title: African and Black Caribbean origin cancer survivors: a qualitative study of the narratives of causes, coping and care experiences.
abstract: OBJECTIVE
  Although there is evidence in the U.S.A. and U.K. to suggest that ethnic minority groups have an inferior experience of cancer care, few studies investigate ethnic disparities in satisfaction and care experiences among survivors. Patients' illness perceptions (lay explanations for illness) and coping styles (emotional and behavioural) are influenced by ethnicity-related cultural beliefs and expectations. Depressive illness or fears of recurrence of cancer may also lead to poorer recovery and function. This paper investigates whether ethnic influences explain different coping behaviours, care experiences and help-seeking behaviours.
  
  
  METHODS
  Eight participants of African or Black Caribbean origin were recruited from a London support group for a series of qualitative in-depth interviews. The interviews were recorded and transcribed, and the transcripts analysed using a framework method of qualitative data analysis. The emergent themes were tested and documented to reflect the issues of importance to patients.
  
  
  RESULTS
  Lay explanations of causes of cancer were complex and diverse reflecting cultural influences and the impact of contact with health professionals. Generally, positive views about cancer care were found, especially at the secondary care level. Primary care attracted mixed views. In contrast to American studies, no acknowledgement of discrimination on the basis of ethnicity was reported. The need to be resilient and think positively were widely acknowledged as coping strategies. Some coped by avoiding contemplation of their condition or diagnosis. Religious beliefs and practices provided coping mechanisms for some, and a means to improve confidence and avoid distressing contemplation about their condition. Family, friends and charitable groups also provided emotional and practical support.
  
  
  CONCLUSIONS
  Subjects were generally satisfied with their care; different coping styles included positive attitudes, minimisation of difficulties or more realistic consideration of the impact of cancer.
authors: Barts and the London School of Medicine and Dentistry, Turner Street, London, E1 2AD, UK. ha1161@qmul.ac.uk
authors: Richard A
authors: RA
authors: Bache
authors: Kamaldeep S
authors: KS
authors: Bhui
authors: Simon
authors: S
authors: Dein
authors: Ania
authors: A
authors: Korszun
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D017691:Caribbean Region / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D011379:Prognosis; D036301:Qualitative Research; D012067:Religion; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*; D013637:Tape Recording; D006113:United Kingdom / Q000453:epidemiology