Exploration of contextual factors influencing the decision making to beginning re-treatment of breast cancer recurrence

Introduction: Recurrence of breast cancer poses many challenges for patients to being re-treatment. The aim of this study was to explore the contextual factors influencing the decision making to beginning re-treatment of breast cancer recurrence. Methods: This study was a qualitative study with content analysis approach that was conducted in two cancer centers in Tehran. Eleven patients with recurrence breast cancer and one oncologist were selected using purposive sampling and interviewd with in-depth semi-structured interviews. The analysis was performed simultaneously with data collection using the method of Elo and Kingas (۲۰۰۸). Guba and Lincoln criteria were used to evaluate the trustworthiness of the study. Results: Two main categories were obtained from data analysis. "Non-supportive structure of healthcare system" as the main category with subcategories (drug supply impairment), (ignoring patient needs) and (authoritarian approaches) and the main category of "supportive resources for decision making" with subcategories (the role of the family in decision making) and (effective interactions) was obtained. Conclusion: The findings show that breast cancer recurrence patients need support to beginning re-treatment. Structural factors in healthcare system such as drug supply impairment, inadequate patient education structure, lack of coordination in the patient treatment, inappropriate service environment, discrimination in service delivery and authoritarian approaches were the most important factors that patients considered as barriers to beginning re-treatment. Patients believed that family and peers group were the most important supporting factors for beginning re-treatment.