title: Patients' learning and understanding during their breast cancer trajectory.
abstract: To explore how women learn and understand their disease, treatment, care, and life-situation during a breast cancer trajectory.
  
  
  
  Semi-structured individual interviews were performed with 16 women suffering from breast cancer. Qualitative content analysis of data was performed.
  
  
  
  Three themes describe the women's learning; Interacting with a diversity of information: women interact with a vast amount of information, including perceptions of bodily sensations and events. Concealed and expressed understandings: women interpret information that results in understanding which is either concealed or expressed. Struggling to understand and manage the new life situation: pre-understanding, driving forces to learn, contemplation and dialogue with healthcare staff influence the women's learning.
  
  
  
  General theories of learning are applicable to learning during a breast cancer trajectory. Significant features of learning during a life-threatening illness are strong personal drivers to understand and deal with all that occurs. Vulnerability remains a challenge in developing understanding as a cancer diagnosis infers uncertainty.
  
  
  
  Patients need time to assimilate and process complex bodies of information in dialogue with health care staff. Patients' understanding needs to be assessed and pedagogical competence in the interprofessional team is assumed to facilitate patients' learning and participation in treatment and care.
authors.affiliation: Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden. Electronic address: lena.boman@ki.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Engqvist Boman
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, P9:03, 171 76 Stockholm, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Sandelin
authors.affiliation: Breast and Sarcoma Unit, Radiumhemmet, Karolinska University Hospital, 171 77, Karolinska Universitetssjukhuset and Department of Neurobiology, Care Sciences and Society, Division of Nursing, 141 83 Huddinge, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wengström
authors.affiliation: Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Silén
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D032882:Comprehension; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D000072638:Patient Portals; D036301:Qualitative Research
keywords: Learning for participation in breast cancer care; Patients’ learning; Understanding breast cancer