Background:
Breast cancer is the most common cancer for women, globally. Social, religious
and healthcare contexts have been shown to influence women’s experiences
of advanced breast cancer; however, research has tended to focus on
resource-rich nations. There is limited research from low-resource contexts,
and little is known on the experiences of Arab, Muslim and African women with
advanced breast cancer.
Aim:
To explore and understand the experiences of advanced breast cancer in the
Islamic Republic of Mauritania, West Africa.
Methods:
Using a constructivist Stakian multi-case study approach, eight cases were
constructed around women (n=8) with advanced breast cancer, family members
(n=10) and health professionals (n=9). Data were collected longitudinally (up to
nine months per case) and consisted of interviews, audio-journals, a patient
reported outcome measurement scale and a performance status scale. Withincase
and cross-case analysis was undertaken, with thematic analysis of
qualitative data.
Findings:
Three key themes were identified: 1. Destiny, 2. Patience & Acceptance and 3.
Journeying in search of a cure. Mauritanian women appreciate that Allah is all
powerful and maintains control over their destinies and their breast cancer. A
fear of causing offence to Allah influences how they express negative
experiences of breast cancer and its treatments. The women’s access to
information and treatment is controlled by health professionals and families.
Women are, therefore, required to use their own observations and
interpretations to understand their breast cancer and empower their pursuit of
treatment and a cure.
Conclusion:
Maure women’s experiences of advanced breast cancer in Mauritania are
influenced by power imbalances. Allah is all-powerful. Families and health
professionals exert power over Maure women’s access to information,
healthcare decisions and how they express negative experiences. This thesis
demonstrates that Maure women are cognisant of these challenges and, either,
accept them as reality or attempt to work around them.