https://orcid.org/0000-0002-9241-7019
Abstract
Objective
The aim of this study is to describe the connotations of health beliefs about adjuvant endocrine therapy (AET) in premenopausal breast cancer survivors in Northeast China and to explore the reasons underlying bad behaviours and influential factors of AET adherence and persistence.
Methods
Semi-structured interviews were conducted using a qualitative description research method with 30 premenopausal breast cancer survivors who had undergone surgery and AET for more than half a year. The researcher collected and coded the interview transcripts and extracted the concepts and themes.
Results
Two main categories of themes regarding the health beliefs of survivors who were undergoing AET were formed in the conceptual framework: connotations and modifiable factors. Subcategories of the first category included perceptions of the survivors regarding the risks and effects of recurrence or metastasis of breast cancer; the methods, benefits and barriers of AET; behavioural clues; and self-efficacy. Subcategories of the second category included religious belief, disposition, matrimony and other demographic factors as well as traditional Chinese female characteristics, gender role and other socio-cultural factors.
Conclusion
Demographic, socio-cultural and other factors play an important role in the health beliefs of breast cancer survivors. Health beliefs such as related knowledge of AET, related cognition of recurrence or metastasis of breast cancer directly affect adherence to and persistence with AET. Therefore, implementing interventions with respect to health beliefs may enhance adherence to AET.
Acknowledgments
We would like to express our gratitude to the breast cancer survivors who participated in this study and to the medical staff in the breast surgery department. We would also like to acknowledge the funding support by Liaoning Provincial Science and Technology Bureau (NO.2015225023).
Clinical implications
Based on the results of this study, a health belief mode framework for breast cancer survivors treated with AET is obtained. This framework can be used to develop a specific beliefs about health questionnaire, which would allow us to develop a comprehensive evaluation of survivors’ health beliefs about AET and create further interventions based in psycho-oncology aimed at survivors’ health beliefs. These could in turn help prolong the life span of survivors and improve their quality of life.
Ethics approval
The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of China Medical University (protocol approval No.2016-5-2), all participants provided written informed consent and this study was conducted in accordance with the Declaration of Helsinki.
Disclosure
The authors declare no conflicts of interest in this work.