Table 5 Physical and Practical needs; categories identified and related quotes from the experts’ perception of the supportive care needs of women with advanced breast cancer

Physical needs

Physical comfort

Symptoms relief

They go through a lot of pain…and loss of appetite…weight lost…nausea…these are some of the side effects of the treatment. (Expert 01)

Fatigue is a side effect of the treatment, so they go through that. Lymphedema is also one of them because here they present with an advanced disease. (Expert 02)

They also experience darken skin and then alopecia. (Expert 03)

They have a wound…they have fungating breast…the odour is bad. (Expert 04)

The acute side effects [include] vomiting sometimes even bleeding, [and] diarrhoea. (Expert 08)

1

Relief of side effects/complications

So, what happens is that before we start treatment, we counsel the patients. We tell them what will happen to them…once we tell them the side effects of the treatments, we also explain to them how to manage it at home. (Expert 04)

2

Comprehensive treatment preparation

I don’t think they are given any proper preparation…I went to a particular ward [site] and most of them didn’t even know much about the condition. So, I don’t think that it is properly done. (Expert 11)

3

Physical support

Nutritional support

Other physical needs [that] you can think about is maybe how well nourish[ed] they are. I mean, that has to do with nutrition and that borders on counselling, and then maybe bringing in the nutritionist, because often they live under the impression certain foods can even cause cancer.” (Expert 09)

4

Exercise advice

And for some of them, like the postmenopausal women, or for some of the drugs it can make their bones lighter and more liable to fracture. So there too we need to advise some kind of exercise, [though] not [a] very vigorous one. (Expert 09)

5

Practical needs

Practical support

Assistance with usual daily tasks

Functionality, you know breast cancer usually comes with lymphedema and the fore limb at the side of where the cancerous lesion is it’s usually affected and definitely cannot be used for daily activities, washing, and they become fatigued…also anaemia. It brings down their functionality, they are not able to function as before.” (Expert 05)

6

Financial assistance

It has a great impact on their finances, seriously, because the treatment is not free even though the government pays for some of the treatment, it’s still not free. It’s very expensive. It is three years down we don’t have most of the drugs coming in, okay. So, they have to go out and buy [them] and sometimes they skip their treatment because they don’t have money to buy [them]. So, it’s a big toll on their finances. Sometimes they have to depend on friends, families to donate. Sometimes [they have to go] to the extent of selling their properties. (Expert 06)

7

Employment assistance

For those who are in government, and civil and public, they don’t have issues with employment, but those who are working in private firms and their own jobs and [as] entrepreneurs, they have issues with the employment. The entrepreneurs, they just leave their job and come, but then the job is also suffering…the money that she is using to purchase the drugs is coming from that same job. (Expert 04)

8

Accompaniment to appointments

I think most of them they need the support of the family, they want their relatives to be around. That is the practical needs. So, they want their family members to follow them to the hospital, they want if they are married, they want their husbands to be supportive that is what they want (Expert 03)

9

Childcare support

Especially for the ones, the young breast cancer patients who have kids, young kids. I mean some have toddlers and infants and those things, mm-hmm so they need to I mean care for those kids. And sometimes it’s difficult for them so they need help (Expert 04)

10

Accommodation support

Those who come from outside Kumasi who have to travel some distance, in the first place they don’t even have money for their treatment, let alone money to rent an apartment or get a decent sleeping place, they come and have to sleep at the open space…So, these women need a place to stay. (Expert 06)

11