Symptoms and Self-Management in Low Income African Americans with Advanced Cancer Open Access
Yeager, Kate (2012)
Abstract
Abstract
Symptoms and Self-Management in Low Income African Americans
with Advanced Cancer
Background:
Little is known about the symptom
experience of African Americans with advanced
cancer, although many African Americans disproportionately
experience advanced
cancer. Individuals with advanced cancer must work to manage
symptoms in order to
function day-to-day and experience a satisfactory quality of life.
The challenges of
symptom management are amplified in persons with little financial
resources.
Purpose:
This purpose of this study was to explore the
symptom experience and symptom self-
management practices of low-income African American adults with
advanced cancer.
Sample:
Twenty-seven participants receiving care at
Grady Memorial Hospital in Atlanta, Georgia
participated in the study by completing an in-depth interview
conducted by two research
interviewers. The majority of the sample was female (n=18) with a
mean age of 57
(range 30 to 79).
Methods:
Our knowledge regarding symptom experience
and self-management practices among
low-income African Americans with advanced cancer is limited. The
qualitative research
paradigm applied in this study allows for an inquiry that considers
the perspective of the
participants, the so-called insiders' perspective. Data analysis
involved the constant
comparison method, including axial coding.
Findings:
Two main themes emerged in terms of the
participants' symptom experiences: (1) "being
in pain," which included the overwhelming experience of living with
pain, both physical
and emotional pain and (2) "symptoms associated with functioning in
everyday life".
Participants frequently used the context of activities in their
daily lives to explain
symptoms, including the effect of symptoms on the activities of
eating, moving/doing,
and communicating. The symptom self- management strategies were
captured in two
main themes: behavioral and spiritual coping. Behavioral coping
included using
medications and lifestyle changes. Spiritual coping included the
use of faith and prayer.
Discussion:
People with advanced cancer have to
negotiate a high frequency of multiple distressful
symptoms with severe to moderate severity requiring multiple
medications and
management strategies. Information gained from this study can help
guide research in
symptom self-management and provide direction for clinicians
working with this
minority group.
Table of Contents
Table of Contents
Chapter 1:Introduction
Statement
of
Problem
1
Purpose of study
3
Aims of study
3
Context of Inquiry
4
Author's
Biography
10
Chapter 2: Literature Review
Advanced
Cancer
14
Symptoms
15
Symptom
Self-
management
18
Role of Socioeconomic Status
23
Summary
24
Significance
24
Chapter 3: Methodology
Research
Design
26
Data analysis
39
Chapter 4: Findings
Sample
Characteristics
45
The
Symptom
Experience
47
Being
in
pain
48
Symptoms associated with functioning
54
in
everyday
life
Summary
60
Strategies
60
Behavioral
coping
61
Spiritual
coping
75
Barriers
and
facilitators
84
Summary
87
Chapter 5: Discussion
The Symptom Experience
88
Being
in
pain
91
Symptoms associated with functioning
92
in
everyday
life
Strategies
96
Behavioral
coping
96
Spiritual
coping 101
Barriers
and
facilitators 103
Limitations
105
Implications
for
Research
106
Implications
for
Clinical
Practice
107
Implications
for
Health
Policy 108
Conclusion
109
References
111
About this Dissertation
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