title: "Weaving balance into life": Development and cultural adaptation of a cancer symptom management toolkit for Southwest American Indians.
abstract: BACKGROUND
  Self-management of cancer symptoms has the potential to decrease the suffering of cancer survivors while improving their health and quality of life. For many racial/ethnic groups, culturally appropriate self-management instruction is not readily available. This paper reports on the first symptom management toolkit developed for American Indian cancer survivors.
  
  
  METHODS
  Part of a larger research study, a three-phase project tested a cancer symptom self-management toolkit to be responsive to the unique learning and communication needs of American Indians in the Southwest U.S.A. American Indian cancer survivors and family members participated in 13 focus groups to identify cultural concepts of cancer and illness beliefs, communication styles, barriers, and recommendations for self-management techniques. Sessions were audiotaped and transcriptions were coded using grounded theory.
  
  
  RESULTS
  Participants expressed a need for an overview of cancer, tips on management of common symptoms, resources in their communities, and suggestions for how to communicate with providers and others. The "Weaving balance into life" toolkit is comprised of a self-help guide, resource directory, and video. Preferred presentation style and content for the toolkit were pilot tested.
  
  
  CONCLUSIONS
  American Indian survivors favor educational materials that provide information on symptom management and are tailored to their culture and beliefs. Suggestions for adapting the toolkit materials for other American Indian populations are made.
  
  
  CONCLUSIONS
  Many cancer survivors lack effective self-management techniques for symptoms, such as pain, fatigue, and depression. The toolkit promotes self-management strategies for survivors and provides family members/caregivers tangible ways to offer support.
authors.affiliation: School of Nursing, University of California, Los Angeles, 700 Tiverton Avenue, Factor Building #5-940, Los Angeles, CA 90095, USA. fhodge@sonnet.ucla.edu
authors.forename: Felicia Schanche
authors.initials: FS
authors.lastname: Hodge
authors.forename: Tracy Line
authors.initials: TL
authors.lastname: Itty
authors.forename: Mary P
authors.initials: MP
authors.lastname: Cadogan
authors.forename: Fernando
authors.initials: F
authors.lastname: Martinez
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D003142:Communication; D003469:Culture; D005221:Fatigue / Q000517:prevention & control; D006801:Humans; D007198:Indians, North American; D009369:Neoplasms / Q000517:prevention & control* / Q000523:psychology*; D010166:Palliative Care; D012648:Self Care; D015206:Southwestern United States; D017741:Survivors / Q000523:psychology*