Perceived Discrimination and Ethnic Identity Among Breast Cancer Survivors

Abstract

Purpose/Objectives To examine ethnic identity and sociodemographic factors in minority patients' perceptions of healthcare discrimination in breast cancer care. Design Mixed methods. Setting Participants' homes in the metropolitan areas of Phoenix and Tucson, AZ. Sample 39 women treated for breast cancer in the past six years: 15 monolingual Spanish-speaking Latinas, 15 English-speaking Latinas, and 9 African Americans. Methods Two questionnaires were administered. Individual interviews with participants were conducted by nurse researchers. Quantitative, qualitative, and matrix analytic methods were used. Main Research Variables Ethnic identity and perceptions of discrimination. Findings Eighteen women (46%) believed race and spoken language affected the quality of health care. Perceived disrespect from providers was attributed to participant's skin color, income level, citizenship status, and ability to speak English. Discrimination was more likely to be described in a primary care context, rather than cancer care. Ethnic identity and early-stage breast cancer diagnosis were the only study variables significantly associated with perceived healthcare discrimination. Conclusions This article describes the first investigation examining ethnic identity and perceived discrimination in cancer care delivery. Replication of this study with larger samples is needed to better understand the role of ethnic identity and cancer stage in perceptions of cancer care delivery. Implications for Nursing Identification of ethnic-specific factors that influence patient's perspectives and healthcare needs will facilitate development of more effective strategies for the delivery of cross-cultural patient-centered cancer care.

Quality of cancer follow-up care: a focus on Latina breast cancer survivors

“…These findings support the existing literature indicating that Latinas report treatment dissatisfaction and lower quality of care ratings [19, 22]. Furthermore, our findings concur with the limited literature reporting that Latina BCS [19], and Latinos in general [33], perceive receiving lower quality of care due to their limited English language proficiency. Limited English language proficiency may interplay with communication and socioeconomic issues, which in turn can affect perceptions of the quality of care received.…”

“…Latinas report poorer provider communication, trust, and greater treatment dissatisfaction [19–21], as well as lower quality care ratings compared to non-Latina White women [19, 22, 23]. Research indicates that good patient-provider relationship and quality of care may enhance patients’ medical outcomes [20, 24].…”

“…Research indicates that good patient-provider relationship and quality of care may enhance patients’ medical outcomes [20, 24]. Also, Latinas attribute their lower quality of cancer care to their ethnic group membership, low income, immigration status, and limited English language proficiency [19]. Despite these documented disparities in cancer care, Latinas are underrepresented in cancer research [25, 26].…”

“Come on Baby. You Know I Love You”: African American Women’s Experiences of Communication with Male Partners and Disclosure in the Context of Unwanted Sex

“…Possible underlying explanations for non-disclosure to formal support resources may be related to medical mistrust, perceived discrimination, and racism. These factors have been cited in previous research with African Americans (Campesino, Saenz, Choi, & Krouse, 2012; Hammond, 2010), but not in the context of unwanted sex. Further research is needed to elucidate how these cultural factors may impede disclosure among African American women with experiences of unwanted sex in order to create culturally-tailored programs for this vulnerable group.…”

Educación de supervivencia para supervivientes de cáncer de mama latinas: empoderando a las supervivientes a través de la educación

“…Latina breast cancer survivors have worse overall quality of life (physical, psychological, social and spiritual) outcomes relative to non-White Latina, African-American and Asian survivors (7-10). Contextual factors contributing to cancer-related health disparities and poor cancer outcomes include low socioeconomic status, lack of health insurance, low education attainment, legal status, linguistic barriers, insufficient information, immigration status, and discrimination (11-13). Latina breast cancer survivors are vulnerable to poor quality of life (QOL) and survivorship outcomes in comparison to Non-Latina whites.…”