“I’m Fighting for My Life”: Exploring Interactions Between Black Women with Breast Cancer and Healthcare Providers

Abstract

Black Americans face a multitude of problems in the healthcare system, including challenges during interactions with healthcare providers. The present study examined the quality of healthcare provider–Black patient interactions in a sample of Black American women with a breast cancer diagnosis. More specifically, the study examined potential contributors to Black Americans’ current healthcare experiences and lack of trust by identifying their specific negative and positive encounters in the healthcare system. Three in-person Gatherings (i.e., culturally curated focus groups; N = 37) were conducted as part of a community–academic research partnership, Project SOAR (Speaking Our African American Realities). Four themes were identified through reflexive thematic analysis: Individual and Systemic Injustice Directed at Black Breast Cancer Survivors; Protecting Myself from an Untrustworthy Medical System; Stereotypes Interfered with My Care; and Good Care Should Include Compassion, Respect, Shared Decision Making, and Tailored Support. The present findings highlight the importance of addressing systemic and individual injustice toward Black Americans in healthcare settings generally, and Black women diagnosed with breast cancer specifically.

Keywords

Black American women breast cancer healthcare provider oncologist doctor–patient interaction equity recommendations

Get full access to this article

View all access options for this article.

References

Berger

(2015). Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219–234. https://doi.org/10.1177/1468794112468475

Benjamin

(2022). Viral justice: How we grow the world we want. Princeton University Press.

Alsheik

Blount

Qiong

Talley

Pohlman

Troeger

Abbey

Mango

V. L.

Pollack

Chong

Donadio

Behling

Mortimer

Conant

(2021). Outcomes by race in breast cancer screening with digital breast tomosynthesis versus digital mammography. Journal of the American College of Radiology, 18(7), 906–918. https://doi.org/10.1016/j.jacr.2020.12.033

American Cancer Society (2020). Breast cancer facts & figures 2019-2020. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf

American Cancer Society (2022a). Breast cancer statistics: How common is breast cancer? American Cancer Society. https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html

American Cancer Society (2022b). Cancer facts & figures. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2022/2022-cancer-facts-and-figures.pdf

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braun

Clarke

Hayfield

Terry

(2019). Thematic analysis. Handbook of research methods in health social sciences (pp. 843–860). Springer Singapore. https://doi.org/10.1007/978-981-10-5251-4_103

Bynum

J. P. W.

Braunstein

J. B.

Sharkey

Haddad

A. W.

(2005). The influence of health status, age, and race on screening mammography in elderly women. Archives of Internal Medicine, 165(18), 2083–2088. https://doi.org/10.1001/ARCHINTE.165.18.2083

10.

Caballo

Dey

Prabhu

Seal

Chu

(2021). The effects of socioeconomic status on the quality and accessibility of healthcare services. Across the Spectrum of Socioeconomics, 4(236), 4734672. https://doi.org/10.5281/zenodo.4740684

11.

Carrie’s TOUCH (2021). Mission + credo — we make the difference. https://www.carriestouch.org/mission-credo

12.

Centers for Disease Control and Prevention (2021). Basic information about breast cancer. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/index.htm

13.

Crenshaw

(1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), 8. http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8/

14.

Denyse

Martin

K. J.

Kim

J. H. J.

Pageot

Y. K.

DeLuz

K. D.

Owoyemi

Stanton

A.L

(2021). Project SOAR: The Strong Black Woman schema in the breast cancer context. Paper presented at the annual San Antonio breast cancer symposium, San Antonio, Texas, 2021. https://doi.org/10.1158/1538-7445.SABCS21-P4-11-23

15.

Denyse

Martin

K. J.

Kim

J. H. J.

Pageot

Y. K.

DeLuz

K. D.

Owoyemi

Stanton

A.L.

(n.d.). “No complaining, no crying”: A qualititative study of the Strong Black Woman schema in the breast cancer context.

16.

Denyse

Martin

K. J.

Stanton

A. L.

(2022). The Ubuntu approach in Project SOAR (Speaking our African American Realities): Building a robust community-academic partnership and culturally curated focus groups. Social Science & Medicine, 314(1), 115452. https://doi.org/10.1016/j.socscimed.2022.115452

17.

Du Bois

W. E. B.

(1899). The Philadelphia Negro: A social study. University of Pennsylvania Press.

18.

Epstein

R. M.

Street

R. L.

(2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100–103. https://doi.org/10.1370/AFM.1239

19.

Geronimus

A. T.

(1992). The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity & Disease, 2(3), 207–221. https://europepmc.org/article/med/1467758

20.

Hall

W. J.

Chapman

M. V.

Lee

K. M.

Merino

Y. M.

Thomas

T. W.

Payne

B. K.

Eng

Day

S. H.

Coyne-Beasley

(2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. American Journal of Public Health, 105(12), e60-e76. https://doi.org/10.2105/AJPH.2015.302903

21.

Hill

L. K.

Hoggard

L. S.

Richmond

A. S.

Gray

D. L.

Williams

D. P.

Thayer

J. F.

(2017). Examining the association between perceived discrimination and heart rate variability in African Americans. Cultural Diversity & Ethnic Minority Psychology, 23(1), 5–14. https://doi.org/10.1037/cdp0000076

22.

