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The psychosocial experiences of women with breast cancer across the lifespan: a systematic review protocol

Campbell-Enns, Heather; Woodgate, Roberta RN, PhD

Author Information
JBI Database of Systematic Reviews and Implementation Reports: January 2015 - Volume 13 - Issue 1 - p 112-121
doi: 10.11124/jbisrir-2015-1795
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Inclusion criteria

Types of participants

This review will consider studies that include women with a breast cancer diagnosis of any type or stage, with the exception of a cancer recurrence. Women with a recurrence will be excluded since the experience of recurrence has been shown, through research, to be dissimilar to the experience of the first diagnosis and treatment of the disease. The experience of women in all treatment modalities will be included (i.e. lumpectomy, mastectomy of all types with or without breast reconstruction, chemotherapy, radiation therapy and hormone therapy).

This review will consider studies that include age as a primary area of interest in the study design. That is, the study will focus on: 1) younger women or older women, or 2) a psychosocial issue and compare it across the lifespan from younger to older. The definition of “younger” and “older” will not be described by the reviewers prior to the review because no consensus has been reached in the literature about defining “young” and “old” in cancer. However, this will be observed in the studies and reported on in the analysis. Therefore, studies that identify the participants as “young” and/or “old”, and provide a range of ages of the participants, will be included. Studies will be excluded if they do not define their population(s) by age or if they combine younger and older populations together.

Phenomenon of interest

The phenomenon of interest is women's psychosocial experience of breast cancer, including the social, psychological, emotional, spiritual and quality-of-life aspects of cancer.


This review will include women from all geographical regions. It will also include all cancer care contexts (e.g. acute care hospital, ambulatory care setting, home care, primary health care).

Types of studies

This review will consider studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.

Search strategy

The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken, followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the articles. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference lists of all identified reports and articles will be searched for additional studies. Studies published in English will be considered for inclusion in this review. Studies published from 1990 to the present will be considered for inclusion in this review based on the timeframe in which psychosocial research in breast cancer began.

The databases to be searched include:

MEDLINE, CINAHL, PsychINFO, SCOPUS, EMBASE (European literature), Web of Science, Google Scholar, ProQuest

Initial keywords to be used will be:

Breast cancer OR breast carcinoma; AND

Psychosocial experience OR psychosocial distress OR psychosocial impact

Assessment of methodological quality

Qualitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Data collection

Qualitative data will be extracted from papers included in the review using the standardized data extraction tool from JBI-QARI (Appendix II). The data extracted will include specific details about the populations, study methods and outcomes of significance to the review question and specific objectives.

Data synthesis

Qualitative research findings will, where possible be pooled using JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Where textual pooling is not possible, the findings will be presented in narrative form. One challenge in this review is the synthesis of different age groups. This will be done by observing the age ranges in the articles and aggregating the findings for each age group in order to distinguish similarities and differences in the groups. It is expected that these age groups will show some variation between articles. However, because this review is looking at ‘younger’ and ‘older’, there is not likely to be an overlap in the age groups (adding a third ‘middle-aged’ group would be more complicated and therefore is not being considered in this review).

Conflicts of interest

There are no conflicts of interest.


Ms Campbell-Enns holds a Canadian Institutes of Health Research (CIHR) Fredrick Banting and Charles Best Canada Graduate Doctoral Award.

Dr Woodgate is a Canadian Institutes of Health Research (CIHR) Applied Chair in Reproductive, Child and Youth Health Services and Policy Research.


