Challenges of Multiple Role Performance and Coping Strategies in Iranian Women with Breast Cancer: A Phenomenological Study

Every day, most adults wear several hats. A person might be a parent, a partner, a worker, and a caregiver for aging parents all at once. These roles are not just titles; they are a constant stream of actions, from cooking dinner and helping with homework to managing a job and visiting relatives. For women, these responsibilities often overlap in a way that demands significant physical strength and mental focus. When a serious illness strikes, it does not just affect the body; it reaches into this complex web of daily duties. Breast cancer, a disease that forms tumors in breast tissue, is the most common cancer among women in Iran and a major health concern worldwide. While modern treatments have helped many women survive longer, living with the disease brings a new set of difficulties. The physical pain, the exhaustion from medication, and the time spent in hospitals can make it nearly impossible to keep up with the life they had before. Understanding how these women navigate this sudden shift is crucial, not just for medical care, but for understanding how people maintain their identities and relationships when their bodies are under siege.

A researcher in Dezful, Iran, set out to explore this exact struggle. They wanted to understand the specific challenges women face when trying to perform their daily roles while battling breast cancer, and how they manage to keep going. The study focused on twelve women, aged between 28 and 51, who were receiving treatment at a local medical center. These women had been diagnosed with breast cancer and were undergoing various treatments, including surgery, chemotherapy, and radiation. The researcher did not use surveys or checklists. Instead, they sat down with each woman for a conversation lasting between 30 and 50 minutes. They asked open questions, allowing the women to tell their stories in their own words about what it felt like to try to be a mother, a wife, or an employee while feeling sick. The researcher listened carefully, recorded the talks, and then analyzed the stories to find common themes in the women's experiences.

What emerged from these conversations was a picture of women caught in a difficult web. The primary challenge was a clash between their physical limitations and the expectations of their daily lives. Many women described a state of constant exhaustion. The treatment caused side effects like severe nausea, pain in their arms and shoulders, and an inability to sleep well. One woman explained that she could not lift her child or drive a car because her arm was swollen and painful. Another described feeling sleepy all day because she could not sleep at night. This physical struggle was compounded by a mental one. The women spoke of a "cognitive burden," a fog that made it hard to focus. They forgot where they put household items, missed details in conversations with their spouses, or made mistakes at work. The mental energy required to simply cope with the illness left little room for the attention needed to be a good parent or a reliable employee.

This clash created a phenomenon the researcher called "role interference." The women found that their different roles were competing for the same limited supply of energy and time. A mother might want to play with her child, but the fatigue from treatment meant she had no energy left. A worker might need to finish a task, but the pain in her body made it impossible to sit at a computer for long. The schedule of medical treatments also created unavoidable conflicts. A chemotherapy session might happen at the same time a child needed to be picked up from school, or a hospital appointment might clash with a family wedding. The women felt forced to choose between being a patient and being a mother, a wife, or a worker. In many cases, they had to withdraw from responsibilities entirely. Some stopped visiting relatives, missed family gatherings, or had to ask for time off work. Others postponed intimate moments with their partners because of pain or exhaustion. The result was a feeling of failure, not because they did not care, but because their bodies and minds could not keep up with the demands of their lives.

Despite these overwhelming obstacles, the women did not simply give up. The study revealed a powerful set of strategies they used to adapt and survive. They became resourceful managers of their own lives, finding ways to align their actions with their new physical reality. To overcome physical barriers, they used tools and changed their methods. Some used shopping carts to carry heavy loads instead of lifting bags. Others sat on stools while cooking or used robotic vacuums to clean the house. They adjusted how they interacted with their families, holding a child while sitting down rather than lifting them, or using pain medication before being intimate with a spouse to make the experience manageable. They also sought help from outside, hiring home services to cook and clean so they could rest.

Mentally, the women developed ways to cope with the fog in their heads. They wrote down tasks on calendars, used reminders on their phones, and asked their spouses to take over jobs that required intense focus. One woman, who used to work as a secretary, asked to be transferred to a job in the archives where she did not have to deal with clients, because she could no longer remember appointments. Another woman started selling goods online instead of running a physical shop, allowing her father to handle the shipping while she managed the business from home. These were not just small changes; they were fundamental shifts in how they approached their daily lives to preserve their ability to function.

The women also learned to be ruthless with their energy and time. They realized they could not do everything they used to do, so they prioritized. They broke big tasks into small steps and took short rests throughout the day instead of waiting until they were completely exhausted. They let go of non-essential activities, such as visiting a sister every day, and focused their energy on the most important roles, like caring for their children or their own recovery. They optimized their time by renting a house closer to the hospital to save travel time, or by using phone calls to stay in touch with friends instead of visiting in person. By coordinating with family members to share the load, they created a support system that allowed them to keep their core roles intact.

The study concludes that while these women face immense challenges in performing their daily roles, they are not passive victims of their illness. They actively learn how to live with these challenges, adapting their methods and managing their resources to preserve their place in their families and society. They do not simply endure; they strategize. The research highlights that the struggle is not just about the disease itself, but about the complex interplay between the physical and mental toll of treatment and the unyielding demands of daily life. The findings suggest that supporting these women requires more than just medical treatment; it involves understanding their need to maintain their roles and helping them find the practical ways to do so. The study was conducted in a single city with a small group of participants, so the results reflect the experiences of these specific women rather than a universal rule for all. However, their stories provide a clear and detailed look at the resilience required to navigate life with breast cancer, showing how ordinary people find extraordinary ways to keep their lives moving forward.