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Senger AR, G Ratcliff C, K Semelsberger R, Chaoul A, Cohen L. The Role of Coping and Posttraumatic Stress in Fostering Posttraumatic Growth and Quality of Life Among Women with Breast Cancer. J Clin Psychol Med Settings 2024; 31:368-378. [PMID: 37803095 DOI: 10.1007/s10880-023-09977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/08/2023]
Abstract
Tedeschi & Calhoun's model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as "active" or "avoidant," and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect = .46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = - .06, 95% CI (- .16, - .003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer.
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Affiliation(s)
| | - Chelsea G Ratcliff
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA.
- Baylor College of Medicine, Houston, TX, USA.
| | - Robin K Semelsberger
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA
| | | | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Cherniak AD, Pirutinsky S, Rosmarin DH. Religious Beliefs, Trust In Public Figures, And Adherence to COVID-19 Health Guidelines among American Orthodox and Non-Orthodox Jews. JOURNAL OF RELIGION AND HEALTH 2023; 62:355-372. [PMID: 36517731 PMCID: PMC9750045 DOI: 10.1007/s10943-022-01718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic and resultant health crisis highlighted the lack of scholarly understanding of the effects of sociocultural factors and religious beliefs on compliance with public health guidelines. Orthodox Jews in particular were suspected of mistrusting medical experts and were singled out for alleged non-compliance with COVID-19 health guidelines. We surveyed American Jews (N = 1,141) during the early stages of the pandemic about their religious beliefs connected with the pandemic, trust in relevant public figures, and compliance with health guidelines to examine whether and how these factors are related. Generally, participants expressed high levels of trust in scientists, medical professionals, and religious leaders and a high degree of adherence to health guidelines. We examined how trust varies as a function of sociodemographic features, religious affiliation, and health-related religious beliefs (i.e., spiritual health locus of control). Overall, our research underscores the relevance of religious beliefs and trust in public figures to adherence to health guidelines and public health messaging.
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Saeed S, Asim M, Sohail MM. Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan. BMC WOMENS HEALTH 2021; 21:151. [PMID: 33853583 PMCID: PMC8045297 DOI: 10.1186/s12905-021-01293-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Background Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment. Methods In this process 45 women (age = 18–50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan. Results An inductive approach was used to analyze the data which resulted in the emergence of eight subthemes under the umbrella of three major themes that delineate individual, socio-cultural and structural barriers to seek screening and treatment of breast cancer in Punjab. Individual barriers included lack of awareness, hesitance in accepting social support, and spiritual healing. The identified socio-cultural factors included feminine sensitivity, stigmatization, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hinder screening and treatment. Conclusions These barriers can be addressed through raising awareness and community mobilization about breast-self exam and treatment. The healthcare system should also pay attention to socio-psychological and cultural factors impeding women's access to available health facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01293-6.
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Affiliation(s)
- Sidra Saeed
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | - Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.
| | - Malik Muhammad Sohail
- Department of Sociology, Institute of Arts and Sciences, Government College University Faisalabad, Chiniot Campus, Chiniot, Pakistan
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Depression, anxiety and quality of life among women living with breast cancer in Ghana: mediating roles of social support and religiosity. Support Care Cancer 2019; 28:2581-2588. [DOI: 10.1007/s00520-019-05027-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022]
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5
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Yan AF, Stevens P, Holt C, Walker A, Ng A, McManus P, Basen-Enguist K, Weinhardt LS, Underwood SM, Asan O, Wang MQ. Culture, identity, strength and spirituality: A qualitative study to understand experiences of African American women breast cancer survivors and recommendations for intervention development. Eur J Cancer Care (Engl) 2019; 28:e13013. [PMID: 30761637 DOI: 10.1111/ecc.13013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Despite advancements in cancer treatment, racial disparities in breast cancer survival persist, with African American women experiencing lower survival rates and poorer quality of life than non-Hispanic White women. Using a social cognitive model of restorative well-being as a framework, this qualitative study sought: (a) to examine strength- and culture-related factors associated with African American female breast cancer survivors' cancer coping and post-treatment experiences and (b) to make recommendations for culturally sensitive intervention. METHODS Eight focus groups occurred with a total of 40 local African American breast cancer survivors. Focus groups were audiotaped and transcribed verbatim. Framework analyses were used to identify themes. NVivo qualitative analysis software-managed data. RESULTS Two major themes emerged from the focus group discussions: (a) God enables breast cancer survivorship and works every day in our lives and (b) the healthiest thing about us is that we are strong African American women. Recommendations for intervention planning and implementation were made towards intervention structure, content development and language framing in a local context. CONCLUSION Findings suggest a need for community-based participatory survivorship interventions that are culturally and spiritually consonant and peer-based. Such interventions may respond to the cancer-related and personal needs of the target population.
