Background Breast cancer is the most common cancer in women globally. Its negative effects on a woman's quality of life are related to the individual and socio-cultural factors. This review aimed to identify and synthesise the reported experiences and quality of life of women with breast cancer in Arab countries. Methods PubMed, Embase, Web of Science, SCOPUS, PsychInfo, CINAHL, Allied and Complementary Medicine Database, and Index Medicus for the Eastern Mediterranean Region were searched for articles published from start to March 2019 using PRISMA guidelines. These searches were complimented by citation tracking and hand searching of relevant journals. A thematic synthesis was carried out on the 'findings/results' sections from the identified papers. Results Of 5228 records identified, 19 were included in the review which represented 401 women from 11 Arab countries. All used qualitative methods of data collection to produce rich descriptions of experiences. Thematic synthesis of the extracted data identified three major themes, Perceptions and reactions, Coping or enduring and Changing roles. Conclusions This review provides a rich description of the reported quality of life and experiences of women with breast cancer in Arab countries. These are influenced by the women's and society's views of cancer, the women's role in society and family, religious faith and the healthcare context and access to treatment choices and information.

Background:Palliative care has been successfully integrated into many Muslim-majority countries, most frequently in urbanised areas with developed health care systems. Less is known as to how the concept of palliative care is perceived by Muslim populations and health workers in rural, resource-limited contexts.Aim:This study seeks to explore whether the principles of palliative care are congruent with the perspectives of health professionals, families and communities in rural areas of the Islamic Republic of Mauritania, in West Africa.Design:A qualitative research design was employed underpinned by a constructionist paradigm. Data were collected through 31 interviews and 8 focus groups. Data were analysed using thematic analysis.Setting/participants:A total of 76 participants were recruited from across rural Mauritania; 33 health care professionals, 12 recently bereaved family members and 31 community leaders. Data collection occurred during training events in the capital and visits to villages and rural health posts.Results:Three major themes were identified. First, there is a perceived lack of congruency between an illness which limits life and the strong belief in destiny. The second theme describes the perceived barriers to communication of issues relating to palliative care. Finally, a good death is described, framed within the interplay of religious faith and cultural practices.Conclusion:The palliative care ethos is viewed positively by the majority of participants. The need to understand and respect a Muslim individual’s faith does not diminish our obligation to personalise palliative care provided for them and their family.

Case study research facilitates the in-depth, real-life exploration of complex phenomena from multiple perspectives. It is a well-established approach to deal with the complexities involved in palliative care research. Case studies are not aligned to a single epistemological paradigm but are defined by the identification of the case to be studied. This article examines the methodological issues of carrying out constructivist Stakian multi-case study research. It is based on the lessons learned from our case study exploring the experiences of advanced breast cancer in Mauritania, a resource-limited, Muslim majority context. Stake provides suggestions and boundaries for the case study researcher, but there is no blueprint available for a Stakian multi-case study. The researcher is encouraged to employ their creativity, intuition and ingenuity. We exercised this freedom by incorporating mixed methods of data collection within our constructivist paradigm. We resourcefully revisited the identity of the case and embedded mini-cases, we rejected traditional views of triangulation in favor of crystallization, and we employed assorted approaches to guide and enrich our within- and cross-case analyses to formulate overarching themes and multi-case assertions. Stakian case study should not be limited to constructivist researchers. We encourage any case study researchers to consider this approach, especially those who wish to employ their intuition and ingenuity to understand and describe experiences and phenomena.