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

OBJECTIVE: 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. METHODS: 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. FINDINGS: 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. CONCLUSION: 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.