Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Breast Cancer | Research

Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan

Authors: Sadia Jabeen, Rubeena Zakar, Muhammad Zakria Zakar, Florian Fischer

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Patients with advanced breast cancer require consistent help and support from family caregivers. These caregivers often endure financial burdens and psychological stress, with their experiences significantly influenced by sociocultural factors. This study aims to explore the experiences of family caregivers of advanced breast cancer patients in Punjab province, Pakistan.

Methods

Data was collected through in-depth interviews with fifteen family caregivers of advanced breast cancer patients in three major cities of Punjab, Pakistan. Caregivers, who had been in close contact with the patient for the last two years, were purposively sampled from five major hospitals. The data was analyzed using thematic analysis.

Results

The study revealed that the experiences of family caregivers are deeply rooted in the sociocultural context. Key themes identified include social responsibility and cultural reciprocity norms; limited awareness and mobility options for caregivers; financial responsibility and strain; impacts of beauty myths and shyness on caregiving attitudes and decisions; the stressful and emotional nature of caregiving; treatment perspectives influenced by social groups; challenges in consulting male physicians and associated stigma; the role of religious beliefs in caregiving; and stress management, with religion often being a coping mechanism. These factors can contribute to delayed treatment decisions for patients.

Conclusions

Family caregivers are crucial in facilitating timely treatment decisions for advanced breast cancer patients in the Pakistani context. To minimize treatment delays and alleviate caregiver stress, addressing sociocultural barriers in care-seeking is essential. A tailored approach, considering sociocultural and religious factors, is imperative for the management and early diagnosis of breast cancer, necessitating appropriate policymaking and implementation.
Literature
1.
Butt S, Harlid S, Borgquist S, Ivarsson M, Landberg G, Dillner J, Carlson J, Manjer J. Genetic predisposition, parity, age at first childbirth and risk for breast cancer. BMC Res Notes. 2012;5:414.PubMedPubMedCentralCrossRef
2.
3.
Sathwara JA, Balasubramaniam G, Bobdey SC, Jain A, Saoba S. Sociodemographic Factors and latestage diagnosis of breast Cancer in India: a Hospitalbased Study. Indian J Med Pediatr Oncol. 2017;38(3):277–81.CrossRef
4.
Tagoe EA, Dwamena-Akoto E, Nsaful J, Aikins AR, Clegg-Lamptey JN, Quaye O. High atherogenic index of plasma and cardiovascular risk factors among Ghanaian breast cancer patients. Experimental Biology Med. 2020;245(18):1648–55.CrossRef
5.
McCutchan G, Weiss B, Quinn-Scoggins H, Dao A, Downs T, Deng Y, Ho H, Trung L, Emery J, Brain K. Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review. BMJ Global Health. 2021;6(2):e004213.PubMedPubMedCentralCrossRef
6.
Shamsi U, Khan S, Azam I, Habib Khan A, Maqbool A, Hanif M, Gill T, Iqbal R, Callen D. A multicenter case control study of association of vitamin D with breast cancer among women in Karachi, Pakistan. PLoS ONE. 2020;15(1):e0225402.PubMedPubMedCentralCrossRef
7.
Northouse LL, Katapodi MC, Schafenacker AM, Weiss D. The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs. 2012;28(4):236–45.PubMedCrossRef
8.
Stenberg U, Ruland CM, Miaskowski C. Review of the literature on the effects of caring for a patient with cancer. Psychooncology. 2010;19(10):1013–25.PubMedCrossRef
9.
Fletcher BS, Miaskowski C, Given B, Schumacher K. The cancer family caregiving experience: an updated and expanded conceptual model. Eur J Oncol Nurs. 2012;16(4):387–98.
10.
Hodges LJ, Humphris GM, Macfarlane G. A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med. 2005;60(1):1–12.PubMedCrossRef
11.
Alizadeh M, Feizollahzadeh H, Abdollahzadeh F, Hasankhani H, Dadashzadeh A, Rezaei T. The relationship between self-efficacy and compliance with self-care behaviors in patients with acute coronary syndrome after coronary angioplasty in Shahid Madani hospital, 2016: a health belief model. J Res Med Dent Sci. 2018;6(3):415–20.
12.
