title: Fatalism or destiny? A qualitative study and interpretative framework on Dominican women's breast cancer beliefs.
abstract: BACKGROUND
  A growing literature on Latino's beliefs about cancer focuses on the concept of fatalismo (fatalism), despite numerous conceptual ambiguities concerning its meaning, definition, and measurement. This study explored Latina women's views on breast cancer and screening within a cultural framework of destino ("destiny"), or the notion that both personal agency and external forces can influence health and life events.
  
  
  METHODS
  Semi-structured interviews were conducted with 25 Latinas from the Dominican Republic aged 40 or over.
  
  
  RESULTS
  Respondents reported complex notions of health locus of control that encompassed both internal (e.g., individual action) and external (e.g., the will of God) forces shaping breast cancer prevention efforts. Furthermore, women actively participated in screening because they believed that cancer could become a death sentence if diagnosed late or left untreated.
  
  
  CONCLUSIONS
  In contrast to simplistic notions of "fatalism", our analysis suggests complex strategies and beliefs regarding breast cancer and cancer screening that speak of resiliency rather than hopelessness.
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168 Street, 5th floor, New York, NY 10032, USA.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Flórez
authors.forename: Alejandra N
authors.initials: AN
authors.lastname: Aguirre
authors.forename: Anahí
authors.initials: A
authors.lastname: Viladrich
authors.forename: Amarilis
authors.initials: A
authors.lastname: Céspedes
authors.forename: Ana Alicia
authors.initials: AA
authors.lastname: De La Cruz
authors.forename: Ana F
authors.initials: AF
authors.lastname: Abraído-Lanza
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D003466:Cultural Characteristics; D004293:Dominican Republic / Q000208:ethnology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D029181:Spirituality; D014481:United States / Q000453:epidemiology