1
|
Droz JP, Couppié P, Fayette J. [Oncology in French Guiana: A challenge to win]. Bull Cancer 2024; 111:597-607. [PMID: 38749776 DOI: 10.1016/j.bulcan.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 06/10/2024]
Abstract
French Guiana is an equatorial, multicultural, overseas territory in South America. The region is unique: a wealthy country with a universal healthcare system, but significant poverty, which bears little resemblance to its neighbors Brazil and Suriname. Cancer is the second leading cause of death. The incidence of cancer is lower than in France, stages are generally more advanced and the prognosis worse. To date, oncology has been organized through a joint venture between local institutions and healthcare professionals and a cancer center in mainland France, in line with the recommendations of the Institut National du Cancer. The implementation of a medical project and a complete medical studies curriculum in French Guiana is a tremendous opportunity for the development of oncology. The main challenges are consolidating medical care for patients, quality control, genetic oncology, molecular biology, implementation of radiotherapy and nuclear medicine, clinical and translational research, and teaching programs. Working in oncology in French Guiana is exciting because of the scientific interest (particular characteristics of cancers, notably the role of viral or micro-organism-induced carcinogenesis, genetic factors in these populations with African and Asian roots, and the importance of a public health policy) and human interest (patients from different cultures; all of them bring original approaches to health and illness that need to be deciphered in order to offer quality care). This requires the support of healthcare professionals who are enthusiastic about this unique adventure.
Collapse
Affiliation(s)
- Jean-Pierre Droz
- Université Claude-Bernard Lyon-1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France.
| | - Pierre Couppié
- Centre hospitalier de Cayenne, rue des Flamboyants, 97306 Cayenne, Guyane française; DFR Santé, université de Guyane, WMMX+5Q3, 97300 Cayenne, Guyane française
| | - Jérôme Fayette
- Centre hospitalier de Cayenne, rue des Flamboyants, 97306 Cayenne, Guyane française; Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France
| |
Collapse
|
2
|
Ojo-Aromokudu O, Suffel A, Bell S, Mounier-Jack S. Views and experiences of primary care among Black communities in the United Kingdom: a qualitative systematic review. ETHNICITY & HEALTH 2023; 28:1006-1025. [PMID: 37160684 DOI: 10.1080/13557858.2023.2208313] [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] [Received: 05/09/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND In the United Kingdom, people with non-white ethnicities are more likely to report being in worse health conditions and have poorer experiences of healthcare services than white counterparts. The voices of those of Black ethnicities are often merged in literature among other non-white ethnicities. This literature review aims to analyse studies that investigate Black participant experiences of primary care in the UK. METHODS We conducted a systematic literature review searching Medline, Web of Science, EMBASE, SCOPUS, Social Policy and Practice, CINAHL plus, Psych INFO and Global Health with specific search terms for appropriate studies. No publish date limit was applied. RESULTS 40 papers (39 articles and 1 thesis) were deemed eligible for inclusion in the review. A number of major themes emerged. Patient expectations of healthcare and the health seeking behaviour impacted their interactions with health systems in the UK. Both language and finances emerged as barriers through which some Black participants interacted with primary care services. (Mis)trust of clinicians and the health system was a common theme that often negatively impacted views of UK primary care services. The social context of the primary care service and instances of a cultural disconnect also impacted views of primary care services. Some papers detail patients recognising differential treatment based on ethnicity. The review included the voices of primary care professionals where descriptions of Black patients were overwhelmingly negative. CONCLUSION Views and experiences of Black groups may be radically different to other ethnic minorities and thus, should be teased out of broader umbrella terms like Black and Asian Minority Ethnic (BAME) and Black Minority Ethnic (BME). To address ethnicity-based health inequalities, culturally sensitive interventions that engage with the impacted community including co-designed interventions should be considered while acknowledging the implications of being racialised as Black in the UK.
