Breast cancer in the cycle of hope and hopelesness: A qualitative research

Abstract

Purpose: Hope is a crucial psychological resource that influences adaptation and coping during the cancer journey. This study aimed to explore the lived experiences of hope and hopelessness among breast cancer survivors. Methods: A descriptive qualitative design was employed. Semi-structured, in-depth interviews were conducted with 19 women who had completed their hospital-based treatment for breast cancer within the past 3-5 years. Data were collected via Zoom and analyzed using inductive content analysis. The study was reported by the COREQ checklist. Results: Four main themes emerged from the data: (1) The cycle of hope (fluctuations across diagnosis, treatment, and post-treatment); (2) Sources of hope (acceptance, positive appraisal of treatment, social and professional support); (3) Factors threatening hope (association with death, symptom burden, stigma, emotional isolation, caregiving responsibilities, and lack of professional support); and (4) Strategies to sustain hope (faith, remaining connected to life, cognitive reframing, treatment adherence, and redefining suffering as a shared human experience). Participants described hope as a shifting and vital internal force that helped them navigate uncertainty, while hopelessness was triggered by a lack of control, negative bodily changes, and unsupportive interactions with healthcare professionals. Conclusion: Hope and hopelessness coexist as dynamic and fluctuating experiences in breast cancer survivors. These emotional responses are shaped by personal meaning-making, social context, and the quality of care interactions. Nurses should assess hope-related risks and offer targeted interventions. Hope-focused communication, emotional acknowledgment, and tailored psychosocial support can reduce hopelessness and improve survivors' well-being.