Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53205, USA.
Division of Research, Patient Care Services, Stanford Healthcare, Palo Alto, CA 94304, USA.
Int J Environ Res Public Health. 2022 Oct 6;19(19):12807. doi: 10.3390/ijerph191912807.
(1) Background: African American women breast cancer survivors face unique experiences that impact their quality of life as they transition beyond treatments. Experiences may be complicated by living at the intersection of systemically oppressed identities, including gender, race, social class, and cancer-related disability. Using the Black Feminist Thought (BFT) framework and the PEN-3 cultural model, this qualitative study sought to: (a) understand African American women breast cancer survivors' lived experiences; (b) examine how the multiple intersecting factors of race, gender, social class/socioeconomic status, and cancer-related disability impact their quality of life; and (c) inform future health promotion programming that is culturally relevant to AAWBCS to improve their quality of life. (2) Methods: Seven focus groups were conducted with 30 African American breast cancer survivors in a Midwestern metropolitan region. Focus groups were audiotaped and transcribed verbatim. Framework analyses were conducted to identify themes with NVivo qualitative analysis software. (3) Results: Four themes emerged: (a) caregiving roles provide both support and challenges for survivors, (b) the "strong Black woman" is inherent in survivor experiences, (c) intersectionality impacts survivorship, and (d) African American women resist oppression through culturally specific supports and advocacy. (4) Conclusions: The intervention point of entry should be at the peer support group level and centered on family and provide community-based support and services. Future research should move upstream to address social determinants of health, including racism, sexism, and ableism; there is a critical need to discuss how structural racism affects health care and develop interventions to address racial discrimination and racial bias in health care.
（1）背景：非裔美国女性乳腺癌幸存者在治疗结束后会面临独特的经历，这些经历会影响她们的生活质量。这些经历可能会因同时存在性别、种族、社会阶层和与癌症相关的残疾等系统性压迫身份而变得复杂。本研究采用黑人女权主义思想（BFT）框架和 PEN-3 文化模型，旨在：（a）了解非裔美国女性乳腺癌幸存者的生活经历；（b）研究种族、性别、社会阶层/社会经济地位和与癌症相关的残疾等多种交叉因素如何影响她们的生活质量；（c）为提高 AAWBCS 的生活质量，提供对非裔美国女性乳腺癌幸存者具有文化相关性的未来健康促进计划。（2）方法：在中西部大都市区，对 30 名非裔美国乳腺癌幸存者进行了 7 次焦点小组讨论。焦点小组进行了录音和逐字记录。使用 NVivo 定性分析软件对框架分析进行了分析，以确定主题。（3）结果：出现了四个主题：（a）照顾角色为幸存者提供了支持和挑战；（b）“坚强的黑人女性”是幸存者经历的固有特征；（c）交叉性影响生存；（d）非裔美国女性通过特定的文化支持和倡导来抵制压迫。（4）结论：干预的切入点应该在同伴支持小组层面，并以家庭为中心，提供社区支持和服务。未来的研究应该从解决健康的社会决定因素入手，包括种族主义、性别歧视和能力歧视；需要认真讨论结构性种族主义如何影响医疗保健，并制定干预措施，以解决医疗保健中的种族歧视和种族偏见问题。
