Vivências de mulheres com câncer de mama: como o luto não reconhecido pode influenciar a jornada

Abstract

Breast cancer represents a major public health challenge due to its high incidence and the physical, emotional, and social consequences associated with the disease. Among these consequences are symbolic losses that are often overlooked and may be understood as manifestations of disenfranchised grief. This study aimed to explore the experiences of possible disenfranchised grief among women with breast cancer, characterize their experiences throughout the illness trajectory, and develop a support and care manual for patients, their support networks, and healthcare professionals. This qualitative, exploratory, and descriptive study was conducted with six women diagnosed with breast cancer. Data were collected through semi-structured interviews and analyzed using a categorization table to facilitate the organization of interview excerpts into thematic categories. The analytical process was carried out in three main stages: exploratory, selective, and analytical reading. The findings were organized into six categories: (1) Diagnosis and treatment: experiences of finitude; (2) Relationships throughout the illness process: between support and loneliness; (3) Body transformations: self-esteem, self-care, and femininity; (4) Suffering and the silencing of pain; (5) Disenfranchised grief and losses associated with illness; and (6) Life perspectives and hope for the future. The analyses revealed that diagnosis and treatment trigger losses related to body image, femininity, self-esteem, autonomy, life projects, social roles, and interpersonal relationships. Because these losses are often neither recognized nor socially validated, they contribute to the silencing of suffering and hinder its psychological processing. Protective factors were also identified, including family support, spirituality, affective bonds, and the reframing of the illness experience, all of which promoted adaptation and personal growth. It is concluded that recognizing disenfranchised grief broadens the nderstanding of the psychosocial impacts of breast cancer and highlights the need for psycho-oncology interventions that address not only biomedical aspects but also the subjective dimensions of suffering. [resumo fornecido pelo autor]