Collapse
Affiliation(s)
- Oyinkansola Ojo-Aromokudu
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Anne Suffel
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
3
|
Binkley JM, Gabram S, Finley J, Fowler D, VanHoose L, McCullough LE. Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums. J Cancer Surviv 2023:10.1007/s11764-023-01373-6. [PMID: 37040001 DOI: 10.1007/s11764-023-01373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/25/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation exist for all BC survivors but are magnified in Black BC survivors. The purpose of this qualitative research was to document patient, clinician, and researchers' perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship. METHODS A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues, and potential solutions surrounding racial disparity in BC survivorship. Forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or BC. RESULTS Three main themes were identified related to racial disparity in BC survivorship: (1) societal and cultural contributing factors, (2) contribution of healthcare providers and systems, and (3) models of care and research considerations. CONCLUSIONS The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Increased awareness related to racial disparity in BC survivorship among survivors, healthcare providers, and researchers will contribute to health equity and improved outcomes for Black individuals.
Collapse
Affiliation(s)
- Jill M Binkley
- TurningPoint Breast Cancer Rehabilitation, Atlanta, GA, USA.
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA.
| | - Sheryl Gabram
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
- Georgia Center for Oncology Research and Education, Atlanta, GA, USA
| | - Janae Finley
- TurningPoint Breast Cancer Rehabilitation, Atlanta, GA, USA
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
| | | | - Lisa VanHoose
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
- College of Saint Mary, Omaha, NE, USA
- The Ujima Center, Monroe, LA, USA
| | - Lauren E McCullough
- Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
4
|
Nwakasi C, Esiaka D, Pawlowicz A, Chidebe RCW, Oyinlola O, Mahmoud K. "He [the doctor] said I should go and wait for my death:" Dualities in care and support access among female cancer survivors. J Cancer Policy 2023; 35:100374. [PMID: 36493986 DOI: 10.1016/j.jcpo.2022.100374] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION While some countries have positive outlooks and technology at their disposals to detect and treat cancer in its earliest stages, other countries frequently demonstrate trends of late-stage presentation and treatment hesitancy. Nigeria is a nation that has a high cancer burden, with poorer outcomes than higher income countries (HICs). To add to the body of cancer knowledge in global health, and inform relevant policies to improve cancer survivorship, our study offers insight on cancer survivors' experiences in accessing care and support in Nigeria. METHODS The study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Nigeria (Mage = 42 years). Their responses were transcribed, coded, and analyzed for themes. RESULTS The four major themes identified were: 1) views about chemotherapy and treatments; 2) support from families and others; 3) support from health care providers; and 4) religion and coping. Each of these themes include sub-themes that offer insights on the dualities of cancer survivorship. DISCUSSION The high cancer death rate in Nigeria may be masking the growing number of cancer survivors, especially women diagnosed with breast cancer. It is important to design interventions that not only target cancer prevention but improving the health and quality of life of those affected by cancer in Nigeria until end of life. The findings highlight a critical need for more attention on cancer survivorship in Nigeria.
Collapse
Affiliation(s)
- Candidus Nwakasi
- Department of Health Sciences, Providence College Providence, RI, USA.
| | - Darlingtina Esiaka
- Department of Family Medicine and Community Health, Rutgers University, Newark, NJ, USA.
| | - Abigail Pawlowicz
- Department of Health Sciences, Providence College Providence, RI, USA
| | - Runcie C W Chidebe
- Department of Sociology and Gerontology Miami University Oxford, OH, USA; University Project PINK BLUE - Health & Psychological Trust Centre, Abuja, Nigeria; Scripps Gerontology Center Miami University Oxford, OH, USA.
| | | | - Kafayat Mahmoud
- University of Kansas Department of Sociology, 719 Fraser Hall 1415 Jayhawk Blvd, Lawrence, KS 66049, USA.
| |
Collapse
|
5
|
Alexis O, Worsley AJ. Black men's experiences of support following treatment for prostate cancer in England: A qualitative study. Eur J Oncol Nurs 2023; 62:102232. [PMID: 36423560 DOI: 10.1016/j.ejon.2022.102232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/10/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Prostate cancer is a leading cause of death in black men in the United Kingdom (UK). Evidence suggests that unmet supportive care needs are prevalent in contemporary healthcare, particularly for men with advanced prostate cancer, whilst less has been written specifically about the supportive care needs of black men. Therefore this study will examine black men's experiences of support following prostate cancer treatment in England. METHOD A qualitative research design was employed. Twenty black African and black Caribbean men were interviewed on a face-to-face basis to obtain insightful information about their experiences of prostate cancer. Interviews were recorded and transcribed. Data were analysed using thematic analysis which allowed for emergent themes. RESULTS In this study there were six emergent themes. These were: dealing with the treatment effect, support from loved ones, individuals and organisations, healthcare support, spirituality, and positivity. Black men used different coping strategies to deal with the side effects of treatment. CONCLUSION Black men experienced a range of supportive care needs. Some men felt that their individual needs as black men were not met by healthcare professionals, although no specific reasons were forthcoming as to why they felt this way. Healthcare professionals should be aware of the support mechanisms that black men have used throughout the prostate cancer journey and to consider these approaches when treating and caring for black men.
