Planteamiento del problema

In addition to working towards ―setting out goals‖ and ―recharging my battery‖, some participants paid attention to how Sanad contributed to better medical recovery. By comparing and contrasting women‘s responses before joining Sanad and after doing so, it was found that they became more accepting of their treatment plan and related interventions. This finding supports the idea of recovery as a medical transition from reluctance in the beginning of diagnosis to acceptance following joining Sanad. This transitional stage cannot be separated from the experience of ―learning from each other‖, as illuminated in the previous chapter, whereby participants shared knowledge and experience about addressing a certain health or complication issue. The analysis revealed that women in the beginning of their journey with breast cancer were largely reluctant to accept cancer treatment, in particular chemotherapy. Treatment itself was often associated with negative changes to the body and thus contributed to social stigma and ―labelling‖ (see chapter five).

Although it is acknowledged here that Sanad itself does not cure breast cancer, evidence from the interviews would seem to indicate that being a member has maximized women‘s willingness to become more accepting of the medical and nursing treatment regimens:

―....when I was diagnosed with this [breast cancer].... I refused even cannulation procedure... the chemotherapy was completely rejected.... I felt that I am dying and it is the end and no need for more suffering.... taking part in Sanad exposed me to a community where I was better understood and supported... many women told me about the side effects of medication and how to cope with them... we compared different types of cancer treatment and day by day I felt that I became more accepting of the [medical regime] of breast cancer... on some occasions I reminded medical staff about my previous lab results.... and investigations...‖. (R2, attended Sanad)

Interestingly, a further examination of data might suggest that being more accepting was associated with the intention to see other women in Sanad. In other words, some women

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in this study visit KHCC not only to get treatment but also to ―have a cup of tea‖ with other members, as elaborated below:

―...having breast cancer was such a disaster when I was diagnosed I refused any medical care.... meeting other women in Sanad encouraged me to stick to the treatment plan.... in fact sometimes I feel that I go to KHCC not only to get [medically] treated, but importantly to have a cup of tea with other women and update each other about many things in life, including the treatment itself.... so my visits have two goals... [laughing]‖. (R21, attended Sanad)

As part of data analysis, the idea of recovery ―from reluctance to acceptance‖ was supported by health care professionals who work closely with women with breast cancer. Based on their observations, health care professionals pointed out that many members of Sanad ―have changed‖ following their attendance at several meetings. The change involves becoming keener to know more about breast cancer treatment, committed to the medical appointment and more cooperative with nursing staff. In fact some health care professionals referred to Sanad as ―anti-resistance to the treatment‖ (i.e. a facilitating factor in treatment compliance):

―… I have been working with women with breast cancer for 12 years.... so I can see any changes in their behaviours.... Three women were very reluctant to have breast cancer treatment... they used to reject everything... Never came on time for their appointments.... after joining Sanad I felt that that they became more responsible and keen to gain information about each medical intervention.... Sanad was like anti-resistance to the treatment [laughing]‖. (Nurse 6)

Further analysis from health care professionals would seem to indicate that joining Sanad affected women‘s adherence to the treatment plan at their own homes. It should be noted that many women with breast cancer are accompanied by a number of their relatives when they visit KHCC. A health care professional reported that women‘s families have witnessed changes in Sanad member‘s behaviours in terms of paying more attention to their illness and its treatment:

―As you know… we get to know both patients and their families in KHCC…. many of them [families] keep in touch with us for advice and what to do in case of medical deterioration of their beloved ones. Many

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relatives told me that women with breast cancer [in Sanad] became more aware of their diagnosis and very careful in taking some medications at home. Others [Sanad members] bought timers so they would not miss an appointment‖ (Nurse 5)

Although running Sanad meetings is not free from pitfalls, as explored in the previous chapter (e.g. speech dominance), evidence would seem to demonstrate that taking part helped women cope better with the idea of breast cancer treatment. This finding is reinforced by data from health care professionals. It is worth noting that according to health care professionals, members of Sanad displayed information-seeking and behaviours that seemed to inform their compliance and recovery. It is interesting here to note that the impact of Sanad on women‘s medical recovery goes beyond KHCC to include serious commitments and adherence to the treatment plan at home.