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Urban voices: The quality-of-life experience among women of color with breast cancer

Published online by Cambridge University Press:  22 May 2007

ANNE M. FATONE ,
ALYSON B. MOADEL ,
FREDERICK W. FOLEY ,
MEGAN FLEMING  and
LINA JANDORF.
ANNE M. FATONE
Affiliation:
Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York
ALYSON B. MOADEL
Affiliation:
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
FREDERICK W. FOLEY
Affiliation:
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
MEGAN FLEMING
Affiliation:
Department of Psychiatry, Beth Israel Medical Center, New York, New York
LINA JANDORF.
Affiliation:
Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York
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Abstract

Objectives: Research on the health-related quality of life (HRQL) among women of color (i.e., Hispanics and African Americans) with breast cancer suggests that they may be at elevated risk for a variety of physical and psychosocial sequelae. The context in which these women perceive, experience, and respond to these HRQL challenges can provide important information for planning a culturally appropriate palliative care treatment plan.

Methods: In an effort to understand the quality of life experience after breast cancer among women of color, this study describes the nature and impact of physical, emotional, and menopausal symptoms among African American (n = 8) and Hispanic (n = 12) breast cancer survivors based on qualitative data gathered through semistructured interviews. Themes were identified and categorized into six HRQL domains: physical (e.g., pain, nausea), psychological (e.g., sadness, irritability), cognitive (e.g., memory problems), sexual (e.g., decreased desire), social/functional (e.g., financial strain, social distress), and spiritual/existential (e.g., increased faith, spiritual coping), with high interrater reliability (kappa = .81).

Results: For both groups, physical issues had a major impact on HRQL, with psychological issues being additionally salient for Hispanic women. Most (88%) African American women voiced positive changes in their faith after diagnosis whereas 50% of Hispanic women viewed faith as an important way of coping with breast cancer.

Significance of results: This research broadens our understanding of the experience of breast cancer among ethnic minority women, and in turn, offers some key directions for guiding the development of culturally tailored HRQL interventions.