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Affiliation(s)
- Alice F Yan
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Patricia Stevens
- Professor Emerita, College of Nursing, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Cheryl Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, Maryland
| | - Alonzo Walker
- Cancer Center, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alexander Ng
- Exercise Science Program, College of Health Sciences, Marquette University, Milwaukee, Wisconsin
| | | | - Karen Basen-Enguist
- Department of Behavioral Science, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lance S Weinhardt
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Sandra M Underwood
- College of Nursing, University of Wisconsin Milwaukee, Milwaukee, Wisconsin
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey
| | - Min Qi Wang
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, Maryland
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van Muijen P, Schellart AJM, Duijts SFA, van der Beek AJ. The mediating role of coping between self-reported health complaints and functional limitations, self-assessed work ability and work status of long-term sick-listed cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12928. [PMID: 30273988 DOI: 10.1111/ecc.12928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 01/14/2018] [Accepted: 08/22/2018] [Indexed: 12/26/2022]
Abstract
Our purpose was to investigate the possible mediating role of active coping and passive coping between self-reported health complaints and functional limitations, as assessed by an insurance physician (IP), self-assessed work ability and work status in cancer survivors on long-term sick leave. Validated questionnaires were used for self-reported health complaints, work ability and work status. The functional limitations of the respondents were transformed into scales for mental and physical limitations and limitations in working hours. Using LISREL, we constructed a model with coping in a mediating role. Active coping mediated between fewer self-reported physical limitations, more depressive symptoms, better cognitive functioning and more fatigue on the one hand, and more physical limitations and limitations in working hours on the other hand. Passive coping played no mediating role and was associated with more self-reported depressive symptoms only. More functional limitations were associated with lower self-assessed work ability of cancer survivors, and with not being at work, whereas higher self-assessed work ability was associated with being at work. Regarding the role of active and passive coping strategies in cancer survivors on long-term sick leave, more longitudinal research is needed to confirm causality.
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Affiliation(s)
- Peter van Muijen
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Dutch Institute for Employee Benefits Schemes (UWV), Amsterdam, The Netherlands.,Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Antonius J M Schellart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Dutch Institute for Employee Benefits Schemes (UWV), Amsterdam, The Netherlands.,Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
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Hansra DM, McIntyre K, Ramdial J, Sacks S, Patrick CS, Cutler J, McIntyre B, Feister K, Miller M, Taylor AK, Farooq F, de Mayolo JA, Ahn E. Evaluation of How Integrative Oncology Services Are Valued between Hematology/Oncology Patients and Hematologists/Oncologists at a Tertiary Care Center. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8081018. [PMID: 29849727 PMCID: PMC5925032 DOI: 10.1155/2018/8081018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/28/2017] [Accepted: 01/04/2018] [Indexed: 11/20/2022]
Abstract
Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods. A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians (P ≤ 0.05). Conclusion. With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints.
