Wells Anjanette A, Gulbas Lauren, Sanders-Thompson Vetta, Shon En-Jung, Kreuter Matthew W
George Warren Brown School of Social Work, Washington University in St. Louis, 210 Brown Hall, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130-4899, USA,
J Cancer Educ. 2014 Dec;29(4):619-25. doi: 10.1007/s13187-013-0592-8.
Despite an overall decline in mortality, breast cancer is the most commonly diagnosed cancer and the second most common cause of cancer death among African-American women. As such, clinicians should prepare to address the unique sociocultural and psychological concerns encountered by African-American women breast cancer survivors. The objective of this study is to examine, using qualitative methods, the main coping facilitators used by African-American women as they transition across the cancer continuum. The identification of these facilitators was then aligned with culturally sensitive interventions most useful with women coping with cancer along the cancer continuum. This was a secondary analysis of 20 videotaped stories of African-American breast cancer survivors collected as a part of the Washington University Center for Excellence in Cancer Communications project. The interview began with a discussion of how the survivor first became aware she had breast cancer, followed by a series of open-ended probes used to explore the following themes: coping, relationships, health care system experiences, follow-up care, and quality of life living with breast cancer. Survivors discussed their experiences and advice for targeting needs at each cancer stage from screening to diagnosis, treatment, and then survivorship. Survivor narratives point to key evidence-based clinical intervention strategies at each stage of the cancer trajectory. This study found that survivors see a cyclical cancer course, whereby African-American breast cancer survivors serve an important role in the lives of unscreened women, newly diagnosed women, and women in treatment.
尽管死亡率总体呈下降趋势，但乳腺癌仍是最常被诊断出的癌症，也是非裔美国女性中第二大常见的癌症死亡原因。因此，临床医生应准备好应对非裔美国女性乳腺癌幸存者所面临的独特社会文化和心理问题。本研究的目的是采用定性方法，考察非裔美国女性在癌症连续过程中所使用的主要应对促进因素。然后，将这些促进因素的识别与对处于癌症连续过程中应对癌症的女性最有用的文化敏感干预措施相结合。这是对作为华盛顿大学癌症传播卓越中心项目一部分收集的20个非裔美国乳腺癌幸存者录像故事的二次分析。访谈首先讨论幸存者最初是如何意识到自己患有乳腺癌的，随后是一系列开放式探究，用于探索以下主题：应对、人际关系、医疗保健系统经历、后续护理以及乳腺癌患者的生活质量。幸存者们讨论了她们在从筛查到诊断、治疗，再到康复的每个癌症阶段的经历以及针对需求的建议。幸存者的叙述指出了癌症轨迹每个阶段基于关键证据的临床干预策略。本研究发现，幸存者看到了一个循环的癌症过程，即非裔美国乳腺癌幸存者在未接受筛查的女性、新诊断出的女性以及正在接受治疗的女性的生活中发挥着重要作用。
