Graduation Year

2020

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Anthropology

Major Professor

Heide Castañeda, Ph.D., M.P.H.

Committee Member

Dinorah Martinez Tyson, Ph.D., M.P.H.

Committee Member

Nancy Romero-Daza, Ph.D.

Committee Member

Tara Deubel, Ph.D.

Committee Member

Cassandra White, Ph.D.

Keywords

cancer, caregivers, disclosure, health communication, Indian immigrants, therapy management

Abstract

Studies of Indian immigrants in Western countries show that the rates of cancer increase significantly within a generation in the host country. The negative social perceptions associated with health outcomes of cancer often perpetuate limited disclosure regarding the diagnosis of cancer among patients and families. This can result in disrupted communication in clinical settings, while causing increased stress among patients and caregivers. These findings demonstrate the need for studying lived experiences of cancer-related illness and its impacts on social relationships in the domestic and public sphere.

This study explored cancer disclosure and communication among Indian immigrants in the United States and their subsequent impact on decisions regarding treatment. Additionally, this study explored the relationship between biomedical ethics and their intersection with cross cultural models of health and caregiving.

Most anthropological studies on cancer have focused on cultural attitudes regarding disclosure of the diagnosis among patients from diverse populations. However, there is limited research on Indian immigrants with regard to cancer. Given the high susceptibility of certain cancers among Indian immigrants, there is a lack of an effective patient-provider communication approach that accounts for the connection between cancer disclosure, caregiving and therapeutic decision making in the Indian immigrant population.

This qualitative study recruited 35 participants (n=35) which included in-person and phone interviews with cancer survivors, family members and health care providers.

The majority of participants were based in metropolitan Atlanta, Georgia, although a few participants were also recruited from other cities in the United States. This study expands on the understanding of social and cultural processes that shape cancer communication among Indian immigrants in the United States. It fills gaps in anthropological literature regarding cultural models of health associated with cancer and its social and therapeutic implications on patients and caregivers. Furthermore, it informs the collective experiences of illness shared by patients and families, and the variation in cancer disclosure practices among Indian immigrants. The study’s findings emphasize the need for a culturally sensitive model of bioethics and patient-provider communication in dealing with cases of cancer in this population. Additionally, the study informs perspectives on cancer communication among other immigrant populations with similar cancer-related disclosure practices.

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