title: Information provision and problem-solving processes in Japanese breast cancer survivors with lymphoedema symptoms.
abstract: BACKGROUND
  In Japan, a high proportion of breast cancer (BC) survivors develop lymphoedema as a consequence of the treatment received. Japanese BC survivors are generally not provided with standardised information about risks, early signs and symptom management. The effects of (in)adequate information on the problem-solving processes among Japanese BC survivors with lymphoedema symptoms have not been investigated.
  
  
  OBJECTIVE
  The aim of this study was to explore how the provision of medical information by doctors affected the problem-solving processes of Japanese BC survivors with lymphoedema symptoms.
  
  
  METHODS
  Ten Japanese BC survivors participated in audio-taped focus group discussions. Transcripts were analysed using an inductive thematic analysis.
  
  
  RESULTS
  Analysis identified two phases during which participants attempted to address problems with managing their lymphoedema symptoms - a help-seeking phase and an evaluation phase. Perceptions of information provision affected emotional responses to the onset and cognitive appraisals of lymphoedema symptoms (seen as accepted or burden). However, perceptions of information provision did not affect help-seeking behaviours from surgeons or adherence behaviours. Participants often perceived compression sleeves as inefficient and not worth continuing.
  
  
  CONCLUSIONS
  This study suggests that information provision is a key process in helping BC patients to adjust to symptoms of lymphoedema. In order to promote effective symptom management, doctors and nurses should provide support not only during the help-seeking phase but also the evaluation phase. Further research on the most effective ways to change negative treatment beliefs should be conducted.
authors.affiliation: School of Psychology, University of Southampton, Southampton, UK. miyako@sky.email.ne.jp
authors.forename: Miyako
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Sandra
authors.initials: S
authors.lastname: Horn
authors.forename: Roger
authors.initials: R
authors.lastname: Ingham
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000534:rehabilitation*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007564:Japan; D008209:Lymphedema / Q000517:prevention & control* / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D011340:Problem Solving; D017741:Survivors / Q000523:psychology