Abstract
AIM: To explore the role of repaying kindness (bào'ēn), a culturally embedded coping mechanism, in the recovery of breast cancer survivors in China and its implications for culturally sensitive nursing care. DESIGN: A qualitative study employing thematic analysis to examine survivors' experiences and coping strategies. METHODS: In-depth interviews were conducted with Chinese breast cancer survivors to investigate how acts of reciprocity influenced their identity, relationships, and emotional well-being. Thematic analysis was applied to identify key patterns in their recovery journey. RESULTS: Repaying kindness enabled survivors to restore disrupted familial roles, uphold cultural values such as filial piety, and regain a sense of control post-diagnosis. This fostered a renewed sense of purpose, strengthened family bonds, reduced stigma, and promoted psychological resilience, facilitating identity reconstruction and enhanced social connectedness. These findings highlight the importance of reciprocity and relational harmony as transformative coping strategies in cancer survivorship. A culturally informed understanding of recovery suggests that integrating reciprocal caregiving and family dynamics into survivorship care can empower patients, enhance resilience, and promote culturally competent nursing practices in collectivist societies. PATIENT OR PUBLIC CONTRIBUTION: Breast cancer survivors contributed to this study by sharing their lived experiences, providing insights into the role of repaying kindness in their recovery. Their narratives helped shape the analysis and ensured the findings reflect the realities of coping and resilience in the Chinese cultural context.