Challenges and Needs of Chinese and Korean American Breast Cancer Survivors: In-Depth Interviews
Keywords:
breast cancer, quality of life, survivorship, Asian American, Chinese American, Korean AmericanAbstract
Breast cancer incidence and the number of breast cancer survivors have been rapidly increasing among Chinese and Korean women in the United States. However, few data are available regarding quality of life in Asian American breast cancer survivors. This qualitative study aims to describe Asian American women’s perceptions of quality of life and their breast cancer experiences. In-depth interviews with four Chinese and five Korean American breast cancer survivors and three oncologists were conducted in Chinese, Korean, or English. Interviews were recorded and transcripts were translated into English. Qualitative analyses were performed by two independent coders and then discussed and agreed upon by the research team. The respondents reported that the breast cancer experience had affected various domains of quality of life, but women reported having limited resources with which to cope effectively. Depression, anxiety, and stress were commonly reported, but women rarely discussed these issues with family and friends or sought professional help. As immigrants, women’s loneliness and a lack of social support and culturally relevant resources seemed to be major barriers to maintaining good quality of life. Women also expressed interest in learning more about alternative therapies and relaxation skills. These findings can be used to help inform the development of a culturally appropriate intervention for Asian American breast cancer survivors. Future programs may provide information in women’s native languages to teach skills to cope with stress and anxiety, increase women’s self-efficacy within the context of their cultural background, and enhance social support among women from the same ethnic group.
References
Gomez SL, Quach T, Horn-Ross PL, et al. Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. Am J Public Health. 2010;100 (Suppl 1):S125-S131.
National Cancer Institute. Relative Survival By Survival Time By Cancer Site, All Ages, All Races, Female 1988-2007 (SEER). Available at: http://seer.cancer.gov/faststats/selections.php?#Output. Accessed Feb 25, 2012.
Drageset S, Lindstrom TC, Underlid K. Coping with breast cancer: between diagnosis and surgery. J Adv Nurs. 2010;66(1):149-158.
Cappiello M, Cunningham RS, Knobf MT, et al. Breast cancer survivors: information and support after treatment. Clin Nurs Res. 2007;16(4):278-293; discussion 294-301.
Henderson PD, Gore SV, Davis BL, et al. African American women coping with breast cancer: a qualitative analysis. Oncol Nurs Forum. 2003;30(4):641-647.
Ashing-Giwa KT, Padilla G, Tejero J, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. 2004;13(6):408-428.
Russell KM, Von Ah DM, Giesler RB, et al. Quality of life of African American breast cancer survivors: how much do we know? Cancer Nurs. 2008;31(6):E36-E45.
Wellisch D, Kagawa-Singer M, Reid SL, et al. An exploratory study of social support: a cross-cultural comparison of Chinese-, Japanese-, and Anglo-American breast cancer patients. Psychooncology. 1999;8(3):207-219.
Tsuchiya M, Horn SA. An exploration of unmet information needs among breast cancer patients in Japan: a qualitative study. Eur J Cancer Care (Engl). 2009;18(2):149-155.
Simpson P. Hong Kong families and breast cancer: beliefs and adaptation strategies. Psychooncology. 2005;14(8):671-683.
Thomsen DK, Pedersen AF, Johansen MB, et al. Breast cancer patients' narratives about positive and negative communication experiences. Acta Oncol. 2007;46(7):900-908.
Kagawa-Singer M, Wellisch DK. Breast cancer patients' perceptions of their husbands' support in a cross-cultural context. Psychooncology. 2003;12(1):24-37.
Tam Ashing K, Padilla G, Tejero J, et al. Understanding the breast cancer experience of Asian American women. Psychooncology. 2003;12(1):38-58.
Wong-Kim E, Sun A, Merighi JR, et al. Understanding quality-of-life issues in Chinese women with breast cancer: a qualitative investigation. Cancer Control. 2005;12 (Suppl 2):6-12.
Sun A, Wong-Kim E, Stearman S, et al. Quality of life in Chinese patients with breast cancer. Cancer. 2005;104(12 Suppl):2952-2954.
Beatty L, Oxlad M, Koczwara B, et al. The psychosocial concerns and needs of women recently diagnosed with breast cancer: a qualitative study of patient, nurse and volunteer perspectives. Health Expect. 2008;11(4):331-342.
Thewes B, Butow P, Girgis A, et al. The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psychooncology. 2004;13(3):177-189.
Howard AF, Balneaves LG, Bottorff JL. Ethnocultural women's experiences of breast cancer: a qualitative meta-study. Cancer Nurs. 2007;30(4):E27-E35.
Weber KM, Solomon DH. Locating relationship and communication issues among stressors associated with breast cancer. Health Commun. 2008;23(6):548-559.
Andersen BL. Biobehavioral outcomes following psychological interventions for cancer patients. J Consult Clin Psychol. 2002;70(3):590-610.
Andersen BL, Farrar WB, Golden-Kreutz DM, et al. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. J Clin Oncol. 2004;22(17):3570-3580.
Andersen BL, Shelby RA, Golden-Kreutz DM. RCT of a psychological intervention for patients with cancer: I. mechanisms of change. J Consult Clin Psychol. 2007;75(6):927-938.
Scheier MF, Helgeson VS, Schulz R, et al. Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer. J Clin Oncol. 2005;23(19):4298-4311.
Butler LD, Koopman C, Neri E, et al. Effects of supportive-expressive group therapy on pain in women with metastatic breast cancer. Health Psychol. 2009;28(5):579-587.
Meneses KD, McNees P, Loerzel VW, et al. Transition from treatment to survivorship: effects of a psychoeducational intervention on quality of life in breast cancer survivors. Oncol Nurs Forum. 2007;34(5):1007-1016.
Thornton LM, Andersen BL, Schuler TA, et al. A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: secondary analysis of a randomized controlled trial. Psychosom Med. 2009;71(7):715-724.
Chan CL, Ho RT, Lee PW, et al. A randomized controlled trial of psychosocial interventions using the psychophysiological framework for Chinese breast cancer patients. J Psychosoc Oncol. 2006;24(1):3-26.
Fukui S, Kugaya A, Okamura H, et al. A psychosocial group intervention for Japanese women with primary breast carcinoma. Cancer. 2000;89(5):1026-1036.
Hosaka T, Sugiyama Y, Hirai K, et al. Factors associated with the effects of a structured psychiatric intervention on breast cancer patients. Tokai J Exp Clin Med. 2001;26(2):33-38.
Miyashita M. A randomized intervention study for breast cancer survivors in Japan: effects of short-term support group focused on possible breast cancer recurrence. Cancer Nurs. 2005;28(1):70-78.
