Experiences and desired nursing assistance of women on out- patient breast cancer chemotherapy in Southeastern Nigeria A. N. Anarado 1 *, E. R. Ezeome 2 , O. B. Ofi 3 , A. C. Nwaneri 1 and Y. Ogbolu 4 1 Department of Nursing Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria 2 Surgical Oncology Unit, University of Nigeria Teaching Hospital Enugu, Enugu State, Nigeria 3 Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria 4 Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA *Correspondence to: Department of Nursing Sciences, University of Nigeria, Enugu Campus, Enugu State Nigeria. E- mail: agnes.anarado@unn.edu.ng Received: 24 March 2015 Revised: 15 August 2015 Accepted: 16 October 2015 Abstract Objective: This study explored the experiences and nursing support needs of women undergoing out- patient breast cancer chemotherapy in two teaching hospitals in Southeastern Nigeria. Methods: Using a qualitative descriptive design, based on grounded theory approach and focus group discussion (FGD) methodology, 20 histological confirmed breast cancer patients at different stages of combination chemotherapy (cyclophosphamide, doxorubicin, and fluorouracil ) were purpo- sively selected and engaged in FGDs at two surgical oncology clinics. Data saturation was reached at the fourth FGD. The audio-taped and transcribed data were content analyzed using thematic approach. Results: Participants were all christians of the Igbo-speaking ethnic group, and aged between 36 and 66 years. Most were married and had at least primary education. Five themes emerged from the FGDs: inadequate preparation for chemotherapy; chemotherapy scary, distressful, and financially de- manding; hope, faith and courage sustained treatment; self-care actions initiated to ‘weather the storm’; and nursing assistance desired to foster hope and enhance patients’ acceptance of, adjustment and adherence to breast cancer chemotherapy in Nigeria. Culture influenced their chemotherapy per- spectives and coping. Conclusion: Women with breast cancer in southeastern Nigeria desired but were inadequately pre- pared to cope with chemotherapy distress they experienced. Nurses could help patients to accept and navigate through chemotherapy by initiating and supporting effective and efficient self-care actions that are culturally congruent. Copyright © 2015 John Wiley & Sons, Ltd. Introduction Breast cancer, with an estimated 1.7 million new cases in 2012, is the leading cause of cancer morbidity and mortal- ity in women worldwide [1]. In Nigeria, the incidence is increasing [2], and mortality remains high because of de- lays in diagnosis and treatment [3,4]. Developed countries report declining mortality from breast cancer due to ad- vances in early detection and multi-modality therapy [5]. In 2008, the estimated age standardized mortality rate for breast cancer in Nigeria was 22.8, whereas that of the world was 14.1 per 100,000 population [6]. Treatment advances notwithstanding, breast cancer re- mains a devastating disease, perceived by patients as syn- onymous with death and suffering [7–9]. Such perceptions could partly be linked to associated treatment side effects, which escalate patients’ distress, impair their quality-of- life, with threat to treatment adherence [10–12]. While pa- tients were reported to adopt some coping strategies to manage these side effects [13,14], various patient educa- tion and psychosocial interventions have been found to facilitate patient navigation through chemotherapy, im- prove fighting spirit and self-care behaviors [5,15]. In Nigeria, while the national guidelines on cancer con- trol adjudge and recommend the use of chemotherapy as a cost-effective measure to improve breast cancer patients’ survival [16], physical and psycho-social impact of breast cancer therapy on women have been understudied with paucity of empirical work exploring patients’ experiences and perspectives during breast cancer chemotherapy. An- ecdotal reports from some formal and informal healthcare providers of cancer patients in Nigeria infer that chemo- therapy worsens patients’ health conditions, suggesting that the treatment is probably not helpful. Understanding the impact of chemotherapy on breast cancer patients in Nigeria could inform development of culturally congruent interventions that may promote treatment adherence, reduce delays in diagnosis and initiation of conventional treatment. The significance of patients’ perspectives in defining their information and support needs has been identified as an important step in preparing patient health education materials [17]. This study explored patients’ Copyright © 2015 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology (2015) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.4034