Graduation Year

2017

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Community and Family Health

Major Professor

Dina Martinez Tyson, Ph.D., M.P.H., M.A.

Committee Member

Julie A. Baldwin, Ph.D.

Committee Member

Carol A. Bryant, Ph.D., M.S.

Committee Member

Cathy D. Meade, Ph.D., R.N., F.A.A.N.

Committee Member

Lauri Wright, Ph.D., R.D.N., L.D.N.

Keywords

coping, Hispanic, nutrition, social support, survivorship

Abstract

Latina breast cancer survivors, especially those who have undergone chemotherapy, may face major disruptions to their diet and eating habits; and a major concern is their ability to function in daily life roles throughout survivorship. Food and nutrition are suggested to be significant factors that can influence the process of cancer development, yet little research has been done to understand the nutritional needs, roles, and expectations among Latina breast cancer survivors. The purpose of this study was to understand Latina breast cancer survivors’ perceptions of the role of diet and nutrition in helping them cope with the effect of chemotherapy treatment. This study was guided by the Transactional Model of Stress and Coping and employed a qualitative research design. A purposive sample of Latina breast cancer survivors (n=32), caregivers identified by the survivors (n=8), and key informants (n=6) were interviewed in their language of preference (Spanish or English) using a semi-structured, open-ended interview guide that explored how coping with a cancer diagnosis influences cancer survivors and caregivers’ nutritional needs and practices. The data were analyzed using an inductive approach to develop an a priori codebook. Thematic analysis was performed using MAXQDA, and emergent codes were added as appropriate.

The results yielded that Latina breast cancer survivors emphasized the value and meaning of nutrition; this was accomplished by increasing their nutritional awareness to restore health, improve the body’s immunity, and regain/maintain agency and control of their food consumption. Food provided by friends and family, assistance from nutritional organizations, doctors’ recommendations, and negative chemotherapy side effects influenced Latina breast cancer survivors and caregivers’ decisions about diet and nutrition during and after treatment. Negative chemotherapy side effects and positive support from husbands, family members, and friends affected the role of Latina women as the ‘nutritional gatekeepers’ in the family, since breast cancer diagnosis and treatment disrupt or limit the role of Latinas within the household unit. Findings from the interviews with Latina breast cancer survivors, caregivers, and key informants indicated that cultural expectations among this population shape the kinds of support and assistance that are provided by family members. Lastly, this research study revealed unmet information needs: Latina breast cancer survivors relied on organizational and online nutrition-related resources but identified a gap in culturally and linguistically tailored information related to diet and nutrition following diagnosis. The study concluded that Latina breast cancer survivors and caregivers mentioned no routine dietary assessment for cancer survivors after beginning chemotherapy and during treatment. Additionally, caregivers specified needing instrumental support to better meet the nutritional needs of Latina breast cancer survivors. This study added to our understanding of Latina breast cancer survivors’ unmet needs that could contribute to the creation of future nutrition education programs and interventions most appropriate during cancer survivorship for diagnosed individuals and their caregivers.

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