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Hamilton JB, Abiri AN, Nicolas CA, Gyan K, Chandler RD, Worthy VC, Grant EJ. African American Women Breast Cancer Survivors: Coping with the COVID-19 Pandemic. J Cancer Educ 2023; 38:1539-1547. [PMID: 37014616 PMCID: PMC10071457 DOI: 10.1007/s13187-023-02296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 06/19/2023]
Abstract
African American women breast cancer survivors are among those with the greater burden of cancer. Breast cancer is the second leading cause of death among black women, and this death rate is 40% higher than that of white women. The COVID-19 pandemic increased the burden of morbidity and mortality among this population of cancer survivors. In this report, we explore the ways in which the COVID-19 pandemic was a source of stress for African American women breast cancer survivors and their subsequent responses to these stressors. This is a qualitative descriptive study with content analysis of data from the narratives of 18 African American breast cancer survivors. Participants were interviewed via phone and video conferencing platform and asked questions related to their experiences with the COVID-19 pandemic. The findings suggest stressors associated with (1) potential COVID-19 spreaders in their immediate environments; (2) closures and restricted access to social- and faith-based activities; (3) televised news broadcasts of COVID-19; and (4) disruptions to planned cancer prevention and control healthcare. Three categories emerged that captured the ways in which these women responded to stressors during the early phase of this pandemic: (1) seeking control in their social environments; (2) following the rules; and (3) seeking support from God, family, and friends. These findings can be used to better support breast cancer patients during the early phases of a pandemic.
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Affiliation(s)
- Jill B Hamilton
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.
- Candler School of Theology, Emory University, Atlanta, GA, 30322, USA.
| | - Autherine N Abiri
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA
| | - Charlyne A Nicolas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA
| | - Kayoll Gyan
- Dana Farber Cancer Institute, Harvard Medical School, Boston, 02115, USA
| | - Rasheeta D Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA
| | | | - Ernest J Grant
- Duke University School of Nursing, Durham, NC, 27708, USA
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Hamilton JB, Best NC, Barney TA, Worthy VC, Phillips NR. Using Spirituality to Cope with COVID-19: the Experiences of African American Breast Cancer Survivors. J Cancer Educ 2022; 37:1422-1428. [PMID: 33595772 PMCID: PMC7886845 DOI: 10.1007/s13187-021-01974-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 05/05/2023]
Abstract
African American women with breast cancer generally rely on their spirituality to cope with psychosocial issues encountered during survivorship. However, in order to mitigate the risk of contracting COVID-19, a potentially deadly disease, it is imperative that community-dwelling older adults physically distance themselves from supportive family, friends, and even traditional faith-based activities. In this report, we explore the ways in which spirituality was used to manage stressors during this pandemic. This is a qualitative descriptive study with content analysis of data from the narratives from 18 African American breast cancer survivors. Participants were interviewed via phone and video conferencing platform and asked to respond to questions of strategies used to manage stressors encountered during this COVID-19 pandemic. Spirituality enabled African American breast cancer survivors to better manage their psychological distress through (1) increased engagement in religious activities; (2) reliance on God for protection when fearful, feeling isolated, and in need of assistance to pay household bills; (3) finding joy and courage from listening to gospel music and reading scripture; and (4) finding meaning through spirituality. These findings suggest that in spite of physical distancing requirements that impose limited access to faith-based institutions during this COVID-19 pandemic, spirituality continues to be a supportive resource to manage emotional stressors.
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Affiliation(s)
- Jill B Hamilton
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.
- Candler School of Theology, Emory University, Atlanta, GA, 30033, USA.
| | - Nakia C Best
- Irvine, Sue & Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA
| | - Tara A Barney
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA
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Corbett CM, Somers TJ, Nuñez CM, Majestic CM, Shelby RA, Worthy VC, Barrett NJ, Patierno SR. Evolution of a longitudinal, multidisciplinary, and scalable patient navigation matrix model. Cancer Med 2020; 9:3202-3210. [PMID: 32129946 PMCID: PMC7196067 DOI: 10.1002/cam4.2950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 12/06/2019] [Accepted: 02/02/2020] [Indexed: 12/12/2022] Open
Abstract
This Longitudinal patient navigation Matrix Model was developed to overcome barriers across the cancer care continuum by offering prepatients, patients, and their families with support services. The extraordinary heterogeneity of patient needs during cancer screening, risk assessment, treatment, and survivorship as well as the vast heterogeneity of oncology care settings make it nearly impossible to follow a static navigation model. Our model of patient cancer navigation is unique as it enhances the traditional model by being highly adaptable based on both patient and family needs and scalable based on institutional needs and resources (eg, clinical volumes, financial resources, and community‐based resources). This relatively new operational model for system‐wide and systematic navigation incorporates a carefully cultivated supportive care program that evolved over the last decade from a bottom up approach that identified patient and family needs and developed appropriate resources. A core component of this model includes shifting away from department‐centric operations. This model does not require a patient to opt in or independently be able to report their needs or ask for services—it is an opt out model. The multidisciplinary “cross‐training” model can also facilitate reimbursement and sustainability by clarifying the differentiating actions that define navigation services: identification of barriers to quality care and specific actions taken to overcome those barriers, across the full continue of cancer care from community engagement to survivorship or end‐of‐life care.
