African-American survivors of prostate cancer: a meta-synthesis of qualitative studies

Abstract

Purpose

The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences.

Method

We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare’s meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program.

Results

This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme.

Conclusion

Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional.

Implications for cancer survivors

This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.

Appendix 1. Literature search strategies

Search strategy for PubMed (United States National Library of Medicine, 1809–present), September 2018

((((((“prostatic neoplasms”[Mesh]) OR prostate cancer)) AND ((“survivors”[Mesh]) OR survivor*)) AND ((“African Americans”[Mesh]) OR ((African American*) OR black american*)))) AND ((((((((((“marriage”[Mesh] OR “Spouses”[Mesh])) OR ((married) OR spous*)) OR ((partnered) OR “in a relationship”))) OR (((((“single person”[Mesh]) OR (((single) OR unmarried) OR unpartnered)) OR solitary) OR ((“divorce”[Mesh]) OR “Widowhood”[Mesh])) OR ((divorce*) OR widow*))) OR (((relationship status) OR “marital status”[Mesh]) OR marital status))) OR (((((couple*) OR dyad*) OR wife) OR wives) AND “last 10 years”[PDat])) AND “last 10 years”[PDat]) Sort by: PublicationDate

Search strategy for PsycINFO (EBSCO, seventeenth century–present), September 2018

(((DE “prostate” AND DE “neoplasms”) OR ((TI prostat* N2 cancer*) OR (AB prostat* N2 cancer*))) AND (TX localized) AND (DE “survivors” OR TX survivor*) AND ((DE “Blacks” OR (TX “African American*” OR TX black N2 American*)) AND ((TX married OR TX spouse* OR TX partner* OR TX “in a relationship” OR TX single OR TX unmarried OR TX unpartnered OR TX solitary OR TX divorce* OR TX widow* OR TX “relationship status” OR TX “marital status” OR TX “significant other*” OR TX couple* OR TX dyad* OR TX wife OR TX wives) OR (DE “spouses” OR DE “husbands” OR DE “wives” OR DE “Couples” OR DE “same sex couples” OR DE “significant others” OR DE “marital status” OR DE “never married” OR DE “divorced persons” OR DE “widowers”))

Search strategy for CINAHL Plus with full text (EBSCO, 1937–present), September 2018

(((MH “prostatic neoplasms+”) OR ((TI prostat* N2 cancer*) OR (AB prostat* N2 cancer*))) AND (TX localized) AND ((MH “survivors+”) OR (TX survivor*)) AND (((MH “Blacks”) OR ((TX “African American*”) OR (TX black N2 American*))) AND ((TX married OR TX spouse* OR TX partner* OR TX “in a relationship” OR TX single OR TX unmarried OR TX unpartnered OR TX solitary OR TX divorce* OR TX widow* OR TX “relationship status” OR TX “marital status” OR TX “significant other*” OR TX couple* OR TX dyad* OR TX wife OR TX wives) OR (MH “marital status+” OR MH “significant other” OR MH “spouses”))

Search strategy for Web of Science (Clarivate Analytics, 1900–present), September 2018

(“prostate cancer” OR “prostate neoplasm*”) AND localized AND survivor* AND (black* NEAR/2 America* OR “African American*” OR “African-American”) AND (married OR spouse* OR partner* OR “in a relationship” OR single OR unmarried OR unpartnered OR solitary OR divorce* OR widow* OR “relationship status” OR “marital status” OR “significant other*” OR couple* OR dyad* OR wife OR wives OR husband* OR couple* OR “significant other*” OR “never married”)

Search strategy for Social Services Abstracts (ProQuest, 1979–present), September 2018

(“prostate cancer” or “prostate neoplasm*”) AND localized AND survivor* AND (black* NEAR/2 America* or “African American*” or “African-American”) AND (married or spouse* or partner* or “in a relationship” or single or unmarried or unpartnered or solitary or divorce* or widow* or “relationship status” or “marital status” or “significant other*” or couple* or dyad* or wife or wives or husband* or couple* or “significant other*” or “never married”)