Skip to main content

Research Repository

Advanced Search

Psychological concerns of Indian women with breast cancer in different national contexts: A systematic review and mixed-methods synthesis

Daniel, Sunitha; Clark, Joseph; Gnanapragasam, Sam; Venkateswaran, Chitra; Johnson, Miriam J.


Sunitha Daniel

Sam Gnanapragasam

Chitra Venkateswaran


© 2020 Author(s). Background: Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population. Aim: To improve understanding of psychological symptoms among Indian women with breast cancer. Design: This is a systematic literature review and critical interpretive synthesis. Medical Subject Headings(MeSH) terms and keywords for breast cancer, psychological symptoms and treatment were used to search databases from inception to 7 May 2019. The reference lists of the included articles were examined. Search results were screened against the inclusion criteria, data were extracted, and quality was appraised by two independent researchers with recourse to a third. Narrative (quantitative) and thematic qualitative syntheses were applied, followed by critical interpretive synthesis. Data sources: ProQuest, MEDLINE, Ovid EMBASE, EBSCO, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Results: 18 of 763 studies from India or Canada were included (13 quantitative, 5 qualitative). Critical interpretive synthesis found psychological concerns similar to 'Western' women, but were framed by the common culture of Indian women in either country. Family structure, religion and community appear to protect against and cause distress in relation to the expected core role of being a wife and a mother and the male dominance in decision making. Stigma was amplified by poor knowledge about the nature of cancer. Migrant Indian women had additional problems due to language barriers. Conclusions: Indian women with breast cancer living in India and Canada experience psychological morbidities which profoundly affect their role in their family and the wider community. Culturally congruent care, including accessible communication and information, may help prevent and alleviate distressing symptoms whether in India or in a migrant community.


Daniel, S., Clark, J., Gnanapragasam, S., Venkateswaran, C., & Johnson, M. J. (in press). Psychological concerns of Indian women with breast cancer in different national contexts: A systematic review and mixed-methods synthesis. BMJ supportive & palliative care,

Journal Article Type Review
Acceptance Date Apr 20, 2020
Online Publication Date May 11, 2020
Deposit Date Apr 23, 2020
Publicly Available Date May 11, 2020
Journal BMJ Supportive and Palliative Care
Print ISSN 2045-435X
Electronic ISSN 2045-4368
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Public URL
Publisher URL


You might also like

Downloadable Citations