Coping with chemotherapy for breast cancer: Asking women what works

Andrea Gibbons, AnnMarie Groarke

To explore the coping strategies women use to cope with the side effects and distress of chemotherapy for breast cancer. Twenty women with breast cancer who received chemotherapy took part in qualitative, semi-structured face-to-face interviews about their coping strategies. Ten women had received their diagnosis via a national breast cancer screening programme, and ten women had been diagnosed through referral to a symptomatic breast cancer services clinic. Data was analysed using thematic analysis based on an interpretative phenomenological approach. A combination of coping strategies were utilised to deal with the side effects of chemotherapy, with three main themes emerging. Behavioural coping strategies such as anticipatory coping and maintenance of activities were used to regain a sense of control. Emotional coping strategies such as seeking support and reappraisal were utilised to cope with treatment-related distress. Women also engaged in coping appraisal, whereby women evaluated how effective their responses were in reducing their distress, often leading to a change in the coping strategies used. Women who were diagnosed through the screening programme were less likely to seek treatment information or access cancer support services. Anticipating side effects and engaging in coping strategies to minimise their impact highlights the importance of providing accurate information about the side effects of treatment, and the potential for these strategies as components of effective interventions to reduce distress. Oncology nurses are ideally placed to drive provision of pre-chemotherapy care programmes that include specific preparatory information to increase adaptive coping, and reduce distress.