Background
Methods
Search strategy
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tracking of citations found in the identified articles and reviews;
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hand searching of the indexes of the following regional journals: The Middle East Journal of Family Medicine, Oman Medical Journal, Journal Medical Libanais, La Tunisie Médicale, the Arab Journal of Psychiatry and the Pan African Journal of Oncology;
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experts in the region were personally contacted for suggestions on eligible articles.
Participant | Experience | Location |
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(Breast OR Mammary) AND (Cancer OR Tumour OR Tumor OR Malignancy OR Neoplasm) | Adaptation, attitudes, anxiety, barrier, belief, believe, coping, culture, depression, enduring, expectation, experience, health knowledge, idea, lived experience, motivation, narrative, perception, perspective, psychological, quality of life, social support, survivor, view | Arab, Algeria, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates, Yemen |
Selection criteria
Inclusion | Exclusion | |
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Study design | Original research with qualitative design published in peer-reviewed journals | Review articles, books, conference articles, posters, letters to editor and opinion pieces |
Language | Published in English or French | Non-English, non-French language |
Focus | Experiences of breast cancer | Other cancers or impossible to disaggregate data relating to breast cancer from other cancers |
Experiences of women with breast cancer | Experiences of relatives, healthcare professionals, or men with breast cancer | |
Context | Arab women in an Arab country | Immigrant Arab women in a non-Arab country |
Selection procedure
Quality assessment
Data extraction and synthesis
Results
Study characteristics
First author | Year | Country | Research focus | Methods | n | Demographics | Main findings |
---|---|---|---|---|---|---|---|
Al-Azri [22] | 2014 | Oman | Coping strategies after diagnosis | Semi-structured interviews (single). Framework analysis | 19 | Aged 24 to 54 years old All stages of disease and treatment Time since diagnosis: 3 months to 3 years (mean 12.2 months) | Six themes: (a) denial, (b) optimism, (c) withdrawal, (d) religious beliefs and practices, (e) support of family members and healthcare providers |
Al-Azri [23] | 2014 | Oman | Psychosocial impact of diagnosis | Semi-structured interviews (single). Framework analysis | 19 | Aged 24 to 54 years old. Attending outpatients or hospitalised. All stages of disease and treatment Time since diagnosis: 3 months to 3 years (mean 12.2 months) | Four themes: (a) psychological distress of the disease and uncertainty, (b) reactions of family members, (c) views of society and (d) worries and threats about the future |
Alqaissi [24] | 2010 | Jordan | Meanings of social support through the cancer journey | Semi-structured interviews (single). Heideggerian hermeneutical analysis | 20 | Aged 24 to 72 years old. All stages of disease. Late stage or post treatment Time since diagnosis: 6 to 24 months (mean 12.7 months) | Six themes: (a) stigmatised disease, (b) social support, (c) being strong for self and others, (d) resources, (e) controlling information for protection and (f) spiritual meaning as support One constitutive pattern: culture influencing the meaning of social support |
Almegewly [25] | 2019 | Saudi Arabia | Perspectives of survivorship following treatment | Interviews (single). Interpretative phenomenological analysis | 18 | Aged 30 to 50 years old with stage I or II. 6 to 47 months post treatment | Three themes: (a) the meaning of cancer, (b) hidden survival and concealing the diagnosis and (c) cultural meanings of survival |
Assaf [26] | 2017 | United Arab Emirates | Experiences following diagnosis and treatment | Semi-structured interviews (single) | 20 | Aged 30 to 65 years old. All disease stages. Undergoing active treatment. Time since diagnosis: 8 to 24 months | Three themes: (a) protecting oneself from stigma, (b) facing uncertainties and (c) getting on with life |
Doumit [27] | 2007 | Lebanon | Lived experiences of oncology patients receiving palliative care | Semi-structured interviews (single). Phenomenological analysis (Utrecht School) | 3 | Age NR Palliative stages of disease Time since diagnosis: NR | Eight themes: (a) distress at being dependent, (b) dislike for pity, (c) worry for the family, (d) reliance on God, (e) dislike of hospitals, (f) fear of pain and (g) need to communicate |
Doumit [28] | 2010 | Lebanon | Coping strategies | Semi-structured interviews (longitudinal). Seven-stage hermeneutical analysis (Diekelmann and Ironside) | 10 | Aged 36 to 63 years old. All disease and treatment stages. Time since diagnosis: 4 months to 9 years | Seven themes: (a) cancer is from God, (b) cancer is similar to any other disease, (c) positive support from others, (d) sharing the experience, (e) changed body image, (f) fear of reoccurrence and (g) pity Constitutive pattern: cancer is a cut in our lives that we have to fight |