Keywords

Breast cancerQuality of lifeEthnic minoritiesQualitative research
Type
Research Article
Information
Palliative & Supportive Care , Volume 5 , Issue 2 , June 2007 , pp. 115 - 125
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Adler, S.R., McGraw, S.A., & McKinlay, J.B. (1998). Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly. Journal of Aging Studies, 12, 331–350.Google Scholar
Allison, K.R. & Yoshida, K.K. (1989). Increasing response rates in community health surveys administered by telephone. Canadian Journal of Public Health, 80, 67–70.Google Scholar
American Cancer Society. (2003). Cancer Facts & Figures for Hispanics/Latinos 2003–2005. Atlanta: American Cancer Society.
American Cancer Society. (2005a). Breast Cancer: Facts and Figures 2005–2006. Atlanta: American Cancer Society.
American Cancer Society. (2005b). Cancer Facts & Figures for African Americans 2005–2006. Atlanta: American Cancer Society.
American Cancer Society. (2006). Cancer Facts and Figures 2006. Atlanta: American Cancer Society.
Andrykowski, M.A., Curran, S.L., Studts, J.L., et al. (1996). Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: A controlled comparison. Journal of Clinical Epidemiology, 49, 827–834.Google Scholar
Ashing-Giwa, K. (1999). Quality of life and psychosocial outcomes in long-term survivors of breast cancer: A focus on African American women. Journal of Psychosocial Oncology, 17, 47–62.Google Scholar
Ashing-Giwa, K. & Ganz, P.A. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15, 19–35.Google Scholar
Ashing-Giwa, K., Ganz, P., & Petersen, L. (1999). Quality of life in African American and White long-term breast cancer survivors. Cancer, 85, 418–426.Google Scholar
Ashing-Giwa, K.T., Padilla, G., Tejero, J., et al. (2004). Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psycho-Oncology, 13, 408–428.Google Scholar
Aziz, N.M. & Rowland, J.H. (2002). Cancer survivorship research among ethnic minority and medically underserved groups. Oncology Nursing Forum, 29, 789–801.Google Scholar
Baker, F., Denniston, M., Smith, T., et al. (2005). Adult cancer survivors: How are they faring? Cancer, 104(Suppl. 11), 2565–2576.Google Scholar
Bauman, L.J. (1993). Collecting data by telephone interviewing. Developmental and Behavioral Pediatrics, 14, 256–257.Google Scholar
Bourjolly, J.N., Kerson, T.S., & Nuamah, I.F. (1999). A comparison of social functioning among black women with breast cancer. Social Work in Health Care, 28, 1–20.Google Scholar
Breitbart, W., Gibson, C., Poppito, S.R., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49, 366–372.Google Scholar
Canales, S., Ganz, P.A., & Coscarelli, C.A. (1995). Translation and validation of a quality of life instrument for Hispanic American cancer patients: Methodological considerations. Quality of Life Research, 4, 3–11.Google Scholar
Carpenter, J.S. (1998). Hot flashes in post-menopausal women treated for breast cancer. Cancer, 82, 1682–1691.Google Scholar
Carver, C., Opzo-Kaderman, C., Price, A., et al. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60, 168–174.Google Scholar
Cella, D. (1998). Quality of life. In Psycho-oncology, Holland, J.C. (ed.), pp. 1135–1146. New York: Oxford University Press.
Chen, P.Y. (1996). Conducting telephone surveys. In The Psychology Research Handbook: A Guide for Graduate Students and Research Assistants, Leong, F.T.L. & Austin, J.T. (eds.). Thousand Oaks, CA: Sage Publications.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–48.Google Scholar
Crandall, C., Petersen, L., Ganz, P.A., et al. (2004). Association of breast cancer and its therapy with menopause-related symptoms. Menopause, 11, 519–530.Google Scholar
Culver, J.L., Arena, P.L., & Wimberly, S.R. (2004). Coping among African American, Hispanic, and Non-Hispanic White women recently treated for early stage breast cancer. Psychology and Health, 19, 157–166.Google Scholar
Eversley, R., Estrin, D., Dibble, S., et al. (2005). Post-treatment symptoms among ethnic minority breast cancer survivors. Oncology Nursing Forum, 32, 250–256.Google Scholar
Facione, N.C. & Giancarlo, C.A. (1998). Narratives of breast symptom discovery and cancer diagnosis: Psychological risk for advanced cancer at diagnosis. Cancer Nursing, 21, 430–440.Google Scholar
Farmer, B.J. & Smith, E.D. (2002). Breast cancer survivorship: Are African American women considered? A concept analysis. Oncology Nursing Forum, 29, 779–787.Google Scholar
Ferrell, B., Grant, M., Funk, B., et al. (1997). Quality of life in breast cancer survivors as identified by focus groups. Psycho-Oncology, 6, 13–23.Google Scholar
Freeman, H.P. & Wasfie, T.J. (1989). Cancer of the breast in poor Black women. Cancer, 63, 2562–2569.Google Scholar
Frey, J.G. (1989). Survey Research by Telephone (2nd ed.). Newbury Park, CA: Sage Publications.
Ganz, P.A., Guadagnoli, E., Landrum, M.B., et al. (2003). Breast cancer in older women: Quality life and psychosocial adjustment in the 15 months after diagnosis. Journal of Clinical Oncology, 21, 4027–4033.Google Scholar
Ganz, P.A., Rowland, J.H., Desmond, K., et al. (1998). Life after breast cancer: Understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16, 501–514.Google Scholar
Gilchrist, V. (1993). Key informant interviews. In Doing Qualitative Research, Crabtree, B. & Miller, W. (eds.), pp. 70–89. Newbury Park, CA: Sage Publications.
Glaus, A., Boehme, C., Thurlimann, B., et al. (2006). Fatigue and menopausal symptoms in women with breast cancer undergoing hormonal cancer treatment. Annals of Oncology, 17, 801–806.Google Scholar
Gotay, C., Holup, J.L., & Pagano, I. (2002). Ethnic differences in quality of life among early breast and prostate cancer survivors. Psycho-Oncology, 11, 103–113.Google Scholar
Gupta, P., Sturdee, D.W., Palin, S.L., et al. (2006). Menopausal symptoms in women treated for breast cancer: The prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric, 9, 49–58.Google Scholar
