• Mary Rosedale and Mei R Fu.
• College of Nursing, New York University, New York City, USA. mtr3@nyu.edu
• Oncol Nurs Forum. 2010 Jan 1; 37 (1): E28-33.

Purpose/ObjectivesTo describe women's unexpected and distressing symptom experiences after breast cancer treatment.Research ApproachQualitative and descriptive.SettingDepending upon their preference, participants were interviewed in their homes or in a private office space in a nearby library.ParticipantsPurposive sample of 13 women 1-18 years after breast cancer treatment.Methodologic ApproachSecondary analysis of phenomenologic data (constant comparative method).Main Research VariablesBreast cancer symptom distress, ongoing symptoms, and unexpected experiences.FindingsWomen described experiences of unexpected and distressing symptoms in the years following breast cancer treatment. Symptoms included pain, loss of energy, impaired limb movement, cognitive disturbance, changed sexual experience, and lymphedema. Four central themes were derived: living with lingering symptoms, confronting unexpected situations, losing precancer being, and feeling like a has-been. Distress intensified when women expected symptoms to disappear but symptoms persisted instead. Increased distress also was associated with sudden and unexpected situations or when symptoms elicited feelings of loss about precancer being and feelings of being a has been. Findings suggest that symptom distress has temporal, situational, and attributive dimensions.ConclusionsBreast cancer survivors' perceptions of ongoing and unexpected symptoms have important influences on quality of life. Understanding temporal, situational, and attributive dimensions of symptom distress empowers nurses and healthcare professionals to help breast cancer survivors prepare for subsequent ongoing or unexpected experiences in the years after breast cancer treatment.InterpretationFollow-up care for breast cancer survivors should foster dialogue about ways that symptoms might emerge and that unexpected situations might occur. Prospective studies are needed to examine symptom distress in terms of temporal, situational, and attributive dimensions and explore the relationship between symptom distress and psychological distress after breast cancer treatment.

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