Doumit [29] | 2010 | Lebanon | Lived experiences of BC | Semi-structured interviews (multiple). Phenomenological analysis (Utrecht School) | 10 | Aged 36 to 63 years old. All disease and treatment stages. Time since diagnosis: 4 months to 9 years | Four themes: (a) living with losses, (b) living with guilt feeling, (c) living with fears and uncertainty and (d) living with a need to know |
Elobaid [30] | 2016 | United Arab Emirates | Delayed presentation and health seeking behaviour | Semi-structured interviews (single). Thematic framework analysis | 19 | Aged 35 to 68 years old. Advanced stages of disease. Time since diagnosis: < 2 years | Three themes: (a) symptom recognition and appraisal, (b) role of community and social network and (c) healthcare delivery system |
Hammoudeh [31] | 2017 | Palestine | Experiences of BC and its impact on families and social relationships | Semi-structured interviews (single) and focus group discussions. Thematic analysis | 35 | Aged 25 to 71 years old. All stages of disease and treatment. Time since diagnosis: < 1 year to several years | Three themes: (a) the transition from shock to the daily struggles, (b) the role of social support in helping women cope and (c) faith and reliance on God |
Jassim [32] | 2014 | Bahrain | Experiences, beliefs, perceptions and attitudes relating to QOL in BC | Semi-structured interviews (single). Constant comparative analysis | 12 | Aged 39 to 68 years old. All stages of disease and treatment. Time since diagnosis: 1 to 8 years (mean 2.6 years) | Five themes: (a) meaning of cancer and QOL, (b) spirituality and beliefs about causes of breast cancer, (c) coping mechanisms, (d) impact of illness and (e) change in relationships |
Kobeissi [33] | 2014 | Lebanon | Translation and validation of FACT-B into Arabic | Focus group discussions | 41 | Aged 20 to 71 years old. All stages of disease and treatment. Time since diagnosis: NR | Five themes: (a) physical well-being, (b) social/family well-being, (c) emotional well-being, (d) functional well-being and (e) additional concerns |
McEwan [34] | 2014 | Egypt | Experiences of diagnosis and treatment delays | Semi-structured interviews (single). Thematic content analysis (social ecological model) | 15 | Aged 29 to 60 years old. All stages of treatment. Staging of disease: NR. Time since diagnosis: NR | Four themes: (a) intrapersonal factors, (b) interpersonal relationships, (c) institutional factors and (d) public policy factors |
Masmoudi [35] | 2016 | Tunisia | Issues of sexuality | NR | 2 | Aged 44 to 48 years old. Post mastectomy. Time since diagnosis: NR | Five themes: (a) difficulties of communicating with the doctor, (b) erroneous beliefs, (c) reactive depression, (d) changing body image and (e) trouble communicating within the couple |
Nizamli [36] | 2011 | Syria | Experiences of chemotherapy | Semi-structured interviews (single). Content analysis | 17 | Aged 30 to 45 years old. All stages of disease. Undergoing active chemotherapy. Time since diagnosis: NR | Four themes: (a) psychological discomfort, (b) physical problems, (c) social dysfunction and (d) failure in the family role |
Obeidat [37] | 2013 | Jordan | Experiences of information exchange following diagnosis of early stage BC | Semi-structured interviews (single). Content analysis | 28 | Aged 29 to 70 years old. All stages of disease. Mastectomy or lumpectomy < 6 months. Time since diagnosis: NR | Three themes: (a) knowledge about BC and its treatment, (b) communication of cancer diagnosis and treatment and (c) education on treatment side effects |
Obeidat [38] | 2013 | Jordan | Personal meanings of diagnosis and surgical treatment for early stage BC | Semi-structured interviews (single). Heideggerian interpretive phenomenological analysis | 28 | Aged 29 to 70 years old. All stages of disease. Mastectomy or lumpectomy < 6 months. Time since diagnosis: NR | Four themes: (a) fearing BC, (b) trusting as coping, (c) surrendering to and suffering through treatment and (d) embodied self as changed One constitutive pattern: controlling fear |
Saati [39] | 2013 | Saudi Arabia | Experiences of diagnosis and treatment | Semi-structured interviews (single) and focus groups. Grounded theory analysis | 60 | Mean age: 46 years old. Stage of disease: NR. All stages of treatment. Time since diagnosis: NR | Five themes: (a) communication, (b) acceptance, (c) knowledge and understanding, (d) limitations imposed by culture and (e) positive dimensions of culture |
Soliman [40] | 2018 | Morocco | Experiences and perspectives of barriers to diagnosis and treatment of BC | Semi-structured interviews (single). Grounded theory analysis | 25 | Age: NR. Stage of disease: II to IV. All stages of treatment. Time since diagnosis: NR | Six themes: (a) treatment-associated costs, (b) burden of transportation and distance, (c) healthcare choice, (d) identity and femininity, (e) community influence and (f) spirituality and conception of death |
Synthesis results
Theme | Sub-theme |
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(1) Perceptions and reactions | (1a) The diagnosis |
(1b) Perceptions of treatment | |
(1c) Changing perceptions | |
(2) Coping or enduring | (2a) Challenges to coping |
(2b) Strategies for coping | |
(3) Changing roles | (3a) Care-provider versus care-receiver |
(3b) Positive new roles |