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Affiliation(s)
- D. M. Hansra
- Cancer Treatment Centers of America, Atlanta, GA, USA
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - K. McIntyre
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J. Ramdial
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - S. Sacks
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - C. S. Patrick
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J. Cutler
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - B. McIntyre
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - K. Feister
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - M. Miller
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - A. K. Taylor
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - F. Farooq
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - E. Ahn
- Cancer Treatment Centers of America, Atlanta, GA, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Miller School of Medicine, University of Miami, Miami, FL, USA
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8
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Namkoong K, Shah DV, McLaughlin B, Chih MY, Moon TJ, Hull S, Gustafson DH. Expression and Reception: An Analytic Method for Assessing Message Production and Consumption in CMC. COMMUNICATION METHODS AND MEASURES 2017; 11:153-172. [PMID: 30123400 PMCID: PMC6095677 DOI: 10.1080/19312458.2017.1313396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article presents an innovative methodology to study computer-mediated communication (CMC), which allows analysis of the multi-layered effects of online expression and reception. The methodology is demonstrated by combining the following three data sets collected from a widely tested eHealth system, the Comprehensive Health Enhancement Support System (CHESS): 1) a flexible and precise computer-aided content analysis; 2) a record of individual message posting and reading; and 3) longitudinal survey data. Further, this article discusses how the resulting data can be applied to online social network analysis and demonstrates how to construct two distinct types of online social networks - open and targeted communication networks - for different types of content embedded in social networks.
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Affiliation(s)
- Kang Namkoong
- Department of Community and Leadership Development, University of Kentucky, 504 Garrigus Building, Lexington, KY 40546-0215, United States, Tel.: 859-257-4657, ,
| | - Dhavan V Shah
- School of Journalism and Mass Communication, University of Wisconsin, Madison,
| | | | | | - Tae Joon Moon
- School of Journalism and Mass Communication, University of Wisconsin, Madison,
| | - Shawnika Hull
- Department of Prevention and Community Health, The George Washington University,
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin, Madison United States,
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Rayne S, Schnippel K, Firnhaber C, Wright K, Kruger D, Benn CA. Fear of Treatments Surpasses Demographic and Socioeconomic Factors in Affecting Patients With Breast Cancer in Urban South Africa. J Glob Oncol 2016; 3:125-134. [PMID: 28717750 PMCID: PMC5493272 DOI: 10.1200/jgo.2015.002691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Breast cancer is the most common cause of cancer in women in South Africa, and often patients present late. There is little understanding of the psychosocial stresses affecting women with breast cancer in Africa. Methods A questionnaire was distributed to 263 patients with breast cancer at two sites (one government and one private facility) in Johannesburg. Self-reported levels of fear were recorded on summative scales and their relationship to demographic variables assessed through univariable and multivariable modified Poisson regression. Results Fears related to treatments and prognosis, particularly radiation, loss of hair, and loss of breast, were far stronger than those related to socioeconomic barriers. Relative risk (RR) of most fears was higher in women younger than age 40 years, including treatment affordability (RR, 1.80; 95% CI, 1.26 to 2.56), hair loss (RR, 1.48; 95% CI, 1.12 to 2.95), and surgery (RR, 1.31; 95% CI, 1.02 to 1.68). Difficulty taking time off work predicted fear of job loss (RR, 2.59; 95% CI, 1.59 to 4.21) and missing appointments because of transport (RR, 2.46; 95% CI, 1.52 to 3.96) or family commitments (RR, 2.46; 95% CI, 1.52 to 3.96). Women with dependents and black women were more afraid of dying (RR, 1.73; 95% CI, 1.03 to 2.90; and RR, 1.79; 95% CI, 1.33 to 2.24, respectively); however, socioeconomic status in this sample was a strong confounder of race and explained most of the racial differences in levels of fear. Conclusion The most significant fears around breast cancer were related to treatment modalities and adverse effects rather than transport, financial, or work concerns. Young age and job insecurity were predictive of increased fears. Education about treatments has a key role to play in improving access to breast cancer care in South Africa.
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Affiliation(s)
- Sarah Rayne
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
| | - Kathryn Schnippel
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
| | - Cynthia Firnhaber
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
| | - Kathryne Wright
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
| | - Deirdre Kruger
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
| | - Carol-Ann Benn
- All authors, University of the Witwatersrand; and Kathryn Schnippel and Cynthia Firnhaber, Right to Care, Johannesburg, South Africa
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Mclaughlin B, Yang J, Yoo W, Shaw B, Kim SY, Shah D, Gustafson D. The Effects of Expressing Religious Support Online for Breast Cancer Patients. HEALTH COMMUNICATION 2015; 31:762-771. [PMID: 26643027 DOI: 10.1080/10410236.2015.1007550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The growth of online support groups has led to an expression effects paradigm within the health communication literature. Although religious support expression is characterized as a typical subdimension of emotional support, we argue that in the context of a life-threatening illness, the inclusion of a religious component creates a unique communication process. Using data from an online group for women with breast cancer, we test a theoretical expression effects model. Results demonstrate that for breast cancer patients, religious support expression has distinct effects from general emotional support messages, which highlights the need to further theorize expression effects along these lines.
