Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Clarence Schumaker, Jr.


This qualitative study examined the phenomenology of advanced breast cancer (ABC) among 7 female participants between the ages of 20 and 45. Oral data were collected to extract participants' interpretations of their spiritual and psychosocial experiences of living with ABC. Findings suggest that these women experienced a dichotomous relationship with regard to their bodies and their relationships with others; this served as a means of making sense of their experiences and as a coping mechanism. Positive psychology and the theory of reasoned action and planned behavior provided the theoretical framework for examining the role of social reinforcements, beliefs, and attitudes and intentions on the health behavior of pre-menopausal African American women with ABC in Northern and Southern Delaware. Additionally, the theoretical framework provided answers to the overarching questions of how pre-menopausal African American women with advanced breast cancer applied meaning-making and spirituality to find purpose in their diagnosis. Inductive analysis of their narrative data suggested a set of themes: the body as a medical object, the body as a feminine object, honesty in relationships, missed opportunities from healthcare professionals, from wounded to mended, and the joy of purposeful living. The participants reported that an intimate relationship with God helped them feel supported in a way that family and friends could not. The findings in this study support potential spiritual and meaning-making interventions as well as promote a more positive quality of life for pre-menopausal women living with advanced breast cancer.-¬-¬-¬