1. Sormanti M, Kayser K, Strainchamps E. A Relational Perspective of Women Coping with Cancer. Soc Work Health Care. 1997; 25: 89-106.
2. Helms RL, O'Hea EL, Corso M. Body image issues in women with breast cancer. Psychol Health Med. 2008; 13: 313-325.
3. Nelson JP. Struggling to Gain Meaning: Living with the Uncertainty of Breast Cancer. Adv Nurs Sci. 1996; 18: 59-76.
4. Siegel K, Gluhoski V, Gorey E. Age-Related Distress Among Young Women with Breast Cancer. J Psychosoc Oncol. 1999; 17: 1-20.
5. Stanton AL, Danoff-Burg S, Huggins ME. The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment. Psychooncology. 2002; 11: 93-102.
6. Stephens PA, Osowski M, Fidale MS, Spagnoli C. Identifying the Educational Needs and Concerns of Newly Diagnosed Patients With Breast Cancer After Surgery. Clin J Oncol Nurs. 2008; 12: 253-258.
7. Coyne E, Borbasi S. Holding it all together: Breast cancer and its impact on life for younger women. Contemp Nurse J Aust Nurs Prof. 2006; 23: 157-169.
    8. Piot-Ziegler C, Sassi ML, Raffoul W, Delaloye JF. Mastectomy, body deconstruction, and impact on identity: A qualitative study. Br J Health Psychol. 2010; 15: 479-510.
    9. Berterö CM. Affected self-respect and self-value: the impact of breast cancer treatment on self-esteem and QoL. Psychooncology. 2002; 11: 356-364.
    10. Hill J. Holcombe C, Clark L, Boothby MR, Hincks A, Fisher J, et al. Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychol Med. 2011; 41: 1429-1436.
    11. White CA. Body image dimensions and cancer: a heuristic cognitive behavioural model. Psychooncology. 2009; 9: 183-192.
    12. Mellon S, Northouse LL, Weiss LK. A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nurs. 2006; 29: 120-131.
    13. Ganz PA,Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of Life in Long-Term, Disease-Free Survivors of Breast Cancer: a Follow-up Study. J Natl Cancer Inst. 2002; 94: 39-49.
    14. Ganz PA. Psychological and social aspects of breast cancer. Oncology. 2008; 22(6): 642-646.
    15. Linden W, Vodermaier A, MacKenzie R, Greig D. Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. J Affec Disord. 2012; 10(2-3): 343-351.
      16. Waldrop DP, O'Connor TL, Trabold N. ‘Waiting for the Other Shoe to Drop:’ Distress and Coping During and After Treatment for Breast Cancer. J Psychosoc Oncol. 2011; 29: 450-473.
      17. Zebrack BJ, Yi J, Petersen L, Ganz PA. The impact of cancer and quality of life for long-term survivors. Psychooncology. 2008; 17: 891-900.
      18. Avis NE, Crawford S, Manuel J. Quality of Life Among Younger Women With Breast Cancer. J Clin Oncol. 2005; 23: 3322-3330.
      19. Wenzel LB, Fairclough DL, Brady MJ, Cella D, Garrett KM, Kluhsman BC, et al. Age-related differences in the quality of life of breast carcinoma patients after treatment. Cancer. 1999; 86: 1768-1774.
      20. Stava CJ, Lopez A, Vassilopoulou-Sellin R. Health profiles of younger and older breast cancer survivors. Cancer. 2006; 107: 1752-1759.
      21. Robb C, Haley WE, Balducci L, Extermann M, Perkins EA, Small BJ, et al. Impact of breast cancer survivorship on quality of life in older women. Crit Rev Oncol Hematol. 2007; 62: 84-91.
      22. Mor V, Allen S, Malin M. The psychosocial impact of cancer on older versus younger patients and their families. Cancer. 1994; 74: 2118-2127.
      23. Lally R. In the Moment: Women Speak About Surgical Treatment Decision Making Days After a Breast Cancer Diagnosis. Oncol Nurs Forum. 2009; 36: E257-E265.
      24. Collie K, Long BC. Considering ‘meaning’ in the context of breast cancer. J Health Psychol. 2005; 10: 843-853.
      25. Shaha M, Bauer-Wu S. Early Adulthood Uprooted. Cancer Nurs. 2009; 32: 246-255.
      26. Foley KL, Farmer DF, Petronis VM, Smith RG, McGraw S, Smith K, et al. A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age. Psychooncology. 2006; 15: 248-258.
      27. Cash TF, Smolak L, editors. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. New York: Guilford Press; 2011.
        28. Fang SY, Balneaves LG, Shu BC. ‘A struggle between vanity and life’: the experience of receiving breast reconstruction in women of Taiwan. Cancer Nurs. 2010; 33: E1-11.
        29. Lee CN, Foster RD. Breast Reconstruction after Mastectomy in Young Women. Breast Dis. 2006; 23: 47-52.
        30. Zimmermann T, Scott JL, Heinrichs N. Individual and dyadic predictors of body image in women with breast cancer. Psychooncology. 2009; 19: 1061-1068.
        31. Zahlis EH, Lewis FM. Coming to Grips with Breast Cancer: The Spouse's Experience with His Wife's First Six Months. J. Psychosoc Oncol. 2010; 28, 79-97.
          32. Bell K, Ristovski-Slijepcevic S. Metastatic Cancer and Mothering: Being a Mother in the Face of a Contracted Future. Med Anthropol. 2011; 30: 629-649.
          33. Elmberger E, Bolund C, Magnusson A, Lützén K, Andershed B. Being a Mother With Cancer. Cancer Nurs. 2008; 31: 58-66.
          34. Raveis VH, Pretter S, Carrero M. ‘It Should Have Been Happening To Me’: The Psychosocial Issues Older Caregiving Mothers Experience. J Fam Soc Work. 2010; 13: 131-148.
          35. Awadalla AW, Ohaeri JU, Gholoum A, Khalid AOA, Hamad HMA, Jacob A. Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study. BMC Cancer. 2007; 7: 102.
          36. Northouse LL. Psychological impact of the diagnosis of breast cancer on the patient and her family. J Am Med Womens Assoc. 1992; 47(5): 161-164.
          37. Faulkner RA, Davey M. Children and Adolescents of Cancer Patients: The Impact of Cancer on the Family. Am J Fam Ther. 2002; 30: 63-72.
          38. Snyder KA, Pearse W. Crisis, social support, and the family response: exploring the narratives of young breast cancer survivors. J Psychosoc Oncol. 2010; 28: 413-431.
          39. Rosedale M. Survivor Loneliness of Women Following Breast Cancer. Oncol Nurs Forum. 2009; 36: 175-183.
          40. Davis H. et al. Towards social connection for young people with cancer. AMC Press (OZCHI '08 Proceedings). 2008; 319-322. doi>10.1145/1517744.1517804

            Appendix I: Appraisal instruments

            QARI appraisal instrument

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            Appendix II: Data extraction instruments

            QARI data extraction instrument

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            breast cancer; psychosocial experience; lifespan; younger women; older women; qualitative; systematic review

            © 2015 by Lippincott williams & Wilkins, Inc.