Supportive Care Needs and Patient Preferences Across the Treatment Journey Among Women with Stage III–IV Breast Cancer in Urban and Rural Tasikmalaya, Indonesia: A Qualitative Study

Purpose: To explore supportive care needs and patient preferences among women with stage III-IV breast cancer across the entire treatment journey, specifically examining how the urban-rural context shapes these experiences in Tasikmalaya, Indonesia. Patients and Methods: This qualitative study recruited 10 women with stage III-IV breast cancer receiving routine care (chemotherapy, hormonal therapy, and/or follow-up) at Jasa Kartini Hospital, Tasikmalaya. Participants were purposively sampled. Data were collected through semi-structured in-depth interviews (audio-recorded) and field notes. Reflexive thematic analysis was conducted following Braun and Clarke. Reporting was guided by the COREQ checklist. Results: Participants experienced treatment delays ranging from 1 to 6 years. Five key findings regarding supportive care needs and preferences were identified: (1) a critical need for credible education to address chemotherapy fears and health-system confusion; (2) a strong preference for psychosocial support through family accompaniment and peer-survivor networks; (3) a reliance on spiritual support (e.g. prayer and dhikr) for hope and acceptance; (4) urgent practical and non-medical financial needs (transport and logistics) that persist despite national insurance coverage; and (5) a dynamic shift in psychological experiences, moving from early distress toward death preparedness and acceptance. Conclusion: Supportive care needs among women with advanced breast cancer are dynamic and significantly moderated by the urban-rural divide, which creates distinct logistical and non-medical economic hurdles even under universal health coverage. Oncology nursing practice should transition toward phase-sensitive care models that prioritize patient navigation to address "hidden" financial burdens and integrate culturally sensitive spiritual support to enhance patient resilience and treatment continuity throughout the complex illness trajectory.