All ETDs from UAB

Advisory Committee Chair

Karen Meneses

Advisory Committee Members

Tiffany L Carson

Susan Davies

Comfort Enah

Nataliya Ivankova

Document Type

Dissertation

Date of Award

2016

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

In the United States, 26,393 young women (≤ 45 years) will be diagnosed with breast cancer in 2016. Though survival rates are improving, there are health disparities among young African American women when compared to young Caucasians (e.g., poorer quality of life). Despite recommendations to provide targeted evidence-based survivorship care, there are about 23,000 young African American breast cancer survivors (YAABCS) in Alabama, Louisiana, and Mississippi for whom this care does not exist. Few studies have examined survivorship experiences and/or tested intervention efficacy among this group. Further study is warranted to understand the experiences of YAABCS and adapt targeted interventions to improve quality of life. The purpose of this transcendental phenomenological study was to explore the lived experience of young African American breast cancer survivorship to inform the adaptation of a Research-Tested Intervention Program (Breast Cancer Education Intervention) for use among YAABCS. This study was guided by the conceptual framework of the Research-Tested Intervention Program (Quality of Life Model Applied to Breast Cancer) and a methodological framework (Nolan’s Evidence-based Disparity Intervention Translation Framework). A purposive and snowball sample of YAABCS was recruited from Alabama, Louisiana, and Mississippi. Data collected included a sociodemographic survey, two semi-structured interviews, field/reflective notes, and volunteered personal effects. Qualitative data were analyzed using NVivo11 Pro Software, then validated with participating YAABCS. Sociodemographic data were analyzed to describe participants’ characteristics. Fifteen YAABCS (mean age = 35 years; mean survivorship = 4 years) perceived survivorship as a labile, “new normal.” The essence of young African American breast cancer survivorship was described as actively structuring life to manage changes to physical, psychological, social, and spiritual self as well as seeking survivorship knowledge. While YAABCS often reported successful survivorship management, they acknowledged that survivorship was an ongoing “struggle” in which spirituality and survivorship knowledge were key. Findings from this study indicate that survivorship among YAABCS was more fluid and complex than the framework. Thus, findings provide formative data to adapt a targeted intervention that will be named Y-AMBIENT. Future testing of Y-AMBIENT will explore quality of life and potentially decrease quality of life health disparity among YAABCS.

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Nursing Commons

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