Psychological adjustment strategies used by Moroccan patients with locally advanced breast cancer to cope with the psychological impact of diagnosis and the effects of neoadjuvant chemotherapy: a qualitative study.

BACKGROUND: Neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC) has significant psychological effects on these patients, which, when added to the impact of being diagnosed at this stage of breast cancer (BC), results in psychological distress. This triggers various psychological adjustment strategies to cope. To better understand these effects and this adjustment process, this study aims to explore the psychological impact of the discovery of LABC and effect the NAC treatment, and to describe the psychological adjustment strategies adopted by Moroccan patients. METHODS: A qualitative exploratory descriptive study was conducted through semi-directive interviews, which reached its saturation point with 36 patients who agreed to participate in our study at the Oncology Clinic of the Hassan II University Hospital in Fez. The data were processed and analyzed using a thematic analysis approach based on the steps of the Clak and Braun method. This study was conducted in accordance with the SRQR and COREQ guidelines for publishing qualitative research. RESULTS: Three themes emerged from the analysis of the interviews conducted. (1) The first is that the diagnostic and announcement of LABC provoke in newly diagnosed women an emotional shock, tearfulness, sleep disorders, and high levels of stress and anxiety. (2) The second is that treatment with NAC induces emotional distress, anxiety, and stress, as well as cognitive disorders and, in some cases, signs of depression. (3) The psychological adjustment strategies mobilized by these patients which are identified in this study are religious coping, acceptance, seeking social support, fighting spirit, distraction and avoidance. CONCLUSION: The implementation of interventions designed to prevent and reduce the onset of the array of negative effects associated with NAC, and helping patients with LABC to adopt effective psychological adjustment strategies can reduce levels of distress related to the disease and treatment in these Moroccan survivors.