ABSTRACT
PURPOSE/OBJECTIVES: To explore the relationships between cultural health beliefs, acculturation, treatment-related decisions, the doctor-patient relationship, and health behaviors among Asian American breast cancer survivors (AABCS), and the contextual meaning of those relationships among Korean American breast cancer survivors (KABCS) and AABCS. DESIGN: A mixed-methods triangulation design. SETTING: Community- and hospital-based support groups and hospital cancer registries in California. SAMPLE: 206 AABCS were included in the quantitative phase, and two focus groups were conducted with KABCS (N = 11) during the qualitative phase. METHODS: The quantitative phase used secondary data for AABCS. Standardized (i.e., cultural health beliefs, doctor-patient relationship, and acculturation) and newly developed instruments (i.e., health behaviors and treatment-related decisions) were used in the quantitative phase. An exploratory, descriptive, qualitative study of KABCS then was undertaken. MAIN RESEARCH VARIABLES: Cultural health beliefs, acculturation, treatment-related decisions, the doctor-patient relationship, and health behaviors. FINDINGS: Inter-intrapersonal health beliefs, doctor-patient relationship, and shared decision making were positively associated with adopting healthy lifestyle practices. Findings from the quantitative phase were explained further by the diverse themes that emerged in the KABCS focus groups. CONCLUSIONS: This study provides new knowledge about cultural health beliefs and health behaviors among KABCS using a mixed-methods approach. IMPLICATIONS FOR NURSING: The results highlight the need for greater attention to the cultural contexts of AABCS to promote healthy behaviors and recognition of the significant relationship between health professionals and breast cancer survivors.
Subject(s)
Asian/ethnology , Asian/psychology , Attitude to Health/ethnology , Breast Neoplasms , Oncology Nursing/methods , Transcultural Nursing/methods , Acculturation , Adult , Breast Neoplasms/ethnology , Breast Neoplasms/nursing , Breast Neoplasms/psychology , California , Culture , Female , Humans , Middle Aged , Nurse-Patient Relations , Nursing Methodology Research , Physician-Patient Relations , Qualitative Research , Registries , Stress, Psychological/ethnology , Stress, Psychological/nursing , Stress, Psychological/psychology , Survivors/psychologyABSTRACT
The purpose of this review article is to assess the available scientific evidence on the effects of couples-based psychosocial interventions for couples when one spouse faces cancer. For the present study, we conducted an extensive search of three electronic databases using a comprehensive search strategy. The literature search identified 14 studies evaluating couples intervention where one partner is facing cancer. Among them, eight studies concluded there was overall improvement for patients and eight studies reported overall improvement for partners, whereas an additional five studies showed partial improvement for patients and three demonstrated partial improvements for partners. Taken in the aggregate, these studies illustrated partial effectiveness--most had some positive results--but with clear limitations in terms of how many aspects of psychosocial well-being changed, lack of equal effectiveness for both patients and their partners, or limited maintenance of improvements over time, a common concern with brief psychosocial interventions. Although couples-based interventions may facilitate emotional support and dyadic coping, how these psychosocial interventions should be delivered, at what point in the illness and treatment they should be delivered, and how long they should continue remain as future challenges.
