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The Impact of Culture and Sociological and Psychological Issues on Muslim Patients With Breast Cancer in Pakistan

Banning, Maggi EdD, MSc, PGDE, BSc, SRN, SCM; Hafeez, Haroon MBBS, MRCP; Faisal, Saima MBBS; Hassan, Mariam MBBS; Zafar, Ammarah BSc, MBBS

doi: 10.1097/NCC.0b013e31819b240f

Breast cancer is the most common form of cancer in Muslim women in Pakistan. The impact of the initial diagnosis, culture, religion, and psychosocial and psychological aspects of the disease is not well established. This qualitative study examined the experience and coping strategies used by patients with breast cancer in relation to its impact on their physical, mental health, religious, and family issues. Thirty patients with breast cancer were interviewed. Data were analyzed using thematic analysis. The patient's experience of breast cancer focused on the range of emotions felt throughout the illness trajectory, the importance of religion and family support on coping strategies used to manage the adverse effects of chemotherapy, and also the financial concerns. This is the first study to examine Pakistani Muslim women's views on the lived experience of breast cancer. This article provides clarification of the voiced experiences of women with breast cancer. The data not only highlight the role of religion and family support as essential coping strategies but also emphasize the issues of isolation, aggression, and anger as common responses to chemotherapy. Unique features of this study are women's need to seek spiritual support for their illness and the overriding innate characteristic of maternal responsibility. These cultural features require further analysis and research.

Authors' Affiliations: Brunel University, School of Health Studies and Social Care, Uxbridge, Middlesex, England (Dr Banning); Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan (Dr Hafeez), Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan (Drs Faisal, Hassan, and Zafar), and University of the Punjab, Pakistan (Dr Hafeez).

Corresponding author: Maggi Banning, EdD, MSc, PGDE, BSc, SRN, SCM, Brunel University, School of Health Studies and Social Care, Uxbridge, UB8 3PH, Middlesex, England (

Accepted for publication January 5, 2009.

© 2009 Lippincott Williams & Wilkins, Inc.