Treatment decision-making, family influences, and cultural influences of Chinese breast cancer survivors: a qualitative study using an expressive writing method

Purpose: Among Chinese breast cancer survivors, treatment decision-making is different than that in western countries. Among Chinese women, family often plays an important role during the treatment period, and Chinese-specific cultural factors have negative influences on their psychological conditions. The aim of the present study was to explore the treatment decision making, family influences, and cultural influences of Chinese breast cancer survivors. Methods: This study used an expressive writing method to explore the experiences of breast cancer survivors who were diagnosed with stage 0 to III cancer. Participants were instructed to write 30 min per week over a period of 3 weeks. All writings were analyzed using a qualitative method. Results: Three themes were identified: treatment decision making, family influences, and cultural influences. Treatment decision-making included the subthemes of preference for mastectomy, passive involvement, and active involvement. Family influences included the subthemes of financial burden, family expectations, and family support. Cultural influences included the subthemes of fatalism, barriers to expressing emotions, and stigma related to cancer. Conclusions: Information on breast cancer treatment and survivorship should be provided to patients through multiple methods to improve their knowledge of breast cancer. Family support should be maintained to ensure patients’ confidence and courage during the treatment period. Necessary and appropriate psychological interventions that consider cultural influences should be administered.