A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients.

OBJECTIVES: One of the most common acute side effects of breast cancer radiotherapy is treatment-induced skin changes, referred to as skin toxicity. Yet no research to date has focused expressly on skin toxicity-related quality of life (QOL) in breast cancer radiotherapy patients. Therefore, our aim was to use qualitative approaches to better understand the impact of skin toxicity on QOL. METHODS: Semistructured interviews were conducted with 20 women (Stage 0-III breast cancer), during their last week of external beam radiotherapy. Each interview was transcribed verbatim, and thematic analysis was performed. RESULTS: Three themes were identified based on the interview responses: First, skin changes affect multiple dimensions of QOL. They cause physical discomfort, body image disturbance, emotional distress, and impair both day-to-day functioning and satisfaction with radiation treatment. Second, individual differences affect women's experiences. Generally African American women, younger women, women who are not currently in a relationship, women who are being treated during the summer, and women who are more invested in their appearance are more distressed by skin toxicity. Third, women use a variety of symptom management strategies including self-medication, complementary/alternative medicine approaches, and psychological strategies. CONCLUSIONS: Implications of results are as follows: (1) skin toxicity affects numerous dimensions of QOL, and assessment approaches and psychosocial interventions should address this; (2) individual differences may affect the experience of skin toxicity and should be considered in treatment and education approaches; and (3) participants' own creativity and problem-solving should be used to improve the treatment experience.

"We'd Be Free": Narratives of Life Without Homophobia, Racism, or Sexism.

Stigma and social inequality deprive disadvantaged social groups of a sense of social well-being. Stress researchers have focused on prejudice-related events and conditions but have not described more intangible stressors experienced by sexual minorities. We use narrative methods to examine how sexual minorities experience stigma and social inequality as we focus on the more intangible stressors that are both pervasive and difficult to measure. Three themes emerged in the narratives of our ethnically diverse sample of 57 adult sexual minority women and men: (a) stigma deprived them of access to critical possibilities and opportunities; (b) stigma deprives them of safety and acceptance; and (c) despite this, the experience of stigma is also related to the adoption of a positive and collective orientation towards their stigmatized identities. Recognizing these stressors and related resilience can direct policy makers toward interventions that go even beyond eliminating prejudice by including goals to strengthen minority communities.

Breast cancer patients' experience of external-beam radiotherapy.

Radiotherapy is a critical component of treatment for the majority of women with breast cancer, particularly those who receive breast conserving surgery. Although medically beneficial, radiotherapy can take a physical and psychological toll on patients. However, little is known about the specific thoughts and feelings experienced by women undergoing breast cancer radiotherapy. Therefore, the study aim was to use qualitative research methods to develop an understanding of these thoughts and feelings based on 180 diary entries completed during radiotherapy by 15 women with stage 0 to stage III breast cancer. Thematic analysis identified four primary participant concerns: (a) a preoccupation with time, (b) fantasies (both optimistic and pessimistic) about life following radiotherapy, (c) the toll their side-effect experience takes on their self-esteem, and (d) feeling mystified by radiotherapy. These themes are consistent with previous literature on illness and identity. These findings have implications for the treatment and care of women undergoing breast cancer radiotherapy.

A Qualitative Approach to the Intersection of Sexual, Ethnic, and Gender Identities.

In this paper we report on a new qualitative instrument designed to study the intersection of identities related to sexuality and race/ethnicity, and how people who hold those identities interact with social contexts. Researchers often resort to using separate measures to assess race/ethnicity, sexual orientation, and other target identities. But this approach can miss elements of a self-system that stem from the intersection of identities, the interactions between identities and social contexts, related shifts in identity over time, and related changes in the prominence and valence of identities. Using a small sub-sample, we demonstrate how our instrument can help researchers overcome these limitations. Our instrument was also designed for economy in administration and analysis, so that it could be used as a qualitative complement in large survey research.

Understanding why gay men seek HIV-seroconcordant partners: intimacy and risk reduction motivations.

Our goal was to situate the interest of some gay men in having HIV-seroconcordant partners within the psychosocial context of concurrent motivations for intimacy and sexual risk reduction. Data were obtained from semi-structured qualitative interviews with a racially/ethnically diverse sample of 32 gay men (16 HIV-positive and 16 HIV-negative) living in New York City who sought HIV-seroconcordant partners. Thematic analysis indicated that seroconcordant partner selection was strongly motivated by a desire to reduce sexual risk as well as the pursuit of multiple forms of intimacy. Affirmative experiences in seroconcordant relationships and goals for future long-term relationships also informed men's current partner selection practices. When seeking seroconcordant partners, men reported key junctures and disjunctures between motivations for intimacy and interests in risk reduction. Our findings suggest that HIV prevention efforts will have greater relevance if they address broader motivational concerns for partner selection and serosorting, including the pursuit of intimacy.