Unger-Saldaña K, Infante-Castañeda CB. Breast cancer delay: a grounded model of help-seeking behaviour. Soc Sci Med. 2011;72(7):1096–104.PubMedCrossRef
13.
Ayabakan-Cot D, Ates E, Kurt B, Nazlican E, Akbaba M. Investigation of depression and quality of life factors in cancer patients’ caregivers. J BUON. 2017;22(2):524–9.PubMed
14.
Nipp RD, El-Jawahri A, Fishbein JN, Eusebio J, Stagl JM, Gallagher ER, Park ER, Jackson VA, Pirl WF, Greer JA, Temel JS. The relationship between coping strategies, quality of life, and mood in patients with incurable cancer. Cancer. 2016;122(13):2110–6.PubMedCrossRef
15.
16.
Geng HM, Chuang DM, Yang F, Yang Y, Liu WM, Liu LH, Tian HM. Prevalence and determinants of depression in caregivers of cancer patients: a systematic review and meta-analysis. Medicine. 2018;97(39):e11863.PubMedPubMedCentralCrossRef
17.
Shaffer KM, Jacobs JM, Nipp RD, Carr A, Jackson VA, Park ER, Pirl WF, El-Jawahri A, Gallagher ER, Greer JA, Temel JS. Mental and physical health correlates among family caregivers of patients with newly-diagnosed incurable cancer: a hierarchical linear regression analysis. Support Care Cancer. 2017;25(3):965–71.PubMedCrossRef
18.
Nemati S, Rassouli M, Ilkhani M, Baghestani AR. Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study. Scand J Caring Sci. 2018;32(1):309–16.PubMedCrossRef
19.
Northouse LL, Katapodi MC, Song L, Zhang L, Mood DW. Interventions with family caregivers of cancer patients: meta-analysis of randomized trials. CA Cancer J Clin. 2010;60(5):317–39.PubMedPubMedCentral
20.
Pedreira PB, Mitchell HR, Ting A, Kim Y. Sociocultural investigation of cancer caregiving. In: Applebaum AJ, editor. Cancer caregivers. Oxford: Oxford University Press; 2019. pp. 70–82.
21.
22.
Kusi G, Boamah Mensah AB, Boamah Mensah K, Dzomeku VM, Apiribu F, Duodu PA. Caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer in Ghana. PLoS ONE. 2020;15(3):e0229683.PubMedPubMedCentralCrossRef
23.
Crotty M. The foundations of social research: meaning and perspective in the research process. Los Angeles, London, New Delhi, Singapore, Washington DC: Sage Publications, Inc.; 1998.
24.
25.
26.
Imran N, Bhatti MR, Haider II, Azhar L, Omar A, Sattar A. Caring for the caregivers: Mental health, family burden and quality of life of caregivers of patients with mental illness. J Pakistan Psychiatric Soc. 2010;7(1):23–8.
27.
Gambe RG, Clark J, Meddick-Dyson SA, Ukoha-Kalu BO, Nyaaba GN, Murtagh FE. The roles and experiences of informal carers providing care to people with advanced cancer in Africa—A systematic review and critical interpretive analysis. PLOS Global Public Health. 2023;3(4):e0001785.PubMedPubMedCentralCrossRef
28.
Smith K. Developing a Deductive Coding Scheme Using Theory.
29.
Namey E, Guest G, Thairu L, Johnson L. Handb team-based qualitative Res. 2008;2(1):137–61. Data reduction techniques for large qualitative data sets.
30.
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77–101.CrossRef
31.
Temple B, Young A. Qualitative research and translation dilemmas. Qualitative Res. 2004;4(2):161–78.CrossRef
32.
Guba EG, Lincoln YS. Competing paradigms in qualitative research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Los Angeles. London, New Delhi, Singapore, Washington DC: Sage Publications, Inc.; 1994. pp. 105–17.
33.
Shaikh BT, Hatcher J. Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers. J Public Health. 2005;27(1):49–54.CrossRef
34.
Abubakar A, Van Baar A, Fischer R, Bomu G, Gona JK, Newton CR. Socio-cultural determinants of health-seeking behaviour on the Kenyan coast: a qualitative study. PLoS ONE. 2013;8(11):e71998.PubMedPubMedCentralCrossRef
35.
Zhang AY, Siminoff LA. The role of the family in treatment decision making by patients with cancer. Oncol Nurs Forum. 2003;30(6):1022–8.PubMedCrossRef
36.
Sonawat R. Understanding families in India: a reflection of societal changes. Psic Teor e Pesq. 2001;17(2):177–86.CrossRef
37.
Alptekin S, Gönüllü G, Yücel İ, Yarış F. Characteristics and quality of life analysis of caregivers of cancer patients. Med Oncol. 2010;27(3):607–17.PubMedCrossRef
38.
Al-Shamsi HO, Alrawi S. Breast cancer screening in the United Arab Emirates: is it time to call for a screening at an earlier age. J Cancer Prev Curr Res. 2018;9(3):123–6.CrossRef
39.
Sharma K, Costas A, Shulman LN, Meara JG. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol. 2012; 121873.