Hoffman

K. M.

Trawalter

Axt

J. R.

Oliver

M. N.

(2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences of the United States of America, 113(16), 4296–4301. https://doi.org/10.1073/pnas.1516047113

23.

Husain

Nolan

T. S.

Foy

Reinbolt

Grenade

Lustberg

(2019). An overview of the unique challenges facing African-American breast cancer survivors. Supportive Care in Cancer, 27(3), 729–743. https://doi.org/10.1007/s00520-018-4545-y

24.

Johnson

R. L.

Roter

Powe

N. R.

Cooper

L. A.

(2004). Patient race/ethnicity and quality of patient-physician communication during medical visits. American Journal of Public Health, 94(12), 2084–2090. https://doi.org/10.2105/AJPH.94.12.2084

25.

Keating

N. L.

Gandhi

T. K.

Orav

E. J.

Bates

D. W.

Ayanian

J. Z.

(2004). Patient characteristics and experiences associated with trust in specialist physicians. Archives of Internal Medicine, 164(9), 1015–1020. https://doi.org/10.1001/archinte.164.9.1015

26.

Lewis

T. T.

Cogburn

C. D.

Williams

D. R.

(2015). Self-reported experiences of discrimination and health: Scientific advances, ongoing controversies, and emerging issues. Annual Review of Clinical Psychology, 11, 407–440. https://doi.org/10.1146/annurev-clinpsy-032814-112728

27.

Martin

K. J.

Stanton

A. L.

Johnson

K. L.

(2022). Current health care experiences, medical trust, and COVID-19 vaccination intention and uptake in Black and White Americans. Health Psychology. https://doi.org/10.1037/HEA0001240

28.

Musa

Schulz

Harris

Silverman

Thomas

S. B.

(2009). Trust in the health care system and the use of preventive health services by older Black and White adults. American Journal of Public Health, 99(7), 1293–1299. https://doi.org/10.2105/AJPH.2007.123927

29.

Nong

Raj

Creary

Kardia

S. L. R.

Platt

J. E.

(2020). Patient-reported experiences of discrimination in the US health care system. JAMA Network Open, 3(12), e2029650–e2029650. https://doi.org/10.1001/JAMANETWORKOPEN.2020.29650

30.

Patel

Pelletier-Bui

Smith

Roberts

M. B.

Kilgannon

Trzeciak

Roberts

B. W.

(2019). Curricula for empathy and compassion training in medical education: A systematic review. PLoS ONE, 14(8), e0221412. https://doi.org/10.1371/JOURNAL.PONE.0221412

31.

QSR International Pty Ltd. (2018). Qualitative data analysis software, NVivo. https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home

32.

Royak-Schaler

Passmore

S. R.

Gadalla

Hoy

M. K.

Zhan

Tkaczuk

Harper

L. M.

Nicholson

P. D.

Hutchison

A. P

(2008). Exploring patient-physician communication in breast cancer care for African American women following primary treatment. Oncology Nursing Forum, 35(5), 836–843. https://doi.org/10.1188/08.ONF.836-843

33.

Street

R. L.

Gordon

Haidet

(2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science & Medicine, 65(3), 586–598. https://doi.org/10.1016/j.socscimed.2007.03.036

34.

Tamir

Budiman

Noe-Bustamante

Mora

(2023). Facts about the U.S. Black population. Pew Research Center. https://www.pewresearch.org/social-trends/fact-sheet/facts-about-the-us-black-population/

35.

Taylor

T. R.

Williams

C. D.

Makambi

K. H.

Mouton

Harrell

J. P.

Cozier

Palmer

J. R.

Rosenberg

Adams-Campbell

L. L

(2007). Racial discrimination and breast cancer incidence in US Black women: The Black Women’s Health Study. American Journal of Epidemiology, 166(1), 46–54. https://doi.org/10.1093/AJE/KWM056

36.

Torres

Dixon

Richman

A. R.

(2016). Understanding the breast cancer experience of survivors: A qualitative study of African American women in rural eastern North Carolina. Journal of Cancer Education, 31(1), 198–206. https://doi.org/10.1007/s13187-015-0833-0

37.

Trawalter

Bart-Plange

D. J.

Hoffman

K. M.

(2020). A socioecological psychology of racism: Making structures and history more visible. Current Opinion in Psychology, 32(1), 47–51. https://doi.org/10.1016/j.copsyc.2019.06.029

38.

Ture

Hamilton

C. V.

(1967). Black power: The politics of liberation in America. Vintage Books.

39.

Walker-Barnes

(2014). Too heavy a yoke: Black women and the burden of strength. Cascade Books.

40.

Washington

H. A.

(2007). Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. Anchor Books.

41.

Williams

D. R.

Mohammed

S. A.

Leavell

Collins

(2010). Race, socioeconomic status and health: Complexities, ongoing challenges and research opportunities. Annals of the New York Academy of Sciences, 1186(1), 69–101. https://doi.org/10.1111/J.1749-6632.2009.05339.X

42.

Williams

D. R.

Rucker

T. D.

(2000). Understanding and addressing racial disparities in health care. Health Care Financing Review, 21(4), 75–90.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.35 MB