White-Means Shelley, Rice Muriel, Dapremont Jill, Davis Barbara, Martin Judy
Department of Clinical Pharmacy, University of Tennessee Health Science Center, 881 Madison, Suite 202, Memphis, TN 38163, USA.
Mustard Seed, Inc., 653 Mississippi Blvd, Memphis, TN 38126, USA.
Int J Environ Res Public Health. 2015 Dec 22;13(1):ijerph13010006. doi: 10.3390/ijerph13010006.
Among the country's 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis.
在该国25个最大的城市中,田纳西州孟菲斯市的乳腺癌死亡率差距最大,非裔美国女性死于乳腺癌的可能性是白人女性的两倍。这项对非裔美国乳腺癌幸存者的定性研究探讨了她们在治疗期间及治疗后的经历,这些经历帮助她们战胜了高死亡率的困境。2012年,研究人员使用半结构化访谈指南,与10名乳腺癌幸存者进行了一次焦点小组访谈。研究采用主题分析和演绎性先验编码模板对数据进行分析。研究确定了五个主要主题:家族病史、乳房/身体意识以及应对乳腺癌事件的准备情况、诊断经历及对诊断的反应、家人的反应以及对生活的影响。祈祷和家庭支持是应对的核心,幸存者表示在文化上接受健康结果方面的种族差异。她们报告称,医护人员对疼痛缺乏敏感度、存在经济困难、家人/朋友有负面反应,以及应对身体和心理限制的恢复策略。我们的研究表明,以患者为中心的消除乳腺癌神秘感的方法(无论是在医患沟通还是在社区环境中)将影响女性应对乳腺癌的方式以及对其诊断信息的反应。