title: Coping response following a diagnosis of breast cancer: A systematic review.
abstract: BACKGROUND
  Coping with breast cancer is an important health issue that results in adjustments to the disease in survivors. The present systematic review aims to synthesize the evidence about the coping strategies used by women who are primary breast cancer survivors to adjust to their new situations in their lives.
  
  
  METHODS
  Searches were conducted using Google Scholar, PubMed, Scopus, Wiley Online Library, and PsycINFO, using the terms "breast cancer," "breast malignancy," "coping strategies," "coping behaviors," and "adjustment" from January 2000 to July 2015. Only relevant studies in English were selected at the end of the search. Only those papers were selected that focused on coping strategies/behaviors that were used by breast cancer survivors.
  
  
  RESULTS
  Searching the electronic databases resulted in 2390 articles. Ultimately, 20 studies met the inclusion criteria of the present study and were included in the review. Two reviewers independently reviewed all relevant articles using the same inclusion criteria. The reviewers completed a quality assessment using the Newcastle-Ottawa Quality Assessment scales for observational studies. The more frequent coping strategies that patients with breast cancer used in the studies were 1) seeking social support (9 studies), 2) positive reframing and reappraisal behaviors as problem focused strategies (7 studies), 3) religious/spirituality-focused efforts (8 studies), 4) emotional expression as positive emotion-focused strategies (3 studies), and 5) avoidance and distraction as avoidance orientated strategies (6 studies). Women with different ethnicities and educational levels used different coping strategies with breast cancer, and they used different strategies in different phases of the disease.
  
  
  CONCLUSIONS
  This systematic review revealed that seeking social support and emotion-focused efforts were the main coping strategies that women with breast cancer diagnosis used, especially in the early phase of breast cancer diagnosis. This information about the coping responses of patients may be useful in designing interventional programs to assist other women in dealing with the various challenges imposed upon them by their illness.
authors.affiliation: Ph.D. Candidate of Reproductive Health, Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Esmat
authors.initials: E
authors.lastname: Mehrabi
authors.affiliation: Ph.D. of Reproductive Health, Assistant Professor, Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Hajian
authors.affiliation: Ph.D. of Reproductive Health, Associate Professor, Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Simbar
authors.affiliation: Oncologist, Associate Professor, Shohada-e-Tajrish Hospital, Department of Radiation Oncology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hoshyari
authors.affiliation: Ph.D. of Statistics, Associate Professor, Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Zayeri
keywords: adjustment; breast cancer; coping behaviors; coping strategies; systematic review
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