title: Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: an ethnographic, photographic study.
abstract: OBJECTIVE
  To describe the caring behaviors and demands of African American women newly diagnosed with breast cancer and to consider the influence of caring on the women's decision to delay prompt diagnosis and maintain continuing treatment.
  
  
  METHODS
  Focused ethnographic design using photography.
  
  
  METHODS
  13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South.
  
  
  METHODS
  Ethnographic interviews (transcribed verbatim), observations at informant-selected sites, field notes, and snapshots of caring taken by the women where caring occurred were analyzed using Lelninger's phases of ethnographic analysis.
  
  
  RESULTS
  Major themes were (a) generic caring for others and self as meaningful and as promoting continued commitment to diagnosis and treatment, (b) generic and professional caring from others as supportive to the women in "going on," and (c) noncaring related to a "wait and see" attitude of healthcare providers and of women in delaying early diagnosis.
  
  
  CONCLUSIONS
  African American women's caring both for and from others was supportive in seeking and continuing diagnosis and treatment. The women with cancer viewed ensuring early diagnosis and continued treatment for other women as their "mission." Delay by providers and women requires further research.
  
  
  CONCLUSIONS
  Nurses must advocate assertiveness for African American women in seeking help for breast cancer symptoms and in challenging providers who adopt a "wait and see" attitude when symptoms are present. Taking snapshots, in addition to fostering the research process, is suggested as a potentially helpful intervention for women as they work through their experiences during treatment for breast cancer.
authors.affiliation: Bronson School of Nursing, Western Michigan University, Kalamazoo, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: Gates
authors.forename: N R
authors.initials: NR
authors.lastname: Lackey
authors.forename: G
authors.initials: G
authors.lastname: Brown
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology* / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009859:Oncology Nursing; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015144:Southeastern United States; D016387:Women's Health