Subjects: R Medicine; RC254-282 Neoplasms. Tumors. Oncology (including Cancer)
• Online Access: http://eprints.usm.my/63213/

Breast cancer (BC) is not only a leading cause of mortality among women worldwide but also has profound effects on their quality of life (QOL), particularly in the context of physical, emotional, and social well-being. Gaining insight into the lived experiences of women is crucial for enhancing healthcare delivery, particularly in Iraq, where religious and cultural factors deeply influence health outcomes. Understanding the lived experiences of women with BC becomes vital for improving healthcare delivery. This study aimed to investigate the QOL, coping skills, their associated factors, and life experience among women with BC in Iraq. A mixed methods approach was employed in two phases among women with BC at The Medical City – Teaching Oncology Hospital, Iraq. The phase I study was a cross-sectional study among 244 Women with BC. The instruments used were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to assess QOL, the Brief COPE-28 Questionnaire to assess coping skills and the Hospital Anxiety and Depression Scale-21 (HADs-14) to assess psychological status. The data was analyzed using Multiple linear regression analysis. The Phase II study was a qualitative study using a phenomenological approach. The participants were selected through purposive sampling from the Phase I study, and in-depth interview was conducted with 18 Women with BC. The interviews were recorded, transcribed, and analyzed using NVivo 12 software. In the phase 1 study, the QOL scores for global, functional, and symptom domains were (53.24 ± 16.80, 46.23 ± 25.16, and 53.82 ± 22.10) respectively. The significant factors influencing the global QOL domain were age, marital status, disease duration, hormonal therapy, passive coping, and anxiety. Age, disease duration, passive coping domain, and anxiety were significant factors for the functional domain of the QOL. The symptom domain of the QOL was notably affected by menstrual status, mastectomy, passive coping, and depression. The mean (SD) coping skills for active coping, passive coping, and seeking support domains were 5.96 (1.31), 4.00 (1.10), and 7.58 (0.84), respectively. Hormonal therapy, anxiety, and depression were significant factors influencing the active coping domain. The passive coping domain-associated factors were the type of surgery and anxiety. The seeking support domain was notably affected by the stage of disease, duration since surgery, breast reconstruction, and anxiety. Five themes were identified for the QOL challenges. The themes were body image, psychological distress, disease and treatment-related events, personal reflection, and financial challenges. To cope with these challenges, women with BC rely on various strategies such as network and financial support, self-distraction, acceptance, surrendering to God, seeking information, and navigating cultural beliefs and stigmas. This mixed-methods study provided an in-depth understanding of the QOL and coping mechanisms among women with BC. The findings indicated that participants had a moderate overall QOL and a high level of coping skills. This study revealed a comprehensive perspective that emphasizes the need for interventions addressing psychological and social needs, promoting active coping and supportive networks to improve QOL