Illness trajectory of metastatic breast cancer: A qualitative narrative study

Purpose: Breast cancer is accompanied with different psychological consequences. This study investigate to describe the physical, emotional, social, and spiritual characteristics of illness trajectory of metastatic breast cancer (MBC). Method: This is a qualitative study, in which repeated in-depth interviews with 15 MBC patients were conducted. The interview data were transcribed verbatim and analysed as a text, using a qualitative biographic narrative approach. Results: Patient’s narratives about the illness trajectories revealed various physical, cognitive, emotional, social, and spiritual needs at the time of breast cancer diagnosis, and the incidence of metastasis. Positive experiences including personal growth, and negative feelings such as rejection and isolation were reported as patient’s narratives about living with MBC. At the anticipatory phase, the Patient’s narratives were classified into pessimistic and optimistic predictions which were affected by spiritual attitude. Similarly, spiritual as well as religious beliefs were highlighted in psychological reactions and patient’s point of view about death. Conclusions: The MBC trajectory is complicated and each phase of the MBC trajectory includes characteristic tasks and focal points. To move away from the predominant traditional approach towards a more comprehensive and better-targeted service, an increased understanding of the complexities of the MBC trajectory is necessary.