title: The experience of distress in relation to surgical treatment and care for breast cancer: An interview study.
abstract: OBJECTIVE
  A diagnosis of breast cancer is a key turning point in a woman's life that may lead to her experiencing severe and persistent distress and potentially presaging a psychiatric disorder, such as major depression. In Denmark an increased standardization of care and a short hospital stay policy minimize the time of medical and nursing surveillance. Consequently, there is the potential risk that distress goes unnoticed, and therefore, untreated. Therefore, the purpose of this study was to explore the experience of distress in Danish women taking part in surgical continuity of care for breast cancer.
  
  
  METHODS
  A phenomenological-hermeneutic approach inspired by the French philosopher Paul Ricoeur was conducted to explore the experience of distress in relation to surgical treatment and care for breast cancer. Semi-structured interviews were conducted with 12 women who recently had surgery for breast cancer at six departments of breast surgery in Denmark from May 2013 to November 2013.
  
  
  RESULTS
  The understanding of the experience of distress in the period of surgical continuity of care for breast cancer is augmented and improved through a discussion related to four identified themes: A time of anxiety, loss of identities, being treated as a person and being part of a system, drawing on theory and other research findings.
  
  
  CONCLUSIONS
  Distress experienced by women in the period following diagnosis arises from multiple sources. Support and care must be based on the woman's individual experience of distress.
authors.affiliation: Department of Breast Surgery, Aalborg University Hospital, Sdr. Skovvej 3, 9000 Aalborg, Denmark. Electronic address: lojo@rn.dk.
authors.forename: L
authors.initials: L
authors.lastname: Jørgensen
authors.affiliation: Department of Breast Surgery, Aalborg University Hospital, Sdr. Skovvej 3, 9000 Aalborg, Denmark. Electronic address: jpg@dadlnet.dk.
authors.forename: J P
authors.initials: JP
authors.lastname: Garne
authors.affiliation: Department of Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark. Electronic address: mso@clin.au.dk.
authors.forename: M
authors.initials: M
authors.lastname: Søgaard
authors.affiliation: Department of Clinical Medicine, Aalborg University, Clinical Nursing Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, 9000 Aalborg Denmark. Electronic address: bisl@rn.dk.
authors.forename: B S
authors.initials: BS
authors.lastname: Laursen
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000503:physiopathology; D001828:Body Image; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D003266:Continuity of Patient Care; D003718:Denmark; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological
keywords: Breast cancer; Continuity of care; Distress; Phenomenological-hermeneutic; Surgery; Women