Abstract
This study examined African-American cancer patients’ attitudes toward cancer and their relationship with long-term mental health outcomes. Using mixed methods, 74 breast and prostate cancer patients including 34 depressed and 23 nondepressed African-Americans and 17 depressed Whites were interviewed. The interviews were audiotaped and transcribed. Qualitative data analysis identified themes that were coded. The codes were entered into SPSS software. Fisher’s exact test was performed to examine group differences in the identified themes. Nondepressed African-Americans more frequently reported cancer as an adaptive experience (p = 0.047) and less frequently as a struggle (p = 0.012) than the depressed African-Americans and Whites. Groups did not significantly differ in the belief that cancer has no cure (p = 0.763), but depressed African-Americans more frequently reported unwillingness to share a cancer diagnosis with family or friends than depressed Whites (p = 0.50). African-Americans’ adaptive attitudes to cancer exhibit a pragmatist approach and a worldview shaped by their lived experience. Participants’ narratives were examined to illuminate the meanings of these findings. Adaptive attitudes to cancer are associated with better long-term mental health outcomes, and conversely, unpreparedness and inability to cope are associated with a higher risk of depression among African-American cancer patients. Education about cancer and supports for treatment navigation are important measures for improving the long-term mental health of African-Americans living with cancer.
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Acknowledgements
This study was supported by the National Institutes of Health/National Cancer Institute (R03 CA115191-01A2; PI: Zhang). University Hospitals of Cleveland Case Medical Center, the Cleveland Department of Veterans Affairs Medical Center, and the MetroHealth System affiliated with Case Western Reserve University provided support for patient access. The authors declare that they have no conflicts of interest.
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Zhang, A.Y., Gary, F. & Zhu, H. Attitudes Toward Cancer and Implications for Mental Health Outcome in African-American Cancer Patients. J Canc Educ 30, 138–144 (2015). https://doi.org/10.1007/s13187-014-0704-0
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DOI: https://doi.org/10.1007/s13187-014-0704-0