Symptoms and Self-Management in Low Income African Americans with Advanced Cancer 公开

Yeager, Kate (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/xg94hq36p?locale=zh
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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


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