Hidden voices: an interpretative phenomenological analysis of the experience of surviving breast cancer in Saudi Arabia

Abstract

Background Women with breast cancer often have difficulties in making sense of and understanding their experiences, specifically the ways in which cultural sensitivities impact on and shape their lifeworlds. Aims The aim of this study is to explore the experience of being a breast cancer survivor in Saudi Arabia. Methods Qualitative, in-depth, semi-structured interviews were conducted with 18 Saudi breast cancer survivors aged between 30 and 50 years who had finished treatment 6–47 months before data collection. The data were transcribed verbatim, translated from Arabic into English and analysed using interpretative phenomenological analysis. Results Three themes emerged: the meaning of cancer; hidden survival; and the cultural meaning of survival. For women in Saudi, breast cancer has a cultural stigma linked to death. It changes the sense of self and of society, leading some women to hide their diagnosis from the public and their families. The meaning of survival in a Muslim context has a cultural and religious base, linked to God's will, normality and resumption of activities. Conclusions The study helps give Saudi women a ‘voice’ through the understanding of their experiences of surviving breast cancer. The unique cultural perspectives provide new insights, which can guide healthcare practice and inform the development of programmes to support women who survive breast cancer.

Qualitative exploration of sexual life among breast cancer survivors at reproductive age

“…Similarly, a qualitative study on eighteen women with BC in Saudi Arabia showed that belief in God and following God's commands were reflected in the feeling of a duty to please their husbands. Therefore, they decided to continue their marital relationships and lifestyle based on previous life routines [38]. A systematic review by Chang et al, concluded that religious beliefs were inseparable from sexuality and affected the reactions of patients with BC to sexual issues [15].…”

Experiences of breast cancer in Arab countries. A thematic synthesis

“…The responses of husbands and families were sometimes challenging for the respondents. Although husbands tended to be valued as sources of emotional and financial support, there were occasions where married Arab women were afraid that their husbands may divorce them or take a second wife, because they were no longer fertile or sexually attractive [25,30,32,36]. There were infrequent examples in the literature where these fears were realised, with the rupture of sexual relationships, separation, divorce, and physical or emotional spousal abuse being experienced [24,26,30,32,35,36].…”

“…Arab women found it difficult to cope with society's negative reactions to their illness. These were characterised as being pitied, shunned and blamed for having breast cancer [25,26,29,31,33,36,38]. Respondents felt that many people, including friends and work colleagues, feared them and avoided them because of a fear that breast cancer was contagious.…”

“…2b Strategies for coping To avoid being viewed as a sick person, Arab women with breast cancer attempted to main-tain their pre-diagnosis persona [25,29,31,33,38]. Several strategies were employed to either achieve this image, or to help when it was no longer possible for the women to maintain the portrayal as a well person.…”

“…The role of women in the Arab societies was primarily viewed as being a daughter, a wife or a mother. However, a diagnosis of breast cancer threatened these identities and roles [25,31,32,36,38,40].…”