Collapse
Affiliation(s)
- Obrey Alexis
- Oxford Brookes University, Joel Joffe Building, Delta 900 Office Park, Swindon Campus, SN5 7XQ, UK.
| | - Aaron James Worsley
- Oxford Brookes University, John Henry Brookes Building, Headington Campus, Oxford, OX3 0BP, UK.
| |
Collapse
|
6
|
Ridge D, Pilkington K, Donovan S, Moschopoulou E, Gopal D, Bhui K, Chalder T, Khan I, Korszun A, Taylor S. A meta-ethnography investigating relational influences on mental health and cancer-related health care interventions for racially minoritised people in the UK. PLoS One 2023; 18:e0284878. [PMID: 37163472 PMCID: PMC10171693 DOI: 10.1371/journal.pone.0284878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/10/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE Despite calls to increase the 'cultural competence' of health care providers, racially minoritised people continue to experience a range of problems when it comes to health care, including discrimination. While relevant qualitative meta-syntheses have suggested better ways forward for health care for racialised minorities, many have lacked conceptual depth, and none have specifically investigated the relational dimensions involved in care. We set out to investigate the social and cultural influences on health care interventions, focusing on psychological approaches and/or cancer care to inform the trial of a new psychological therapy for those living with or beyond cancer. METHOD A meta-ethnography approach was used to examine the relevant qualitative studies, following Noblit and Hare, and guided by patient involvement throughout. Papers were analysed between September 2018 and February 2023, with some interruptions caused by the Covid pandemic. The following databases were searched: Ovid MEDLINE, EBSCO CINAHL, Ovid Embase, EBSCO PsycINFO, Proquest Sociology Collection (including Applied Social Sciences Index & Abstracts (ASSIA), Sociological Abstracts and Sociology Database), EBSCO SocINDEX, Ovid AMED, and Web of Science. The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42018107695), and reporting follows the eMERGe Reporting Guidance for meta-ethnographies (France et al. 2019). RESULTS Twenty-nine journal papers were included in the final review. Themes (third-order constructs) developed in the paper include the centrality of the patient-practitioner relationship; how participants give meaning to their illness in connection to others; how families (rather than individuals) may make health decisions; how links with a higher power and spiritual/religious others can play a role in coping; and the ways in which a hierarchy of help-seeking develops, frequently with the first port of call being the resources of oneself. Participants in studies had a need to avoid being 'othered' in their care, valuing practitioners that connected with them, and who were able to recognise them as whole and complex (sometimes described in relational languages like 'love'). Complex family-based health decision-making and/or the importance of relations with non-human interactants (e.g. God, spiritual beings) were frequently uncovered, not to mention the profoundly emergent nature of stigma, whereby families could be relatively safe havens for containing and dealing with health challenges. A conceptual framework of 'animated via (frequently hidden) affective relationality' emerged in the final synthesis, bringing all themes together, and drawing attention to the emergent nature of the salient issues facing minoritised patients in health care interactions. CONCLUSION Our analysis is important because it sheds light on the hitherto buried relational forces animating and producing the specific issues facing racially minoritised patients, which study participants thought were largely overlooked, but to which professionals can readily relate (given the universal nature of human relations). Thus, training around the affective relationality of consultations could be a fruitful avenue to explore to improve care of diverse patients.
