A qualitative study on the mismatch between health literacy and nursing needs in the postoperative recovery of breast cancer: nurse and survivor perspectives

This study aimed to explore the mismatch between health literacy and care needs at various stages from the perspectives of both breast cancer survivors (BCS) and nurses. This descriptive study utilized purposive sampling to conduct semi-structured in-depth interviews with postoperative BCS and nurses at a hospital in Henan, China, from April to August 2025. Data processing was executed using NVivo 12 software, and content analysis was employed for data analysis. A total of 25 BCS and 9 nurses participated in the study. Four themes and sixteen sub-themes were identified from the analysis: (1) discharge transition period: construction of safety nets and perceived gaps, (2) treatment and rehabilitation period: the “compliance” dilemma and the absence of empowerment, (3) navigating the transitional teachable moment: the support vacuum from clinical outcomes to life’s new beginnings, (4) the cross-cutting nexus: communication and interaction. Discrepancies exist between BCS and nurses regarding health literacy perceptions and care needs across different survivorship phases. Addressing these gaps requires establishing a new model that integrates dynamic health literacy assessment, relational communication, collaborative rehabilitation planning, and systematic support.