Zhang Amy Y, Gary Faye, Zhu Hui
J Cancer Educ. 2015 Mar;30(1):138-44. doi: 10.1007/s13187-014-0704-0.
This study examined African-American cancer patients’ attitudes toward cancer and their relationship with long-term mental health outcomes. Using mixed methods, 74 breast and prostate cancer patients including 34 depressed and 23 nondepressed African-Americans and 17 depressed Whites were interviewed. The interviews were audiotaped and transcribed. Qualitative data analysis identified themes that were coded. The codes were entered into SPSS software. Fisher’s exact test was performed to examine group differences in the identified themes. Nondepressed African-Americans more frequently reported cancer as an adaptive experience (p = 0.047) and less frequently as a struggle (p = 0.012) than the depressed African-Americans and Whites. Groups did not significantly differ in the belief that cancer has no cure (p = 0.763), but depressed African-Americans more frequently reported unwillingness to share a cancer diagnosis with family or friends than depressed Whites (p = 0.50). African-Americans’ adaptive attitudes to cancer exhibit a pragmatist approach and a worldview shaped by their lived experience. Participants’ narratives were examined to illuminate the meanings of these findings. Adaptive attitudes to cancer are associated with better long-term mental health outcomes, and conversely, unpreparedness and inability to cope are associated with a higher risk of depression among African-American cancer patients. Education about cancer and supports for treatment navigation are important measures for improving the long-term mental health of African-Americans living with cancer.
本研究调查了非裔美国癌症患者对癌症的态度及其与长期心理健康结果的关系。采用混合方法，对74名乳腺癌和前列腺癌患者进行了访谈，其中包括34名抑郁的非裔美国人、23名非抑郁的非裔美国人以及17名抑郁的白人。访谈进行了录音和转录。对定性数据分析确定的主题进行编码。将编码输入SPSS软件。采用Fisher精确检验来检验所确定主题中的组间差异。与抑郁的非裔美国人和白人相比，非抑郁的非裔美国人更频繁地将癌症视为一种适应性经历（p = 0.047），而较少将其视为一种挣扎（p = 0.012）。在认为癌症无法治愈这一信念上，各组之间没有显著差异（p = 0.763），但抑郁的非裔美国人比抑郁的白人更频繁地表示不愿意与家人或朋友分享癌症诊断结果（p = 0.50）。非裔美国人对癌症的适应性态度表现出一种实用主义方法以及由其生活经历塑造的世界观。对参与者的叙述进行了审视，以阐明这些发现的意义。对癌症的适应性态度与更好的长期心理健康结果相关，相反，准备不足和无法应对与非裔美国癌症患者中更高的抑郁风险相关。关于癌症的教育以及对治疗导航的支持是改善患癌非裔美国人长期心理健康的重要措施。