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Affiliation(s)
- Cheyenne M Corbett
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Christine M Nuñez
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Catherine M Majestic
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Valarie C Worthy
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Nadine J Barrett
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.,Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Steven R Patierno
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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Hamilton JB, Worthy VC, Moore AD, Best NC, Stewart JM, Song MK. Messages of Hope: Helping Family Members to Overcome Fears and Fatalistic Attitudes Toward Cancer. J Cancer Educ 2017; 32:190-197. [PMID: 26314571 DOI: 10.1007/s13187-015-0895-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This qualitative study explored strategies family members of African-American cancer patients used to overcome their fears and fatalistic attitudes toward cancer. Twenty-four family members were recruited through criterion purposeful sampling. Data were collected and analyzed using open-ended interviews and thematic analysis. Fears and fatalistic attitudes could be traced to personal experiences with cancer and information being communicated within their networks. Strategies used to overcome fears and fatalistic attitudes toward cancer included an awareness of advances in cancer treatments, information obtained from their health-care providers, and faith in God. Family members supported the patient through efforts of encouraging them to talk about what they were going through, to be strong, to maintain a positive environment and normalcy, and to use spirituality as a source of strength. Family members also suggested that health-care providers and researchers tailor intervention studies to consider that the patient is a part of a larger family system and that the entire family needs support to overcome long-held fears and fatalistic attitudes toward cancer. These findings suggest that despite advances in cancer care and widespread media coverage to change perceptions about cancer, fears and fatalistic attitudes toward cancer persist and likely influence the family members' ability to optimally support the cancer patient. At the time of diagnosis, both patient and the entire family unit should be educated of advances in cancer care, that cancer is no longer a death sentence, and supported to overcome fears and fatalistic attitudes.
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Affiliation(s)
- Jill B Hamilton
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | | | - Angelo D Moore
- Moore & Moore Healthcare Consulting, LLC., P.O. Box 48852, Cumberland, NC, 28331, USA
| | - Nakia C Best
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | - Jennifer M Stewart
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Mi-Kyung Song
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
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Hamilton JB, Best NC, Galbraith KV, Worthy VC, Moore LTCAD. Strategies African-American Cancer Survivors Use to Overcome Fears and Fatalistic Attitudes. J Cancer Educ 2015; 30:629-635. [PMID: 25266472 DOI: 10.1007/s13187-014-0738-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This qualitative study explored strategies African-American cancer survivors use to overcome their fears and fatalistic attitudes toward cancer at the point of diagnosis through completion of treatment. Thirty-one African-American cancer survivors who had completed or nearly completed treatment were recruited through criterion purposeful sampling. In-depth, open-ended interviews were used to collect data. The data were analyzed using thematic analysis. Of the 31 survivors interviewed, 26 reported being fearful of cancer and believed that cancer would result in death. These cancer survivors were particularly fearful of having a cancer had spread, of being isolated, and performing less effectively at work. Strategies used to overcome these fears included increasing their own awareness about cancer, using positive self-talk, and avoiding negative people. The findings suggest that past experiences continue to influence fears and fatalistic perspectives about cancer and that educational resources to inform the public about cancer may be ignored until there is a confirmed diagnosis of cancer. Televised news broadcasts of high-profile personalities who had died from cancer were also anxiety provoking, particularly if the cancer survivor died of a recurrence from cancer. Prevalent sources of information and support for these survivors were family members or close friends they trusted with personal information, perceived as strong, or experienced in the care of other cancer survivors.
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Affiliation(s)
- Jill B Hamilton
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Nakia C Best
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | - Kayoll V Galbraith
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | | | - L T C Angelo D Moore
- Center for Nursing Science and Clinical Inquiry, Womack Army Medical Center, U.S. Army, 2817 Reilly Road, Fort Bragg, NC, USA
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Hamilton JB, Galbraith KV, Best NC, Worthy VC, Moore LTCAD. African-American Cancer Survivors' Use of Religious Beliefs to Positively Influence the Utilization of Cancer Care. J Relig Health 2015; 54:1856-69. [PMID: 25269756 DOI: 10.1007/s10943-014-9948-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Among African-Americans, religion impacts health-seeking behaviors. This qualitative study used criterion purposeful sampling and thematic analysis in analysis of data from 31 African-American cancer patients to understand the influence of religion on the utilization of cancer care services. Our findings suggest that religious beliefs and practices positively influenced attitudes toward their illness and ability to endure treatment. God's ability to heal and cure, God's control over survival, God's will over their lives, and God's promise for health and prosperity were examples of survivor's religious beliefs. Religious practices such as prayer promoted a trusting relationship with healthcare providers and were a source of strength and encouragement.
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Affiliation(s)
- Jill B Hamilton
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA,
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Hamilton JB, Best NC, Galbraith KV, Worthy VC, Moore AD. Erratum to: Strategies African-American Cancer Survivors Use to Overcome Fears and Fatalistic Attitudes. J Cancer Educ 2015; 30:204. [PMID: 25510365 DOI: 10.1007/s13187-014-0763-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Jill B Hamilton
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA,
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