Howe, H.L., Wingo, P.A., Thun, M.J., et al. (2001). Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. Journal of the National Cancer Institute, 93, 824–842.Google Scholar
Hughes, M. & Thomas, M. (1998). The continuing significance of race revisited: A study of race, class, and quality of life in America, 1972 to 1996. American Sociological Review, 63, 785–795.Google Scholar
King, M.T., Kenny, P., Shiell, A., et al. (2000). Quality of life three months and one year after first treatment for early stage breast cancer: Influence of treatment and patient characteristics. Quality of Life Research, 9, 789–800.Google Scholar
Kissane, D.W., Clarke, D., Ikin, J., et al. (1998). Psychological morbidity and quality of life in Australian women with early-stage breast cancer: A cross-sectional survey. Medical Journal of Australia, 169, 192–196.Google Scholar
Lopez, E.D.S., Eng, E., Randall-David, E., et al. (2005). Quality-of-life concerns of African American breast cancer survivors within rural North Carolina: Blending the techniques of photovoice and grounded theory. Quality of Health Research, 15, 99–115.Google Scholar
Marin, G., Vanoss, B., & Perez-Stable, E. (1990). Feasibility of a telephone survey to study a minority community: Hispanics in San Francisco. American Journal of Public Health, 80, 323–326.Google Scholar
Mathews, H., Lannin, D., & Mitchell, J. (1994). Coming to terms with advanced breast cancer: Black women's narratives from eastern North Carolina. Social Science and Medicine, 38, 789–800.Google Scholar
Meyerowitz, B., Desmond, K., Rowland, J., et al. (1999). Sexuality following breast cancer. Journal of Sex & Marital Therapy, 25, 37–250.Google Scholar
Mickley, J. & Soeken, K. (1993). Religiousness and hope in Hispanic- and Angle-American women with breast cancer. Oncology Nursing Forum, 20, 1171–1177.Google Scholar
Moadel, A., Morgan, C., & Dutcher, J. (2007). Psychosocial needs assessment among an underserved, ethnically diverse cancer patient population. Cancer, 109(2 Suppl.), 446–454.Google Scholar
Moadel, A., Morgan, C., Fatone, A., et al. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psycho-Oncology, 8, 378–385.Google Scholar
Moadel, A.B., Ostroff, J.S., Lesko, L.M., et al. (1995). Psychosexual adjustment among women receiving hormone replacement therapy for premature menopause following cancer treatment. Psycho-Oncology, 4, 273–282.Google Scholar
Moadel, A., Paul, D., Sparano, J., et al. (2005). Evaluation of a Spiritual-Existential vs. Psycho-Educational Intervention for Underserved, Advanced-Stage Cancer Patients. Presented at the American Cancer Society's conference on Exploring Models to Eliminate Cancer Disparities among African American and Latino Populations, Atlanta, GA.
Moadel, A., Perez, A., Gharraee, Z., et al. (2002a). Examining quality of life after breast cancer: Cultural, treatment, and menstrual factors. Psychosomatic Medicine, 64, 106 (Abstract).Google Scholar
Moadel, A., Perez, A., & Sparano, J. (2002b). Quality of Life among Underserved Breast Cancer Patients: A Case/Control Study. Presentation at the 38th Annual Meeting of the American Society of Clinical Oncology, Orlando, FL.
Mols, F., Vingerhoets, A.J.J.M., Coebergh, J.W., et al. (2005). Quality of life among long-term breast cancer survivors: A systematic review. European Journal of Cancer, 41, 2613–2619.Google Scholar
Moore, R.J. (2001). African American women and breast cancer: Notes from a study of narrative. Cancer Nursing, 24, 35–42.Google Scholar
Moyer, A. & Salovey, P. (1996). Psychosocial sequelae of breast cancer and its treatments. Annals of Behavioral Medicine, 18, 10–125.Google Scholar
Naranjo, L. & Dirksen, S. (1998). The recruitment and participation of Hispanic women in nursing research: A learning process. Public Health Nursing, 15, 25–29.Google Scholar
Oppenheim, A.N. (1992). Questionnaire Design, Interviewing and Attitude Measurement. London: Pinter.
Rodrigue, J.R. (1997). An examination of race differences in patients' psychological adjustment to cancer. Journal of Clinical Psychology in Medical Settings, 4, 271–280.Google Scholar
Schover, L.R. (1994). Sexuality and body image in younger women with breast cancer. Journal of the National Cancer Institute Monographs, 16, 177–197.Google Scholar
Scudds, R. & Pederson, L. (1996). Phone, paper and pencil, in person: Methods of data collection for the '90s. American Journal of Health Behavior, 20, 443–447.Google Scholar
Spencer, S.M., Lehman, J.M., Wynings, C., et al. (1999). Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. Health Psychology, 18, 159–168.Google Scholar
U.S. Bureau of the Census. (2000). 2000 Summary File. Available at: http://factfinder/census.gov.
Vacek, P.M., Winstead-Frye, P., Secker-Walker, R.H., et al. (2003). Factors influencing quality of life in breast cancer survivors. Quality of Life Research, 12, 527–537.Google Scholar
Wan, G., Counte, M., Cella, D., et al. (1999). The impact of socio-cultural and clinical factors on health-related quality of life reports among Hispanic and African American cancer patients. Journal of Outcome Measurement, 3, 200–215.Google Scholar
Warnecke, R.B., Ferrans, C.E., Johnson, T., et al. (1996). Measuring quality of life in culturally diverse populations. Journal of the National Cancer Institute Monographs, 20, 30–38.Google Scholar
Waxler-Morrison, N., Doll, R., & Hislop, T. (1995). The Use of Qualitative Methods to Strengthen Psychosocial Resource Variables in Cancer Studies. New York: The Haworth Medical Press.
Wilmoth, M.C. & Sanders, L.D. (2001). Accept me for myself: African American women's issues after breast cancer. Oncology Nursing Form, 28, 875–879.Google Scholar
Wyatt, G.E., Desmond, K.A., Ganz, P.A., et al. (1998). Sexual functioning and intimacy in African American and White breast cancer survivors: A descriptive study. Women's Health: Research on Gender, Behavior, and Policy, 4, 385–405.Google Scholar