40.
Papadopoulos A, Vrettos I, Kamposioras K, Anagnostopoulos F, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Impact of cancer patients’ disease awareness on their family members’ health-related quality of life: a cross‐sectional survey. Psychoncology. 2011;20(3):294–301.CrossRef
41.
Garssen B, Uwland-Sikkema NF, Visser A. How spirituality helps cancer patients with the adjustment to their disease. J Relig Health. 2015;54(4):1249–65.PubMedCrossRef
42.
Ussher JM, Sandoval M, Perz J, Wong WT, Butow P. The gendered construction and experience of difficulties and rewards in cancer care. Qual Health Res. 2013;23(7):900–15.PubMedCrossRef
43.
Koenig Kellas J, Castle KM, Johnson A, Cohen MZ. Communicatively constructing the bright and dark sides of hope: family caregivers’ experiences during end of life cancer care. Behav Sci. 2017;7(2):33.PubMedPubMedCentralCrossRef
44.
Ali R, Mathew A, Rajan B. Effects of socio-economic and demographic factors in delayed reporting and late-stage presentation among patients with breast cancer in a major cancer hospital in South India. Asian Pac J Cancer Prev. 2008;9(4):703–7.PubMed
45.
Mansoor T, Abid S. Negotiating femininity, motherhood and beauty: experiences of Pakistani women breast cancer patients. Asian J Women’s Stud. 2020;26(4):485–502.CrossRef
46.
47.
Martins Faria B, Martins Rodrigues I, Verri Marquez L, da Silva Pires U, Vilges de Oliveira S. The impact of mastectomy on body image and sexuality in women with breast cancer: a systematic review. Psicooncología. 2021; 18(1).
48.
Burgess C, Hunter MS, Ramirez AJ. A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Pract. 2001;51(473):967–71.PubMedPubMedCentral
49.
Khan MA, Shafique S, Khan MT, Shahzad MF, Iqbal S. Presentation delay in breast cancer patients, identifying the barriers in North Pakistan. Asian Pac J Cancer Prev. 2015;16(1):377–80.PubMedCrossRef
50.
Agha N, Rind RD. Beliefs and perceptions about breast cancer among the people living in rural and less privileged areas in Sindh, Pakistan. Health Educ. 2021;121(2):200–14.CrossRef
51.
Abbas Q, Kanwal U, Saeed W, Khan MU, Shahzadi M, Faran M. Relationship of muslim religiosity and death anxiety with the Mediating Effect of Optimism and Depression among Cancer patients. J Relig Health. 2022;61(2):1418–36.
52.
Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol. 2007;25(5):555.PubMedCrossRef
53.
Zargani A, Nasiri M, Hekmat K, Abbaspour Z, Vahabi S. A survey on the relationship between religiosity and quality of life in patients with breast cancer: a study in Iranian muslims. Asia-Pacific J Oncol Nurs. 2018;5(2):217–22.CrossRef
54.
Fradelos EC, Latsou D, Mitsi D, Tsaras K, Lekka D, Lavdaniti M, Tzavella F, Papathanasiou IV. Assessment of the relation between religiosity, mental health, and psychological resilience in breast cancer patients. Contemp Oncology/Współczesna Onkologia. 2018;22(3):172–7.PubMedCrossRef
55.
Toledo G, Ochoa CY, Farias AJ. Religion and spirituality: their role in the psychosocial adjustment to breast cancer and subsequent symptom management of adjuvant endocrine therapy. Support Care Cancer. 2021;29:3017–24.PubMedCrossRef
Metadata
Title
Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan
Authors
Sadia Jabeen
Rubeena Zakar
Muhammad Zakria Zakar
Florian Fischer
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18404-1

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

The impact of multimorbidity among adults with cardiovascular diseases on healthcare costs in Indonesia: a multilevel analysis

Research

High prevalence of fatty liver and its association with metabolic syndrome among rural adults with chronic hepatitis C: Implications for primary healthcare

Research

Assessing the modifiable and non-modifiable risk factors associated with multimorbidity in reproductive aged women in India

Research

Frequency of cigarette smoking and its associated factors among men in East Africa: a pooled prevalence analysis of national survey using multinomial regression

Research

Experiences with family planning and abortion services during the Covid-19 pandemic: a qualitative study in Bangladesh, Iran and Netherlands

Research

Effectiveness of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of students with premenstrual syndrome