McArthur Amy Roder, Magasi Susan, Hamlish Tamara, Winters Cassandra A, Hammel Joy
Department of Disability and Human Development, University of Illinois Chicago, 1640 W. Roosevelt Rd, Chicago, IL, 60612, USA.
Department of Occupational Therapy, University of Illinois Chicago, 1919 W. Tailor St, Chicago, IL, 60612, USA.
BMC Womens Health. 2025 May 30;25(1):265. doi: 10.1186/s12905-025-03814-z.
Though there is increasing attention to the experiences of young breast cancer survivors, there is a need to further examine participation changes for this population after active treatment. This study aimed to examine how person-environment interactions mediate young breast cancer survivors' participation in life, focusing on features of disability within breast cancer survivorship.
This qualitative study utilized a series of two semi-structured interviews to explore the experiences of nine women diagnosed with early-stage breast cancer at or below the age of forty-five. Interpretative phenomenological analysis was used to analyze interviews.
Three cross-case themes were identified: (1) Nothing untouched: changes in self (2), Cancer is "not over": the influences of social environment on survivorship, and (3) Gaps in services and supports: systems level influences on participation.
Participants' participation changes were shaped by environmental factors, such as the complexity of healthcare system navigation. Participants pointed to a need to connect young survivors with services and supports to improve opportunities for participation in daily life following breast cancer diagnosis and treatment. This aligns with conceptualizations of disability that identify the environment as a major driver of restricted participation for disabled people. Late effects of breast cancer impact participation and should be routinely addressed as part of cancer and survivorship care. Acknowledging disability as part of breast cancer survivorship can encourage breast cancer survivors to discuss their experiences openly and to ensure they receive the supports needed to participate fully in life.
尽管对年轻乳腺癌幸存者的经历越来越受到关注，但仍有必要进一步研究这一人群在积极治疗后的参与情况变化。本研究旨在探讨人与环境的相互作用如何介导年轻乳腺癌幸存者的生活参与，重点关注乳腺癌幸存者中的残疾特征。
这项定性研究采用了一系列两次半结构化访谈，以探索九名年龄在四十五岁及以下被诊断为早期乳腺癌的女性的经历。采用解释性现象学分析来分析访谈内容。
确定了三个跨案例主题：（1）无一幸免：自我的变化；（2）癌症“尚未结束”：社会环境对生存的影响；（3）服务与支持的差距：系统层面对参与的影响。
参与者的参与变化受到环境因素的影响，例如医疗保健系统导航的复杂性。参与者指出，需要将年轻幸存者与服务和支持联系起来，以改善乳腺癌诊断和治疗后参与日常生活的机会。这与将环境视为残疾人参与受限的主要驱动因素的残疾概念相一致。乳腺癌的晚期影响会影响参与，应作为癌症和生存护理的一部分常规加以解决。承认残疾是乳腺癌生存的一部分，可以鼓励乳腺癌幸存者公开讨论他们的经历，并确保他们获得充分参与生活所需的支持。
