Distress among women taking part in surgical continuity of care for breast cancer - a mixed methods study

Breast cancer is the most common cancer among women worldwide. In Denmark, one in every 9 women will be diagnosed with breast cancer during her life. The initial treatment is removal of the tumour and the surrounding tissue, or removal of the breast. The axillary is examined to stage spread of cancer and if metastases are detected, an axillary clearance is performed. Consequences of breast cancer are manifold and vary within individuals, but the most cited are anxiety, depression, pain, sleep disturbance, fatigue, and/or altered body image. These consequences may cause distress at some point during breast cancer trajectory. Overall, distress has been linked to suffering, and lower quality of life, increased admission rates, and greater health care costs. This thesis uses mixed methods to investigate the prevalence of distress among women taking part in surgical continuity of care at time of diagnosis, and possible changes in distress during surgical continuity of care. In addition, it determines predictors of distress and explores the experience of distress in more depth.