Divided Loyalty: Caregiving Experiences of Family Members of Older African American Women with Breast Cancer

Discovery and disclosure of the diagnosis of a life-threatening illness, such as cancer, can be stressful for the individual who is diagnosed as well as for family members who are most likely then entrusted with new roles as “caregivers”. African American family caregivers may face particular challenges as the combination of age and ethnicity puts older African American women at high risk for poor cancer outcomes. The primary aims of this study were to understand the “cancer experience” of family members of older African American women diagnosed with breast cancer as they provided caregiving support throughout treatment.

A qualitative phenomenological approach was utilized in this study.  In-depth interviews were conducted with 15 family members of older African American women (45 and older) who had been diagnosed with and received treatment for breast cancer. Relationships were: 3 husbands, 4 daughters, 1 daughter-in-law, 3 sisters, 2 nieces, 1 friend and 1 mother-in-law. Interviews were semi-structured, audio-taped, transcribed, and data organized with Atlasti software.

Themes that emerged included: divided loyalty, reluctance to disclose cancer diagnosis to family member; religious/spiritual coping; differential need for information from health providers; and concerns/fears for self.  The experiences of these family members revealed the importance of obtaining information that can support their caregiving role and help incorporate cancer diagnoses into their lives.