Addressing trauma, post-traumatic stress disorder, and post-traumatic growth in breast cancer patients

Table 1 Features of the articles reviewed

Ref.	Location	Variables	Participant characteristics	Method/sample	Instruments	Results
Bosire et al[27], 2020	South Africa	BC Comorbid suffering		Qualitative study 50 women	Interview	This study revealed that participants experienced discrimination and isolation, as well as fear of been rejected by their families. It was also found that BC patients are dissociated from their family members and the wider community
Maree et al[28], 2015	Zambian	BC Severe suffering	48.2 years	Qualitative descriptive survey 10 participants	Interview	This qualitative study revealed that patients with advanced BC experience severe suffering before diagnosis. After undergoing chemotherapy, the patient became fearful of stigma and lost their femininity, strength, appearance, role, and support system
Lambert et al[29], 2020	South Africa	BC Trauma	Aged between 28 and 76 years. Average 49	Qualitative 50 black women	Interview	This study revealed that most patients felt that they would die once diagnosed with cancer. Participants reported that chemotherapy causes fear, distress, and pain, which leads to traumatization
Coetzee et al[30], 2019	South Africa	Breast treatment and experiences Distress	Age between 48 and 66 years	Qualitative. 12 South African women	Interview	South African women react to BC with shock and disbelief. Women's experiences of diagnosis and treatment were accompanied by psychological distress
Teye-Kwadjo et al[31], 2022	Ghana	BC Persistent pain, physical appearance	Between 22 and 69	Qualitative 12 Ghanaian women	Interview	Participants revealed that BC treatment and diagnosis are associated with chronic pain in the breast, chest, and armpit areas. It was revealed that participants feared loss of hair, swollen hands, and numbness due to treatment
Nwakasi et al[32], 2023	Nigeria	BC Cancer stigma		Qualitative 30 BC survival	Interview	BC is a potentially stigmatizing illness
Iddrisu et al[33], 2020	Ghana	BC Trauma	From 28 to 45 years	Qualitative exploratory 12 participants	Interview	BC patients felt depressed, cried, and were traumatized after being diagnosed with BC. Some of the patients felt that they were unattractive due to the mastectomy done; however, they used handkerchiefs as breast prostheses
Lebimoyo and Sanni[34], 2023	Nigeria	BC, PTSD	Between 25 to 60 years	Descriptive 183 patiently diagnosed female BCs	Questionnaires	Post-traumatic stress symptoms were 46% at baseline assessment. However, there was a significant reduction after 3 months (31%) and 6 months (22%). It was observed that PTSS is higher at early diagnosis
Eugenia et al[35], 2019	Zimbabwe	BC Anxiety, fear and depression, PTSD	Aged 30 to 80 years	Qualitative study 12 participants	Semi-structured interviews	100% of participants experienced anxiety, 80% experienced post-traumatic stress, and 20% experienced depression
Alagizy et al[36], 2020	Egypt	BC, Trauma symptoms (anxiety, perceived stress, and depression).	Mean age 52.29 ± 11.64 years	Mixed method 60 BC patients	Questionnaires and interview	The study found that depressive symptoms, anxiety symptoms, and perceived stress were 68.6%, 73.3%, and 78.1% among patients, respectively
van Oers and Schlebusch[37], 2021	South Africa	BC Trauma symptoms (distress, suicidal ideation)		Quantitative study. 80 female BC patients	Descriptive statistics Questionnaires	BC patients experienced high levels of hopelessness and suicidal ideation. These patients also encounter psychological stress
Schlebusch and van Oers et al[38], 1999	South Africa	BC Trauma symptoms (psychological distress, hopelessness, and suicidal ideation)	Mean age for black 42.2 years and 54.3 years for white	Descriptive survey study. 50 South African women	Questionnaire	Black South Africans were found to experience depression, somatization, and body image dysphoria, and use less adaptive styles than white South Africans. As a result of BC symptoms, both groups experience the same level of anxiety
Stecher et al[39], 2023	South Africa	BC Mastectomy	Age (34 to 58)	Qualitative 7 participants	Semi-structured interviews	Cultural stigma against BC patients still exists in the South African population
Ofei et al[40], 2023	Ghana	BC PTG		128 BC survival	Questionnaire	PTG among BC patients is determined by social supports, optimism, religiosity, and hope, all of which assist them in managing their illness
Aliche et al[41], 2023	Nigeria	BC and other cancers PTG	Age range 28–55	957 cancer patients	Questionnaire	In the Nigerian context, meaning in life, a mechanism of mindfulness was found to promote PTG in cancer patients
Olaseni et al[42], 2016	Nigeria	BC and other cancers PTG	Age range of 28–55	120 participants	Questionnaire	PTG was predicted by age, sex, education, and the results of the diagnosis
Aliche[43], 2022	Nigeria	General cancer PTG		550 patients	Questionnaire	Positive reappraisal and self-compassion independently mediated PTG. This indicates that reappraisal and self-compassion significantly facilitate PTG in patients with cancer
Gorven et al[44], 2018	South Africa	BC PTG	25 and 50 years	Qualitative study 6 women	Interview	In South Africa, PTG involves losing body control, reclaiming body control, surrendering final control over the body, rebuilding personified identity, and gaining a new appreciation for the body
Agyei[45], 2018	Ghana	BC PTG		Cross-sectional survey. 150 BC women	Questionnaires.	PTG was positively associated with age, survival year, and marital status. There was no association between educational level, religion, employment status, and PTG. It was also revealed that social support, coping, and optimism were directly related to PTG
Fekih-Romdhane et al[46], 2022	Tunisia	BC PTG	Mean age of 52.7 ± 9.8	Quantitative seventy-nine (79) postoperative BC women	Questionnaires	Patients found that they were stronger than they assumed (70.0%), had strong religious faith (65%), and had the capacity to accept the way things work out (63.8%). The results also revealed that anxiety and social support are substantially associated with PTG
Njoroge and Asata et al[47], 2022	Kenya	BC Traumatic stress, and PTSD	Age group of 25–47 years	Mixed method research design. 60 females sampled through purposeful sampling	Impact of events scale revised and interviews	The structure of traumatic stress at the time of BC diagnosis and treatment depended on how test results were communicated to the patients, and treatment associated side effects like body image changes, mastectomy, and weight loss or gain. Also, 90% of the participants reported severe PTSD, while 6.70% and 3.30% reported moderate and low PTSD, respectively
Kagee et al[48], 2017	South Africa	BC Trauma symptoms (distress, and depression)	Mean age 55.70 years	Quantitative study. Sample of 201 female BC	Checklist Questionnaire	Distress and depression were prevalent among BC patients in South Africa, specifically those with higher body change stress and lower perceived support
Berhil et al[49], 2017	Morocco	BC Traumatic distress	Age 50 ± 8	Quantitative sample of 446 Moroccan women	Questionnaire	A psychological distress prevalence rate of 26.9% was reported among Moroccan BC patients
Ohaeri et al[50], 2012	Nigeria	BC, Trauma symptom (psychic distress, and adjustment)	Age 49.9	Descriptive research design. Sample of 63 attendees	Questionnaire	The greatest worry was associated with fear of death. Psychic distress was negatively associated with BC management. Fear of people's perceptions was a predictor of psychological distress

BC: Breast cancer; PTSD: Post-traumatic stress disorder; PTG: Post-traumatic growth.