“They Paid No Mind to My State of Mind”: African American Breast Cancer Patients’ Experiences of Cancer Care Delivery

2010 ◽  
Vol 28 (6) ◽  
pp. 683-698 ◽  
Author(s):  
Maureen P. Davey ◽  
Karni Kissil ◽  
Alba Niño ◽  
Carolyn Y. Tubbs
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Cancer Patients ◽  
Cancer Care ◽  
Care Delivery ◽  
Breast Cancer Patients ◽  
State Of Mind

scholarly journals Breast cancer mortality disparities: Providers' perspective

2017 ◽  
Vol 7 (6) ◽  
pp. 46 ◽  
Author(s):  
Shelley White-Means ◽  
Jill Dapremont ◽  
Muriel Rice ◽  
Barbara Davis ◽  
Okoia Stoddard
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
White Women ◽  
Care Delivery ◽  
Breast Cancer Mortality ◽  
Breast Cancer Patients ◽  
American Women

This research is part two of a study to gain understanding of reasons for the large breast cancer mortality disparity between African-American and White women who live in Memphis, Tennessee. Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African-American women are twice as likely to die from breast cancer as White women. In part one of this study, we sought to gain the perspective of African-American breast cancer survivors. Now we explore the perspective from the providers of care who interface with breast cancer patients, health systems, and health insurers. This is a descriptive research study that used qualitative methodology to inteview seven medical, surgical and radiation oncologists who serve African-American breast cancer patients in Memphis. Data were collected using semi-structured in-depth interviews. Themes included: (1) socioeconomic factors; (2) lack of knowledge about treatment, progression and side effects, and diagnosis; (3) information/communication about the diagnosis; (4) support system: need for another person to process information given; (5) limited access and resources: no insurance and no available services for treatment in African-American neighborhoods; and (6) fear of the unknown: fear of cancer, fear of losing breast, and fear about the disease’s impact on personal relationships. These results suggest that resources that aid geographical access to services need to change in order for disparities to decrease. A new model for health care delivery for African-American women at high risk of or diagnosed with breast cancer needs to be developed to address these findings.

How breast cancer care is coordinated in hospitals serving predominantly minority women.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17592-e17592
Author(s):  
Ann Scheck McAlearney ◽  
Alexandra Moss ◽  
Rebeca Franco ◽  
Nina A. Bickell
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Care Delivery ◽  
Comparative Method ◽  
Minority Women ◽  
Breast Cancer Patients ◽  
Breast Cancer Care ◽  
Integration Of Care ◽  
Fully Integrated

e17592 Background: Underuse of adjuvant breast cancer treatment results from system failures and occurs more commonly in minority women. We assessed organizational processes associated with care coordination prior to implementing an intervention. Methods: We interviewed 29 clinical and 20 administrative key informants from 6 hospitals with high volumes of minority breast cancer patients. We analyzed qualitative interview data using the constant comparative method. Results: Hospitals varied in approaches to coordinate adjuvant therapy delivery. All hospitals made a “basic” effort to follow up with patients who missed appointments (e.g., certified letters), but some sites included “extra” efforts such as clinician calls. Processes to coordinate handoffs among providers involved use of clerical staff to reach out across specialties in most sites; several sites also explicitly involved clinicians. Effective tracking and handoffs were hindered where electronic health record (EHR) systems were not fully integrated. A critical distinction was whether breast cancer care delivery was integrated within the hospital. Better integration appeared to facilitate communication among clinicians, as well as promote service coordination. Accountability was an important factor contributing to integration, particularly in sites that were less integrated. Conclusions: Appropriate delivery of adjuvant therapies to breast cancer patients appears to be facilitated by better integration of care and services within the hospitals we studied. A fully integrated EHR and enhanced processes for tracking no shows and supporting handoffs seemed to increase integration in these hospitals. Integration was further facilitated when there was accountability for results. Strong clinical leadership can promote integration, but its impact may be lessened if hospitals’ processes are integrated. [Table: see text]

scholarly journals Hypertension is an independent predictor of survival disparity between African-American and white breast cancer patients

2009 ◽  
Vol 124 (5) ◽  
pp. 1213-1219 ◽  
Author(s):  
Dejana Braithwaite ◽  
C. Martin Tammemagi ◽  
Dan H. Moore ◽  
Elissa M. Ozanne ◽  
Robert A. Hiatt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Cancer Patients ◽  
Independent Predictor ◽  
Breast Cancer Patients

Communication Between Physicians and Older Women With Localized Breast Cancer: Implications for Treatment and Patient Satisfaction

2002 ◽  
Vol 20 (4) ◽  
pp. 1008-1016 ◽  
Author(s):  
Wenchi Liang ◽  
Caroline B. Burnett ◽  
Julia H. Rowland ◽  
Neal J. Meropol ◽  
Lynne Eggert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Treatment Options ◽  
Treatment Choice ◽  
Satisfaction With Care ◽  
Physician Communication ◽  
Breast Cancer Patients ◽  
Actual Treatment ◽  
The Impact

PURPOSE: To identify factors associated with patient-physician communication and to examine the impact of communication on patients’ perception of having a treatment choice, actual treatment received, and satisfaction with care among older breast cancer patients. MATERIALS AND METHODS: Data were collected from 613 pairs of surgeons and their older (≥ 67 years) patients diagnosed with localized breast cancer. Measures of patients’ self-reported communication included physician- and patient-initiated communication and the number of treatment options discussed. Logistic regression analyses were conducted to examine the relationships between communication and outcomes. RESULTS: Patients who reported that their surgeons mentioned more treatment options were 2.21 times (95% confidence interval [CI], 1.62 to 3.01) more likely to report being given a treatment choice, and 1.33 times (95% CI, 1.02 to 1.73) more likely to get breast-conserving surgery with radiation than other types of treatment. Surgeons who were trained in surgical oncology, or who treated a high volume of breast cancer patients (≥ 75% of practice), were more likely to initiate communication with patients (odds ratio [OR] = 1.62; 95% CI, 1.02 to 2.56; and OR = 1.68; 95% CI, 1.01 to 2.76, respectively). A high degree of physician-initiated communication, in turn, was associated with patients’ perception of having a treatment choice (OR = 2.46; 95% CI, 1.29 to 4.70), and satisfaction with breast cancer care (OR = 2.13; 95% CI, 1.17 to 3.85) in the 3 to 6 months after surgery. CONCLUSION: Greater patient-physician communication was associated with a sense of choice, actual treatment, and satisfaction with care. Technical information and caring components of communication impacted outcomes differently. Thus, the quality of cancer care for older breast cancer patients may be improved through interventions that improve communication within the physician-patient dyad.

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