Identity transformation after breast cancer: A qualitative study informed by attention reorientation

To explore patterned processes of identity transformation among Chinese women living with breast cancer.

An interpretive description qualitative study was conducted using in-depth narrative interviews with 18 Chinese women. Participants were recruited from multiple provinces across China through a tertiary oncology department and a survivor-led non-profit organization. Purposive and snowball sampling were used. Data were collected between June 2024 and March 2025 and analyzed using Braun and Clarke's reflexive thematic analysis (RTA).

Four themes and twelve subthemes were identified, capturing women's experiences of identity transformation following breast cancer: Identity Fracture at Diagnosis, Awakening of the Inner Self, Active Reconstruction of Self, and Identity Integrating and Expanding. This process was characterized by a dynamic pattern of attention reorientation, shifting from habitual other-focused absorption shaped by caregiving expectations, to forced and intentional self-focused attention, and in some narratives, to a meaning-driven re-engagement with others.

Breast cancer survivorship among Chinese women involves more than physical recovery. Women described ongoing processes of meaning reconstruction and identity realignment. Attention reorientation provides a culturally grounded explanation mechanism for understanding how women navigate identity reconstruction. These findings underscore the importance of attention-informed and culturally responsive nursing care that supports identity reconstruction and psychosocial adaptation across the survivorship continuum.