Date of Conferral

1-1-2008

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Jeanne Connors

Abstract

Research documents that breast cancer is the leading cause of death in Latina females. The exact numbers are unknown, but studies reveal that Latinas with breast cancer underuse recommended follow-up chemotherapy, decreasing their rates of survival. Although several factors may be responsible, cultural influences are a possible barrier. However, there is a gap in the literature about how culture affects decisions about breast cancer treatment. This focused ethnographic study examined the role of cultural beliefs and perceptions in the decision-making process for Latina women about whether or not to receive chemotherapy following a breast cancer diagnosis. Drawing from Douglas' cultural theory of risk, archived in-depth interview data from 20 Latina breast cancer survivors were open coded into 56 primary codes which were then categorized into hierarchical trees of overarching themes and subcategories. Unique elements of the patterns observed in these data were analyzed and interpreted to explain how culture may influence Latina breast cancer patients to underuse recommended chemotherapy. The results of this qualitative analysis revealed that various cultural factors including social role-related themes, avoidance of information and communication, as well as employment and immigration status influenced the treatment decisions of Latina women. Analysis suggested that these cultural factors influenced both the amount and quality of information Latina women had available to make these decisions, as well as how they processed information to reach their decisions. Results of this study can accelerate social change by drawing increased attention to cultural differences in medical decision making, by informing the communication process between medical providers and their Latina patients, and thus eventually increasing survival from breast cancer among Latinas.

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