The impact of cervical cancer and dysplasia: A qualitative, multiethnic study

School of Nursing, University of California, San Francisco, San Francisco, California, United States
Psycho-Oncology (Impact Factor: 2.44). 10/2004; 13(10):709-28. DOI: 10.1002/pon.785
Source: PubMed


Cervical cancer (CCA) remains a health challenge nationally and globally. In the US, more than 12,000 women are diagnosed each year with invasive cervical cancer and more than 220,000 are living with a history of this diagnosis (ACS, 2003). This qualitative study aims to examine health related quality of life (HRQOL) from a culturally consistent framework.
Key-informant interviews (N = 23) and focus group interviews (N = 51) were conducted with a multiethnic sample of cervical cancer survivors (CCS) recruited from hospitals and clinics. ANALYSES AND RESULTS: Content and theme analyses were conducted. Findings indicate that cultural and family factors often promote coping and well-being, but may foster delay in care seeking and self-deprecation, particularly among Latina and Asian CCS. Faith in God was relied on for comfort, strength and healing by many survivors, especially the African Americans and Latinas. Overall, our participants reported moderate HRQOL. However, persistent concerns included treatment side-effects; difficulties accessing quality care; inadequate health insurance, barriers to good physician-patient relationship such as language and doctors' time constraints; insufficient knowledge about CCA due to limited information from medical staff; lack of control over treatments; social support, family well-being, functional and work issues; and sexuality and relationship concerns. Socioeconomic status, ethnicity, cultural beliefs and practices, age and family support dictated the level of cancer-related burden.
Invasive CCA is primarily a cancer of women who are economically disenfranchised. Women with a CCA diagnosis are disproportionately challenged by lack of resources including quality, affordable health care and psychosocial services. CCS experience persistent medical, psychological, social, and relational concerns. Information concerning CCS is needed, particularly in Spanish, Vietnamese and Korean. There is an urgent need for further research to understand the risk factors, and the social and cultural mediators of cancer-related HRQOL for CCS.

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    • "However, persistent concerns included the side effects of treatment, difficulties accessing quality care, inadequate health insurance, barriers to a good physician–patient relationship such as language and doctors’ time constraints, insufficient knowledge about cervical cancer due to limited information from medical staff, along with lack of control over treatment, social support, family well-being, functional, and work issues, and sexuality and relationship concerns. Socioeconomic status, ethnicity, cultural beliefs and practices, age, and family support dictated the level of cancer-related burden.24 "
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    ABSTRACT: The aim of this study was to evaluate health behaviors and quality of life (QoL) in cervical cancer survivors, and to identify factors that may compromise or enhance their health-related QoL. Data were collected retrospectively from the records of 102 consecutive patients with cervical cancer treated from May 2007 to January 2009 at the People's Hospital of Xintai City in Shandong Province. The study methodology was guided by the contextual model of health-related QoL. The results showed the significant mediating effects of general health status and psychological well-being between life burden and health-related QoL, between sexual impact of the disease and health-related QoL, and between the patient-doctor relationship and health-related QoL. In addition, there were a significant association between health-related QoL, education level, tumor stage, marital status, and age. Life burden and the patient-doctor relationship was also related to the sexual impact of the disease. However, no significant difference in health-related QoL and sexual impact was observed according to type of treatment received. These results advance our understanding of the predictors of health-related QoL and the relationship between them. Health-related QoL in cervical cancer survivors may be improved by mediating life burden, sexual functioning, and the patient-doctor relationship.
    Full-text · Article · Apr 2014 · OncoTargets and Therapy
    • "In this regard, Meyerowitz et al. found that received social support from family members is associated with flexibility and emotional vitality in women with cervical cancer.[8] Furthermore, Ashing-Giwa et al. also found that in order to increase disease improvement, American women have faith in God and rely on their families.[9] The results of another study about experiences of patients after prostatectomy showed that men consider their spouses as an important supportive source to control their anxiety.[10] "
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    ABSTRACT: Cancer diagnosis is an important event in an individual's life which has considerable outcomes and implications for patient and his/her family. Meanwhile, receiving assistance and support from family and friends has a significant impact on patients to help them to cope with disease-related stress and its treatment. This study aimed to assess the received social support and its correlation with demographic and medical variables. This was a cross-sectional descriptive study on two hundred cancer patients referred to Sayed Al-Shohada Medical Center in Isfahan, Iran. The study subjects were selected through convenient sampling method and required information collected by questionnaire containing demographic and medical data and Multidimensional Scale of Perceived Social Support (MSPSS). Some of the inclusion criteria included age over 18 with no history of mental disorders and not being at final stages of the disease. Content validity of MSPSS was confirmed by experts and its reliability was evaluated by test-retest (r > 0.85). The majority of cancer patients (94.5%) perceived a high rate of social support from their families, friends and relatives. Furthermore, the findings indicated a statistical significant correlation between the numbers of children with social support; however, no significant correlation was found between other demographic and medical variables with social support. The findings of this study indicated receiving the maximum acceptable social support from family, especially children, in patients with cancer. However, conducting further extensive studies is recommended to find effective factors on social support of patients with cancer.
    No preview · Article · May 2012 · Iranian journal of nursing and midwifery research
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    • "In many ways, however, the causal explanations formulated by Zambian women departed from those described in other parts of the world. Salient lay causal mechanisms not commonly expressed by our participants included fate, sin (Wong et al., 2008, Ramanakumar et al., 2005, Ratanasiri et al., 2000) or divine punishment (Ashing- Giwa et al., 2004); carelessness and negligence (Goldman & Risica, 2004) ingestion of taboo food (Wong et al., 2008; Ratanasiri et al., 2000); and other lifestyle factors such as stress, physical activity, or smoking (Ashing-Giwa et al., 2004; Chavez et al., 1995). A cause cited by other Zambian women but not noted amongst our participants is lack of routine hygiene (AUTHORS, 2010). "
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    ABSTRACT: Invasive cervical cancer is the second most common cancer among women worldwide, with approximately 85% of the disease burden occurring in developing countries. To date, there have been few systematic efforts to document African women's conceptualization of cervical cancer after participation in a visual inspection with acetic acid (VIA)-based "see and treat" cervical cancer prevention program. In this study, conducted between September, 2009-July, 2010, focus groups and in-depth interviews were conducted with 60 women who had recently undergone cervical cancer screening at a government-operated primary health care clinic in Lusaka, Zambia. Interviewers elicited participants' causal representations of cervical cancer, associated physical signs and symptoms, perceived physical and psychological effects, and social norms regarding the disease. The lay model of illness causation portrayed by participants after recent exposure to program promotion messages departed in several ways from causal models described in other parts of the world. However, causal conceptualizations included both lay and biomedical elements, suggesting a possible shift from a purely traditional causal model to one that incorporates both traditional concepts and recently promoted biomedical concepts. Most, but not all, women still equated cervical cancer with death, and perceived it to be a highly stigmatized disease in Zambia because of its anatomic location, dire natural course, connections to socially-condemned behaviors, and association with HIV/AIDS. No substantive differences of disease conceptualization existed according to HIV serostatus, though HIV positive women acknowledged that their immune status makes them more aware of their health and more likely to seek medical attention. Further attention should be dedicated to the processes by which women incorporate new knowledge into their representations of cervical cancer.
    Full-text · Article · Mar 2012 · Social Science [?] Medicine
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