title: Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.
abstract: OBJECTIVE
  The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization.
  
  
  METHODS
  Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces.
  
  
  RESULTS
  A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers.
  
  
  CONCLUSIONS
  The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.
authors.affiliation: Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, New Brunswick, Canada. Baukje.Miedema@HorizonNB.ca
authors.forename: Baukje
authors.initials: B
authors.lastname: Miedema
authors.forename: Julie
authors.initials: J
authors.lastname: Easley
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D002170:Canada; D005260:Female; D005783:Gender Identity; D017048:Health Care Costs; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D014195:Travel