title: The Psychological Process of Breast Cancer Patients Receiving Initial Chemotherapy: Rising From the Ashes.
abstract: In Taiwan, breast cancer is the most common cancer in women. Most breast cancer patients are willing to receive chemotherapy and experience adverse effects and suffering during the process of chemotherapy.
  
  
  
  The aim of this study was to explore patients' psychological process when receiving initial chemotherapy for breast cancer.
  
  
  
  A qualitative grounded theory approach was used. Data were collected through semistructured interviews of 20 patients who were from 1 district teaching hospital during 2012 to 2013.
  
  
  
  A substantive theory was generated to describe the psychological process experienced by breast cancer patients in their initial treatment. The core category was "rising from the ashes." Four categories emerged and represented 4 stages of the psychological process experienced by breast cancer patients. They were (1) fear stage: patients are frightened about permanent separation from family, chemotherapy, and the disease getting worse; (2) hardship stage: patients experience physical suffering and mental torment; (3) adjustment stage: patients fight against the disease, find methods for adjustment, and get assistance from supporting systems; (4) relaxation stage: patients were released from both the physical and mental sufferings, and patients accepted the disease-related change in their lives.
  
  
  
  Each stage is closely related to the other stages, and each is likely to occur repeatedly. It is important to help patients achieve the relaxation stage.
  
  
  
  The results of this study may enhance nurses' understanding of the psychological process of patients receiving initial chemotherapy for breast cancer, thereby helping nurses to provide appropriate assistance to improve the quality of patient care.
authors.affiliation: Author Affiliations: Department of Nursing, National Cheng Kung University Hospital (Ms Chen); and Department of Nursing, Chang Jung Christian University, Tainan (Dr Huang); and Department of Healthcare Administration (Dr Kao), Department of Emergency Medicine, E-Da Hospital (MD Sun), and Department of Nursing, I-Shou University, Kaohsiung (Drs Chiang and Sun), Taiwan, Republic of China.
authors.forename: Yen-Chieh
authors.initials: YC
authors.lastname: Chen
authors.forename: Hui-Man
authors.initials: HM
authors.lastname: Huang
authors.forename: Chia-Chan
authors.initials: CC
authors.lastname: Kao
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Chiang
authors.forename: Fan-Ko
authors.initials: FK
authors.lastname: Sun
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008875:Middle Aged; D011582:Psychological Theory; D036301:Qualitative Research; D013315:Stress, Psychological / Q000523:psychology; D013624:Taiwan