Exploring Experiences of Individuals With Breast Cancer Post-mastectomy at Kenyatta National Hospital - a Phenomenological Study

Abstract

Background: Worldwide, breast cancer (BC) is the most prevalent malignancy affecting women and ranks as the second most fatal form of cancer. When detected early in stages i and ii, mastectomy is the most prevalent and efficacious surgical intervention for breast cancer. Nevertheless, post-mastectomy body image changes may negatively impact the psychological, physiological, sex-related and social well- being of affected women. Objective: This study explored the experiences and perspectives of individuals with breast cancer post-mastectomy at Kenyatta National Hospital. Methods: A cross-sectional qualitative survey was undertaken. The constructivism paradigm was adopted. Adult patients with breast cancer post mastectomy attending clinics or admitted at Cancer Treatment Center (CTC) in KNH were targeted as respondents. A study sample of 10 patients was purposively interviewed on the basis of the principle of data saturation. In-depth interviews using an interview guide were carried out among the study participants. Audio-recording was done using SONY ICD PX 333, data transcribed verbatim with the data analysed using thematic content analysis using NVivo v.11 Software. The study was approved by both the KNH-UoN Ethics and Research Committee and KNH management. Results: The study participants were females most of whom had visited KNH for treatment. In relation to the participant’s physiological experiences and perspectives post-mastectomy, diminished physical strength/functioning emerged as the main theme with altered body image, disrupted work life and disrupted sexual life as it’s sub-themes. In relation to the participant’s psychological experiences and perspectives post-mastectomy, mental distress emerged as the main theme with anxiety and stress, hopelessness in life and low self-esteem as it’s sub-themes. In relation to the participant’s sociological experiences and perspectives post-mastectomy, social support emerged as the main theme with family support and social life as it’s sub- themes. In relation to rehabilitation support systems available to persons with breast cancer post-mastectomy, psychosocial support programs emerged as the main theme with counselling, group therapy and breast reconstructive surgery as it’s sub-themes. Conclusions: The quality of life of individuals with breast cancer post mastectomy is affected in three dimensions; physiologically by reduced physical strength disrupting their normal work and sexual life; psychologically by having mental distress, anxiety and low self-esteem which may require continuous counselling to regain mental stability; sociologically by having disruptions of social and family life keeping them isolated from normal functions. Recommendations: Health practitioners at KNH’s Cancer Treatment Centre could ensure that individuals with breast cancer post mastectomy seen in the hospital go through a structured evaluation of physiological, psychological and sociological needs for execution of holistic care