Carolyn Spence Cagle

“They Care But Don’t Understand”: Family Support of African American Women With Type 2 Diabetes

PURPOSE This study evaluated the relationship between perceived social support among African American women with type 2 diabetes and diabetes self-management. METHODS The sample included 12 African American female patients at a diabetes clinic in the southeastern United States. Focus group participants responded to questions related to social support and its influence on diabetes management. RESULTS Support comes particularly from family, but also friends and/or healthcare providers. The dual challenges of diabetes management and multicaregiving were an expected theme from the sessions. A unique emerging theme, however, was the womens perception of a lack of understanding of their needs by members of their social networks. Participants believed that those who provide support claim they care and try to be helpful but provide minimal physical assistance or emotional understanding of their needs, which could vary daily. Those who provide informational support seem to care but misunderstand the type of information actually needed and how best to deliver it. CONCLUSIONS Healthcare providers can help improve communication with these women by actively seeking to meet their support needs and educating families so that provisional support is more meaningful and diabetes management more attainable.

Voices of Mexican American caregivers for family members with cancer: on becoming stronger.

This grounded theory study report describes the experience of 34 Mexican American (MA) female caregivers who provided care to a family member with cancer. Caregivers identified a process of “Becoming Stronger” as a result of their caregiver role. The emerging theoretical model of female MA cancer caregiving offers evidence to change current cancer care approaches from patient-focused to family-focused care for this ethnic group. Findings suggest that changes most responsive to cultural values and likely to provide accessible and quality cancer care for MA families are those that involve active partnering with MA caregivers to prioritize the patients cancer care.

Perceived Mood, Health, and Burden in Female Mexican American Family Cancer Caregivers

Female family caregivers of various global cultures provide basic care in health, social, emotional, and financial domains for family members with cancer and may sacrifice their own health to do so. To learn about role-related mood, health status self-perceptions, and burden of one cultural group, we used qualitative and quantitative approaches to study 34 Mexican American (MA) women who provided care for an ill family member with cancer. We report quantitative data on study variables and make comparisons with caregiver qualitative reports. Implications for health planning, service delivery, and future research with underserved, minority female caregivers are presented.

Preparation and participation of undergraduate students to inform culturally sensitive research

Most student work as research assistants occurs at the graduate level of nursing education, and little is known about the role of undergraduate students as research assistants (RAs) in major research projects. Based on our desire to study Mexican American (MA) cancer caregivers, we needed bilingual and bicultural RAs to serve as data collectors with women who spoke Spanish and possessed cultural beliefs that influenced their caregiving. Following successful recruitment, orientation, and mentoring based on Banduras social learning theory [Bandura, A., 2001. Social learning theory: an agentic perspective. Annual Review of Psychology 52, 1-26] and accepted teaching-learning principles, RAs engaged in various behaviors that facilitated study outcomes. Faculty researchers, RAs, and study participants benefitted greatly from the undergraduate student involvement in this project. This article describes successful student inclusion approaches, ongoing faculty-RA interactions, and lessons learned from the research team experience. Guidelines discussed support the potential for making the undergraduate RA role a useful and unique learning experience.

Healthcare Literacy: Multiple Perspectives Grounded in the Experience of Mexican American Caregivers

Cancer caregivers in Mexican American families experience role-related challenges influenced by limited healthcare literacy. The lack of functional health literacy becomes complex when Mexican Americans have limited English proficiency (LEP) and cultural beliefs that contrast with those of the American healthcare system. Three sequential studies focused on assessing the experience of Mexican American, female cancer caregivers, including their role learning needs; evaluating available community learning materials; and identifying healthcare provider perceptions of caregiver learning needs. Study findings provide direction to improve the process and content of teaching to caregivers with LEP and other caregivers facing the crisis of cancer. Practice recommendations focus on development of targeted learning materials appropriate to caregiver-identified learning needs, language, and education level. Priority learning needs include strategies to meet patient needs for home medication administration, nutrition, and psychological support. Caregiver-preferred formats for learning include videotapes in a family-assisted setting and oral exchanges with other caregivers and care providers. Bilingual clinic personnel who partner with Mexican American family caregivers to address their literacy issues support positive health outcomes in this vulnerable population. Healthcare Literacy: Multiple Perspectives Grounded in the Experience of Mexican American Caregivers

Culturally Sensitive Care: Enlisting Community Partners to Meet Mexican American Caregiver Needs

BACKGROUND: Culturally sensitive interventions are needed to assist Mexican American (MA) patients with cancer and their family members in managing their care, navigating the healthcare system, and decreasing disparities in healthcare outcomes for Hispanics with cancer. OBJECTIVES: The objectives of this study were to understand the meaning of culturally sensitive care for oncology clinic healthcare providers and to assess the usefulness and feasibility of the role of a promotora de salud to meet caregiver needs. METHODS: This study involved focus groups of 18 diverse providers who provided data for qualitative analyses. FINDINGS: The findings (themes) defined the facilitators of and barriers to culturally sensitive care and the perceived role of a promotora de salud to support the healthcare team and improve cancer care provided by MA caregivers. In addition, promotoras de salud can help reduce health costs by decreasing patient clinic visits.