Collapse
Affiliation(s)
- Damien Ridge
- School of Social Sciences, University of Westminster, London, United Kingdom
| | - Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, Portsmouth, United Kingdom
| | - Sheila Donovan
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Elisavet Moschopoulou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Dipesh Gopal
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Wadham College, University of Oxford, Oxford, United Kingdom
- World Psychiatric Association Collaborating Centre, Oxford, United Kingdom
| | - Trudie Chalder
- Department of Psychological Medicine, Kings College London, London, United Kingdom
| | - Imran Khan
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ania Korszun
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Stephanie Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
7
|
Jidong DE, Ike JT, Husain N, Murshed M, Francis C, Mwankon BS, Jack BD, Jidong JE, Pwajok YJ, Nyam PP, Kiran T, Bassett P. Culturally adapted psychological intervention for treating maternal depression in British mothers of African and Caribbean origin: A randomized controlled feasibility trial. Clin Psychol Psychother 2022. [PMID: 36478339 DOI: 10.1002/cpp.2807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/09/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Women are likely to suffer from maternal depression due to childbirth difficulties and parenting responsibilities, leading to long-term negative consequences on their children and families. British mothers of African/Caribbean origin uptake of mental healthcare is low due to the lack of access to culturally appropriate care. METHODS A mixed-methods randomized controlled feasibility trial was adopted to test the appropriateness and acceptability of Learning Through Play plus Culturally adapted Cognitive Behaviour Therapy (LTP+CaCBT) for treating maternal depression compared with Psychoeducation (PE). Mothers (N = 26) aged 20-55 were screened for depression using the Patient Health Questionnaire (PHQ-9). Those who scored >5 on PHQ-9 were further interviewed using the Revised Clinical Interview Schedule to confirm the diagnosis and randomized into LTP+CaCBT (n = 13) or PE (n = 13) groups. Assessments were taken at baseline, end of the intervention at 3- and 6-months post-randomization. N = 2 focus groups (LTP+CaCBT, n = 12; PE, n = 7) and N = 8 individual interviews were conducted (LTP+CaCBT, n = 4; PE, n = 4). RESULTS The LTP+CaCBT group showed higher acceptability, feasibility and satisfaction levels than the PE group. Participants experienced the intervention as beneficial to their parenting skills with reduced depression and anxiety in the LTP+CaCBT compared to the PE group. CONCLUSIONS This is the first feasibility trial of an integrated online parenting intervention for British African and Caribbean mothers. The results indicated that culturally adapted LTP+CaCBT is acceptable and feasible. There is a need to study the clinical and cost-effectiveness of LTP+CaCBT in an appropriately powered randomized control trial and include the child's outcomes. TRIAL REGISTRATION www. CLINICALTRIALS gov (no. NCT04820920).
Collapse
Affiliation(s)
| | - Juliet Tarela Ike
- Department of Criminology and Sociology, Teesside University, Middlesbrough, UK
| | - Nusrat Husain
- Department of Psychiatry, University of Manchester, Manchester, UK
| | - Maisha Murshed
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | | | | | - B David Jack
- Research Unit, Dung Jidong Foundation (DJF), Jos, Nigeria
| | | | | | - P Pam Nyam
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Tayyaba Kiran
- Pakistan Institute of Living and Learning (PILL), Islamabad, Pakistan
| | - Paul Bassett
- Pakistan Institute of Living and Learning (PILL), Islamabad, Pakistan
| |
Collapse
|
8
|
Anderson K, Smith A'B, Diaz A, Shaw J, Butow P, Sharpe L, Girgis A, Lebel S, Dhillon H, Burhansstipanov L, Tighe B, Garvey G. A Systematic Review of Fear of Cancer Recurrence Among Indigenous and Minority Peoples. Front Psychol 2021; 12:621850. [PMID: 34012412 PMCID: PMC8126623 DOI: 10.3389/fpsyg.2021.621850] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence (FCR). Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020 (Registration number: CRD42020161655). A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries (United States of America, Canada, Australia and the United Kingdom) met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence (n = 3) or severity (n = 9). While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: (i) variations in the lived experience of FCR; (ii) spirituality and worldview impacting on FCR; (iii) the importance of staying positive; (iv) complexities around support; and (v) increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655].
