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Psychological Empowerment Profiles in Breast Cancer Rehabilitation: A Multicenter Cross-Sectional Qualitative Study
Kaina Zhou1, Li Yang2, Ling Yuan3
1School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Objective:
This study identified psychological empowerment profiles of women with breast cancer to provide a clinical care framework.
Methods:
This multicenter cross-sectional qualitative study used an interpretative phenomenological approach with semi-structured in-depth interviews. Participants were selected from five tertiary hospitals in northeast (Harbin and Shenyang), east (Nanjing), and northwest (Xi'an) China. Each participant underwent a face-to-face interview lasting 30-60 min. Data were collected between September and December 2024 and thematically analyzed. Forty-six women (33-72 years old) with breast cancer were interviewed; the rehabilitation timeframe spanned three days after surgery to 19 years after initial diagnosis.
Results:
The psychological empowerment profile comprised 25 subthemes and six themes. Themes 1 (Informed and Stress) and 2 (Ambivalence and Distress) reflect the negative profile; Theme 3 (Challenge and Confrontation) marks the turning point between negative and positive coping modes; Themes 4 (Adjustment and Buffer), 5 (Rationality and Acceptance), and 6 (Insight and Growth) reflect positive profiles. Participants receiving treatment (n = 36) showed higher counts in Themes 1, 3, and 4. Those from Harbin and Shenyang had higher counts across themes than those from Nanjing and Xi'an. Survivors (n = 10) dominated Theme 6, with Nanjing survivors exhibiting greater counts across themes than their Xi'an counterparts.
Conclusions:
Women with breast cancer showed a negative-positive psychological empowerment trajectory during rehabilitation. Geographic differences revealed the impact of healthcare infrastructure and culture, with northeastern cities (Harbin/Shenyang) engaging more themes (5/6) than eastern and northwestern cities (Nanjing/Xi'an), indicating the need for regional support programs.
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