African American and Caucasian Women: Differences in Spiritual and Social Support in Experiencing Cancer

Background and Purpose: Women's response to a diagnosis and treatment of cancer continues to be an area of significant empirical investigation; however, the overwhelming majority of that attention focuses on breast cancer. While nearly 45% of all cancer patients report distress following diagnosis, less than 10% receive psychosocial interventions (Carlson & Bultz, 2003). Psychosocial distress experienced by women with different types of cancers is one area needing further investigation as well as how these differences manifest among women from different racial and martial backgrounds. The objective of this study was to examine how women perceived their level of psychosocial distress, quality of life (QOL), social support and the influence of spirituality after controlling for race, marital status and cancer type. Methods: Using data from a Comprehensive Cancer Center's Psychosocial Registry containing 743 participants, a subsample of 466 women were identified. Psychosocial distress and QOL were measured using the Functional Assessment of Cancer Therapy (FACT-G) specifically Emotional Well-Being [EWB] and Functional Well-Being [FWB] subscales. Social support was measured using the Medical Outcome Study (MOS). Spirituality was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACT-Sp). Data were analyzed using cross-sectional analyses at T1 & T2 assessing change over time. Results: The mean age of women in this study was 60.80 (SD=12.1). Caucasian women comprised 75% of the survey. The most common cancers were: lung, ovarian, colon, endometrial, and breast. Acceptable reliability was established for each measure used: FACT-G á=.87, MOS á=.95 & FACIT-Sp á=.77. At T1, married women were found to have statistically significant higher overall social support (p<.000) as well as statistically significant differences on each of the 4 subscales of the MOS (e.g., tangible support, p=.000). African Americans reported statistically higher spirituality at T1 and T2 (p<.000, p<.005). At T2, African Americans reported higher EWB (p=.017) than Caucasians which was not found at T1. African Americans with lung cancer had significantly higher spirituality (p=.008) than whites, while married patients with lung cancer reported better FWB than those not married (p=.028) Conclusion and Implications: Women continue to experience increased psychosocial distress following the diagnosis and treatment of cancer across various cancer types. Spiritual and social support were found to be related to increased QOL among women with cancer. Study findings indicating that unmarried women are more likely to receive less social support from their environment necessitates the need for active assessment of possible sources of support for these women. For example, connecting with community-based cancer survivor groups is one potential source of expanding their support networks. African American women's reliance on spirituality as a coping mechanism to maintain emotional well-being offers a direction for practitioners to utilize when working with cancer patients. It is critical practitioners provide interventions and services to patients in maintaining or increasing their emotional well-being through the disease trajectory of cancer. Researchers must expand their investigation of psychosocial concerns beyond those associated with breast cancer. Researchers could examine those factors contributing to the change in emotional well-being overtime from diagnosis through treatment outcomes.