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Background: Pakistan has the highest rate of breast cancer in Asia. Many women delay seeking heath advice and treatment for breast cancer, and between 50% and 70% of women will present when the disease in is in an advanced, aggressive form, particularly young women. The psychological impact of breast cancer is challenged by the negative public perception of cancer., Objectives: This qualitative study explored the psychological impact of advanced breast cancer in women receiving follow-up care in an oncology hospital in Pakistan., Methods: This qualitative study used semistructured interviews to explore women's experiences of living with advanced breast cancer and the impact that this had on their lives as women, mothers, and wives. Twenty-one women were interviewed. Data were analyzed using thematic analysis., Results: The majority of 21 women interviewed were diagnosed between 1 and 11 years, and 15 women had a history of metastases. Four themes emerged from the data. These were reaction to the diagnosis, change in outlook, living life positively, and motivating factors., Conclusion: Women acknowledged the significance of their illness on their health and longevity. Their individual cancer journey was multilayered and imbued with the hope of cure, remission, and an emotional catalog of feelings. All married women wished for sufficient time to visualize their children reach adulthood and marry. Single women wished to care for their mothers and families., Implications for Practice: Through education and support, nurses can provide women with advanced breast cancer and their families educational, spiritual, and psychological care.

Caring is a complex phenomenon. Nurses aim to relieve patient suffering, acknowledge subjective experiences, display empathy but also manage emotions related to care provision. This study explored nurses' perceptions, experiences and emotions related to caring for cancer patients. This qualitative study used semi-structured interviews to explore the emotions management of 32 nurses working in a cancer hospital in Pakistan. Data saturation occurred after 20 interviews. Three themes emerged from the data related to caring, acknowledgement of patients' feelings, professional behaviour, patient involvement and emotional control. Some nurses repressed their emotions and feelings over patients who had difficulties sustaining hope. In such cases nurses require supportive networks to assist their emotions management and intra-personal skills. Educational support is needed to help nurses express their views in relation to emotional contagion, significance of repressed emotions and to identify supportive ways to assist nurses to communicate their experiences.

Aim: There is a paucity of British and international literature on the psychological, sociological and cultural correlates of breast health in ethnic minority women., Methods: This two centre qualitative study was part of a larger study that aimed to examine the influence of culture on the lived experience of Pakistani Muslim breast cancer patients. Thirty six patients attending hospital out-patient breast cancer clinics in Lahore, Pakistan and London, UK were recruited to the study. Women were predominantly married, 20-76 years of age with an average of three children. Semi-structured interviews were undertaken. Interview data were analysed using thematic analysis., Results: Five themes emerged: Discovery and reaction to the disease; disclosure to family; developing emotions; emerging reality; long term uncertainty., Conclusions: Data infer that irrespective of city of residence, the cultural attributes of women, breast health awareness and reactions to the diagnosis and treatment are similar. To raise awareness, more focused health education interventions are needed.

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.

Objective: Even though breast cancer is the most common form of cancer in females in Pakistan, there is a paucity of evidence on the views of Pakistani Muslim women in relation to breast cancer. This study aimed to investigate the perceptions of Pakistani Muslim women in relation to the aetiology of breast cancer and impressions of breast health. The study took place in Lahore, Pakistan., Methods: This survey used a questionnaire and focus group interviews to investigate women's perspectives on breast health. Data was collected over a period of six months, quantitative data was analysed using descriptive statistics and qualitative data was analysed using thematic analysis., Results: 105 women participated in the questionnaire and 48 women contributed to 6 focus group interviews. Women generally were aware of the term breast cancer but were unsure of its aetiology. The questionnaire data revealed that women were aware of both mammography (55%) and breast self-examination (BSE) (77%). Fifty five percent of women had been taught the BSE technique. In comparison, the majority of women attending the focus group interviews had limited exposure to BSE or mammography. Although women had heard of mammograms and BSE they were unaware of BSE technique or breast cancer screening procedures., Conclusions: Even though there is a desire amongst women to engage in BSE by being taught the necessary technique and specific pathological changes to look for, there is a strong cultural opinion that breasts are private organs that should not be discussed publically. In view of this and the frequency of breast cancer in Pakistani Muslim women, it is essential that breast awareness campaigns are implemented by health care professionals such as breast cancer nurses, midwives and medical practitioners to explore the concept of BSE and breast cancer. Selective health education can educate women and lead to changes in health behavior.