Collapse
Affiliation(s)
- Kate Anderson
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Allan 'Ben' Smith
- Centre for Oncology Education & Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Abbey Diaz
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Louise Sharpe
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Afaf Girgis
- Centre for Oncology Education & Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Haryana Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | | | - Boden Tighe
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gail Garvey
- Menzies School of Health Research, Brisbane, QLD, Australia.,Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| |
Collapse
|
9
|
Shafiq S, Parveen S, Oyebode JR. How people of African Caribbean or Irish ethnicity cope with long-term health conditions in UK community settings: A systematic review of qualitative, quantitative and mixed method studies. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:319-327. [PMID: 33025714 DOI: 10.1111/hsc.13181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/11/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
Living with a chronic or mental health condition can be challenging and requires considerable adjustment. As ways of coping are culturally influenced, it is important to understand how minority ethnic populations cope, to inform appropriate services. This review aimed to explore the coping strategies used by UK residents from an African Caribbean or Irish background between 1960 and 2020. A systematic literature search on strategies used to cope with chronic health conditions in both populations living in the United Kingdom identified 26 relevant studies. Data were extracted, quality of papers was appraised and critical interpretive synthesis was applied. Two major foci of the studies were coping strategies and barriers to coping. The main coping strategies were denial/scepticism, self-management, spirituality and religion. Within each population, there was variation in ways of coping. The review highlights the complex role of religion in influencing coping strategies. It demonstrates how personal and minority ethnic populations' experiences of service use are connected with stigma, fear and mistrust, which also act as barriers to seeking help and to coping. Coping with a chronic or mental health condition in the Irish and African Caribbean populations is under-researched. Stigma, fear and mistrust in services act as key barriers to help-seeking and religion is a prominent coping strategy. However, few detailed examples were given on how it was used to assist individuals when managing a chronic or mental health condition. Also due to a lack of research, firm conclusions cannot be drawn for the Irish population.
Collapse
Affiliation(s)
- Saba Shafiq
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Sahdia Parveen
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Jan R Oyebode
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| |
Collapse
|
10
|
Self-care Experiences of Advanced Prostate Cancer Survivors Who Underwent Androgen Deprivation Therapy. Cancer Nurs 2021; 45:190-200. [PMID: 33654010 DOI: 10.1097/ncc.0000000000000933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Androgen deprivation therapy is the primary treatment for advanced cases of prostate cancer, but its adverse effects may decrease prostate cancer survivors' quality of life. OBJECTIVE The aim of this study was to understand the self-care experiences of prostate cancer survivors before and while receiving androgen deprivation therapy. METHODS A qualitative study design with inductive content analysis was used. Semistructured interviews were conducted with 13 prostate cancer survivors in Taiwan treated with androgen deprivation therapy. Data collection and analysis proceeded simultaneously until data saturation was reached. RESULTS The survivors' self-care experiences were categorized into generic categories: physical impacts, psychosocial impacts, lack of supporting information, changing lifestyle habits, coping with physical symptoms, relieving stress, and acquiring disease-related knowledge. These generic categories were then organized into 2 main categories: impacts and adjustments. CONCLUSIONS This article describes the experiences of prostate cancer survivors in terms of the impacts of disease and its treatment and adjustments in self-care before and while receiving treatment. It was found that the information acquired by survivors and the adjustment strategies they used were not entirely appropriate or adequate. IMPLICATIONS FOR PRACTICE Healthcare providers should continually assess the self-care experiences of prostate cancer survivors receiving androgen deprivation therapy, provide them with appropriate information, and clarify their understanding. This will improve survivors' disease care-related knowledge, increase the success of their experience of self-care, alleviate their emotional distress, and strengthen their ability to adjust their self-care to cope with the impacts of the disease and its treatment.
