Barriers and facilitators for weight management interventions in breast cancer patients: a systematic review of qualitative studies

Introduction: This systematic review and meta-synthesis of qualitative studies provides an overview of barriers and facilitators that breast cancer patients experience in weight management interventions. Methods: We included qualitative studies describing barriers and facilitators for weight management interventions as experienced by adult breast cancer patients after the completion of initial treatment. The data was extracted and using thematic analysis. Results: After analysis, eleven themes were determined. Six of those themes could be linked to the Attitude, Social Influence and self Efficacy (ASE)-model. Physical and mental benefits, anticipated regret and a lack of motivation were linked to attitude. Integrating a weight management programme in daily life, stigma and fears were linked to self-efficacy. With regard to the social influence determinant, encouragement and discouragement by family members were developed as a theme. Four additional themes were conducted related to weight management behaviour; external barriers, economic barriers, cultural barriers and physical barriers. In addition, integrating weight management in cancer care was described as a separate theme. Conclusions: Several disease specific issues, including feeling stigmatized after cancer treatment and treatment-related side effects and peer-support should be given specific attention to maximize adherence of weight management programmes.