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Affiliation(s)
| | - JungHwan Yang
- b School of Journalism and Mass Communication , University of Madison-Wisconsin
| | - Woohyun Yoo
- c Survey & Health Policy Research Center , Dongguck University
| | - Bret Shaw
- d Life Sciences Communication , University of Madison-Wisconsin
| | - Soo Yun Kim
- b School of Journalism and Mass Communication , University of Madison-Wisconsin
| | - Dhavan Shah
- b School of Journalism and Mass Communication , University of Madison-Wisconsin
| | - David Gustafson
- e Department of Industrial and Systems Engineering , University of Madison-Wisconsin
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Pérez JE, Rex Smith A. Intrinsic religiousness and well-being among cancer patients: the mediating role of control-related religious coping and self-efficacy for coping with cancer. J Behav Med 2014; 38:183-93. [PMID: 25169026 DOI: 10.1007/s10865-014-9593-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 08/18/2014] [Indexed: 11/26/2022]
Abstract
We examined the relationship between intrinsic religiousness and well-being, with control-related religious coping and self-efficacy for coping with cancer as potential mediators of this relationship among cancer patients. In a cross-sectional design, 179 ambulatory cancer patients completed measures of intrinsic religiousness, religious coping, self-efficacy for coping with cancer, well-being, and demographic variables. Type of cancer, stage of cancer, and time since diagnosis were collected from electronic medical charts. In a path model, the positive association between intrinsic religiousness and three types of well-being--physical, functional, and social-was fully mediated by active religious surrender and self-efficacy for coping with cancer. In addition, the negative association between passive religious deferral and all four types of well-being--physical, functional, social, and emotional--was fully mediated by self-efficacy for coping with cancer. Finally, there was a negative direct association between pleading for God's direct intercession and emotional well-being. These findings suggest pathways by which intrinsic religiousness and control-related religious coping are linked to various dimensions of well-being among cancer patients.
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Affiliation(s)
- John E Pérez
- Department of Psychology, University of San Francisco, 2130 Fulton Street, San Francisco, CA, 94117-1080, USA,
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12
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"We both just trusted and leaned on the Lord": a qualitative study of religiousness and spirituality among African American breast cancer survivors and their caregivers. Qual Life Res 2014; 23:1909-20. [PMID: 24578149 DOI: 10.1007/s11136-014-0654-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2014] [Indexed: 12/13/2022]
Abstract
PURPOSE Most breast cancer (BC) survivorship research focuses on the general population of survivors. Scant research investigates the potentially unique experiences of minorities, especially during and after the difficult transition from primary treatment to post-treatment. This qualitative study explored African American BC survivors' and caregivers' quality-of-life in the post-treatment period with a focus on social and spiritual well-being. METHODS Participants included a convenience sample of African American women with stage I-III BC (N = 23) who completed treatment 6-24 months before enrollment. Primary caregivers (N = 22) included friends, spouses and other family members (21 complete dyads). Participants completed separate semi-structured telephone interviews. Template analysis was used to evaluate themes related to religiousness and spirituality, both across and within dyads. RESULTS After treatment, religiousness and spirituality played a major role in both survivors' and caregivers' lives by: (1) providing global guidance, (2) guiding illness management efforts and (3) facilitating recovery. Participants described a spiritual connectedness with God and others in their social networks. Dyad members shared the goal of keeping a positive attitude and described positive growth from cancer. Few future concerns were expressed due to the belief that survivors were healed and "done" with cancer. Beyond practical and emotional support, provision of spiritual assistance was common. CONCLUSIONS Results highlight the principal, positive role of religiousness and spirituality for African American BC survivors and caregivers after treatment. Findings emphasize the need to assess the importance of religious and spiritual beliefs and practices, and if appropriate, to provide resources that promote spiritual well-being.
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