Collapse
|
11
|
Luo D, Eicher M, White K. Individual resilience in adult cancer care: A concept analysis. Int J Nurs Stud 2020; 102:103467. [DOI: 10.1016/j.ijnurstu.2019.103467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023]
|
12
|
Wagland R, Nayoan J, Matheson L, Rivas C, Brett J, Collaco N, Alexis O, Gavin A, Glaser AW, Watson E. Adjustment strategies amongst black African and black Caribbean men following treatment for prostate cancer: Findings from the Life After Prostate Cancer Diagnosis (LAPCD) study. Eur J Cancer Care (Engl) 2019; 29:e13183. [PMID: 31642565 DOI: 10.1111/ecc.13183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore adjustment strategies adopted by Black African (BA) and Black Caribbean (BC) men in the UK as a response to the impact of PCa diagnosis and treatment effects. METHODS Men were recruited through the UK-wide 'Life After Prostate Cancer Diagnosis' (LAPCD) survey. Telephone interviews were conducted with men (n = 14) with BA and BC backgrounds between 18 and 42 months post-diagnosis. Data were analysed using a Framework approach. RESULTS Most men (n = 12) were born outside the UK, were married (n = 9) and employed (n = 9). Median age was 66 years (range: 55-85). Six overarching themes emerged: a strong reliance upon faith beliefs; maintaining a 'positive' front; work as distraction; non-disclosure of diagnosis even amongst family members, influenced by stigma and masculinity concerns; active awareness-raising amongst a minority and support-seeking from close community. A few men emphasised a need to 'pitch' awareness-raising messages appropriately. Potential links existed between faith beliefs, presenting a positive front, community support-seeking and local awareness-raising. CONCLUSION The provision of patient-centred care requires cultural sensitivity. Interventions that challenge stigma and men's reluctance to disclose problems associated with PCa and treatment may encourage help-seeking for symptom support. Research is needed to determine how best awareness-raising messages should be conveyed to black men.
Collapse
Affiliation(s)
| | - Johana Nayoan
- Health Psychology Research Group, University College London, London, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Carol Rivas
- Social Science Research Unit, University College London, London, UK
| | - Jo Brett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Nicole Collaco
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| |
Collapse
|
13
|
Do cancer patients use the term resilience? A systematic review of qualitative studies. Support Care Cancer 2018; 27:43-56. [PMID: 30209600 DOI: 10.1007/s00520-018-4456-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Resilience is a dynamic process of positive adaptation to adversity, including cancer. While the term is used frequently by researchers, controversy exists over its conceptualisation and little is known if and how cancer patients use the term resilience. We examined qualitative studies exploring cancer patient experiences/perceptions of resilience to understand: (a) definitions of resilience as identified by patients and researchers and (b) the themes relating to attributes of resilience as identified by patients. METHODS Four electronic databases (MEDLINE, PsycINFO, SCOPUS, and CINAHL) were searched from database inception to November 2017, identifying qualitative studies of adult cancer patients/survivors which included resilience and cancer in the title, abstract, or medical subject headings. Articles were excluded if resilience was not a theme or outcome or was discussed primarily in the context of non-individuals. Thematic analysis was used to code studies and generate analytical themes, and a single author identified definitions of resilience within the studies. RESULTS Five hundred and seventy-three non-duplicate citations were screened, resulting in 65 citations screened for full-text review. Of these, 33 were excluded, leaving 32 studies. Four thematic categories emerged; coping strategies, social support, spirituality, and growth, within which 79 individual themes were identified. Eight researcher definitions and no patient definitions of resilience were identified. CONCLUSION This review found no cancer patient definitions of resilience and that cancer patients are seldom quoted using the term resilience directly, instead identifying coping strategies, social support, growth, and spirituality as attributes associated with resilience.
Collapse
|
14
|
Kerr A, Ross E, Jacques G, Cunningham‐Burley S. The sociology of cancer: a decade of research. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:552-576. [PMID: 29446117 PMCID: PMC5901049 DOI: 10.1111/1467-9566.12662] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Biomedicine is often presented as the driving force behind improvements in cancer care, with genomics the latest innovation poised to change the meaning, diagnosis, treatment, prevention and lived experience of cancer. Reviewing sociological analyses of a diversity of patient and practitioner experiences and accounts of cancer during the last decade (2007-17), we explore the experiences of, approaches to and understandings of cancer in this period. We identify three key areas of focus: (i) cancer patient experiences and identities; (ii) cancer risk and responsibilities and (iii) bioclinical collectives. We explore these sociological studies of societal and biomedical developments and how sociologists have sought to influence developments in cancer identities, care and research. We end by suggesting that we extend our understanding of innovations in the fields of cancer research to take better account of these wider social and cultural innovations, together with patients, activists' and sociologists' contributions therein.
