Breast Cancer Survivors’ Perception on Health Promotion and Healthy Lifestyle: A Systematic Review and Qualitative Meta-Synthesis

Luca Guardamagna, Orejeta Diamanti, Giovanna Artioli, Lorenzo Casole, Matteo Bernardi, Francesca Bonadies, Enrico Zennaro, Gloria Maria Modena, Tiziana Nania and Federica Dellafiore ()
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Luca Guardamagna: Department of Orthopedics and Traumatology, Istituto di Cura Città di Pavia, 27100 Pavia, Italy
Orejeta Diamanti: Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
Giovanna Artioli: Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
Lorenzo Casole: Integrated Home Care and Home Palliative Care Units, Fondazione Conte Franco Cella di Rivara Onlus, 27043 Broni, Italy
Matteo Bernardi: Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
Francesca Bonadies: Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
Enrico Zennaro: Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
Gloria Maria Modena: Welfare Services Area, IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Italy
Tiziana Nania: Training Office, IRCCS Policlinico San Donato, 20097 Milano, Italy
Federica Dellafiore: Department of Life Health Sciences and Health Professions, Link Campus University, 00165 Roma, Italy

IJERPH, 2025, vol. 22, issue 7, 1-21

Abstract: Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design : A systematic review and qualitative meta-synthesis were performed. Data Sources : A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods : Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results : The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges , (II) Self-motivation and empowerment , (III) The relationships as a facilitator , (IV) Barriers to change , and (V) Proactive support strategies . Conclusions : Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact : Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies.

Keywords: breast cancer survivors; healthy lifestyle; health promotion; recurrence; meta-synthesis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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