title: Managing One's Symptoms: A Qualitative Study of Low-Income African Americans With Advanced Cancer.
abstract: BACKGROUND
  African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life.
  
  
  OBJECTIVE
  The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do.
  
  
  METHODS
  A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management.
  
  
  RESULTS
  Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience.
  
  
  CONCLUSIONS
  This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms.
  
  
  CONCLUSIONS
  As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.
authors.affiliation: Author Affiliations: Nell Hodgson Woodruff School of Nursing, Emory University (Drs Yeager and Vena); Rollins School of Public Health, Emory University (Drs DiIorio and Sterk); Department of Veterans Affairs, Atlanta, Georgia (Dr Quest); Department of Emergency Medicine, Emory University (Dr Quest), Atlanta, Georgia; School of Nursing, University of Virginia, Charlottesville (Dr Bauer-Wu).
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Yeager
authors.forename: Claire E
authors.initials: CE
authors.lastname: Sterk
authors.forename: Tammie E
authors.initials: TE
authors.lastname: Quest
authors.forename: Colleen
authors.initials: C
authors.lastname: DiIorio
authors.forename: Catherine
authors.initials: C
authors.lastname: Vena
authors.forename: Susan
authors.initials: S
authors.lastname: Bauer-Wu
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology / Q000523:psychology; D000368:Aged; D017281:Cost of Illness; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D011203:Poverty / Q000208:ethnology / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology*; D014481:United States / Q000208:ethnology