Collapse
Affiliation(s)
- Anne Kerr
- School of Sociology and Social PolicyUniversity of LeedsUK
| | - Emily Ross
- The Usher InstituteEdinburgh Medical SchoolUniversity of EdinburghUK
| | - Gwen Jacques
- School of Sociology and Social PolicyUniversity of LeedsUK
| | | |
Collapse
|
15
|
Machirori M, Patch C, Metcalfe A. Study of the relationship between Black men, culture and prostate cancer beliefs. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1442636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Mavis Machirori
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Christine Patch
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Alison Metcalfe
- Florence Nightingale Faculty of Nursing, Midwifery, Palliative Care, King’s College London, 1.32 James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| |
Collapse
|
16
|
Bamidele O, McGarvey H, Lagan B, Ali N, Chinegwundoh MBE F, Parahoo K, McCaughan E. Life after prostate cancer: A systematic literature review and thematic synthesis of the post-treatment experiences of Black African and Black Caribbean men. Eur J Cancer Care (Engl) 2017; 27. [DOI: 10.1111/ecc.12784] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/27/2022]
Affiliation(s)
- O. Bamidele
- Institute of Nursing and Health Research; Ulster University; Jordanstown UK
| | - H. McGarvey
- School of Nursing; Ulster University; Londonderry UK
| | - B.M. Lagan
- Institute of Nursing and Health Research; Ulster University; Jordanstown UK
| | - N. Ali
- Institute of Health Research; University of Bedfordshire; Luton UK
| | - F. Chinegwundoh MBE
- Barts Health NHS Trust; London UK
- City, University of London; School of Health Sciences; London UK
| | - K. Parahoo
- Institute of Nursing and Health Research; Ulster University; Coleraine UK
| | - E. McCaughan
- Institute of Nursing and Health Research; Ulster University; Coleraine UK
| |
Collapse
|
17
|
Moorley CR, Cahill S, Corcoran NT. Life after Stroke: Coping mechanisms among African Caribbean Women. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:769-778. [PMID: 26094703 DOI: 10.1111/hsc.12256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
In the UK, stroke is the third most common cause of death for women and the incidence in African Caribbean women is higher than that in the general population. Stroke burden has major consequences for the physical, mental and social health of African Caribbean women. In order to adjust to life after stroke, individuals affected employ a range of strategies which may include personal, religious (church) or spiritual support (i.e. prayer), individual motivation or resignation to life with a disability. This study explored these areas through the coping mechanisms that African Caribbean women utilised post stroke in the context of stroke recovery and lifestyle modification efforts needed to promote healthy living post stroke. A qualitative approach using interpretative phenomenological analysis was adopted. Seven women were recruited into the study. Semi-structured, in-depth interviews were audio recorded and were transcribed verbatim. Data were analysed using a four-stage framework: familiarisation, sense making, developing themes, and data refinement and analysis. Three main themes on coping emerged: the need to follow medical rules to manage stroke, strength and determination, and the use of religion and faith to cope with life after stroke. These findings illustrate both a tension between religious beliefs and the medical approach to stroke and highlight the potential benefits that religion and the church can play in stroke recovery. Implications for practice include acknowledgement and inclusion of religion- and church-based health promotion in post-stroke recovery.
Collapse
Affiliation(s)
- Calvin R Moorley
- Adult Nursing, Faculty of Health and Social Care, London South Bank University, London, UK.
| | - Sharon Cahill
- School of Psychology, University of East London, London, UK
| | - Nova T Corcoran
- School of Life Sciences, University of South Wales, Cardiff, UK
| |
Collapse
|
18
|
Arrey AE, Bilsen J, Lacor P, Deschepper R. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium. PLoS One 2016; 11:e0159488. [PMID: 27447487 PMCID: PMC4957758 DOI: 10.1371/journal.pone.0159488] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/04/2016] [Indexed: 01/09/2023] Open
Abstract
Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration in providing a caring and healthy environment.
Collapse
Affiliation(s)
- Agnes Ebotabe Arrey
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail:
| | - Johan Bilsen
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick Lacor
- Department of Internal Medicine and Infectious Diseases-AIDS Reference Center, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
19
|
Hurtado-de-Mendoza A, Song M, Kigen O, Jennings Y, Nwabukwu I, Sheppard VB. Addressing cancer control needs of African-born immigrants in the US: a systematic literature review. Prev Med 2014; 67:89-99. [PMID: 25034729 PMCID: PMC4203373 DOI: 10.1016/j.ypmed.2014.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 04/03/2014] [Accepted: 07/07/2014] [Indexed: 12/31/2022]
Abstract
Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsycINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US-born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors is necessary to inform future directions.
Collapse
Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.
| | - Minna Song
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Ocla Kigen
- Cancer Biology, Prevention & Control, University District of Columbia, Lombardi Cancer Center Cancer Prevention Master's Degree Program, Washington, DC, USA
| | - Yvonne Jennings
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Ify Nwabukwu
- African Women's Cancer Awareness Association, Silver Spring, MD, USA
| | - Vanessa B Sheppard
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
20
|
Bibila S, Rabiee F. Training the powerful: issues that emerged during the evaluation of a communication skills training programme for senior cancer care professionals. Eur J Cancer Care (Engl) 2013; 23:531-44. [PMID: 24373021 DOI: 10.1111/ecc.12167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2004] [Indexed: 11/28/2022]
Abstract
'Connected' is the name of the national advanced communication skills training programme developed in 2008 for cancer care professionals in the NHS. A 3-day training course combining didactic and experiential learning elements is run by two facilitators with course participants expected to engage fully in simulated consultations with trained actors. In 2011, and as a result of participant feedback on the length of the course and increasing pressures on budgets and clinical time, the Connected team developed and piloted an alternative 2-day training course. Before its roll-out in 2012, Birmingham City University was commissioned to evaluate the effectiveness and quality of the 2-day course vis-à-vis the 'traditional' 3-day one. This article is written by the two evaluators and it discusses some of the issues that emerged during the evaluation. We broadly grouped these issues into two overlapping categories: the mandatory nature of the course and the different professional background and seniority of participants. In our discussion we consider the implications these issues have for communication skills training policy and practice and put forward suggestions for further research.
Collapse
Affiliation(s)
- S Bibila
- Centre for Health and Social Care Research, Faculty of Health, Birmingham City University, Birmingham, UK
| | | |
Collapse
|
21
|
Cooper M, Harding S, Mullen K, O'Donnell C. 'A chronic disease is a disease which keeps coming back…it is like the flu': chronic disease risk perception and explanatory models among French- and Swahili-speaking African migrants. ETHNICITY & HEALTH 2012; 17:597-613. [PMID: 23153320 DOI: 10.1080/13557858.2012.740003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND African migrants to the West are at increased risk of hypertensive related diseases and certain cancers compared with other ethnic groups. Little is known about their awareness of this risk or knowledge of associated risk factors. OBJECTIVES To explore African migrants' perceptions of chronic disease risk, risk factors and underlying explanatory models. DESIGN In-depth interviews with 19 Africans from French- or Swahili-speaking countries living in Glasgow were conducted. Interviews were transcribed and 10 translated (3 Swahili and 7 French). Analysis was informed by a grounded theory approach. RESULTS Narratives suggested low awareness of chronic disease risk among participants. Africans reported a positive outlook on life that discouraged thought about future sickness. Infectious diseases were considered the dominant health threat for African migrants, mainly HIV but also TB and 'flu'. Chronic diseases were sometimes described as contagious. Explanatory models of chronic disease included bodily/dietary imbalance, stress/exertion, heredity/predisposition and food contamination. Cancer was feared but not considered a major threat. Cancer was considered more common in Europe than Africa and attributed to chemical contamination from fertilisers, food preservatives and industrial pollution. Evidence cited for these chemicals was rapid livestock/vegetable production, large size of livestock (e.g., fish), softness of meat and flavourless food. Chemicals were reported to circulate silently inside the body and cancer to form in the part where they deposit, sometimes years later. Cardiovascular diseases were described in terms of acute symptoms that required short-term medication. Confidentiality concerns were reported to prevent discussion of chronic disease between Africans. CONCLUSION This study suggests a need to improve chronic disease health literacy among African migrants to promote engagement with preventive behaviours. This should build on not only participants' existing knowledge of disease causation and risk factors but also their self-reliance in the pursuit of a healthy lifestyle and desire to retain cultural knowledge and practice.
Collapse
Affiliation(s)
- Maxwell Cooper
- General Practice and Primary Care, Institute of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
| | | | | | | |
Collapse
|