Costellia H. Talley

African American Women’s Limited Knowledge and Experiences with Genetic Counseling for Hereditary Breast Cancer

Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n = 13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n = 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community.

EXPLORING SPIRITUAL WELL-BEING AMONG SURVIVORS OF COLORECTAL AND LUNG CANCER.

This descriptive, exploratory study is part of a larger observational study of the quality of cancer care delivered to population‐based cohorts of newly diagnosed patients with lung and colorectal cancer. The current study explores the role of spiritual well‐being in adjustment to life after the cancer diagnosis, utilizing the Functional Assessment of Chronic Illness Therapy–Spiritual Well‐Being–Expanded (FACIT‐Sp‐Ex) Scale. Survey data collected from 304 newly diagnosed cancer survivors were analyzed to explore important aspects of spirituality, such as sense of meaning in ones life, harmony, peacefulness, and a sense of strength and comfort from ones faith. Spiritual well‐being scores, particularly meaning/peace, were statistically significant for African Americans, women, and colorectal cancer survivors. These findings amplify a need for oncology social workers and other practitioners to assess spiritual well‐being in cancer survivors in an effort to strengthen psychosocial treatment plans. Implications for social work practice and research are discussed.

A pilot study of the self-reported quality of life for patients with chronic obstructive pulmonary disease

BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) experience significant impairment in their quality of life (QOL). However, relatively few studies have examined overall and global QOL in patients with COPD using both generic QOL and health-related quality of life (HRQOL) measures. PURPOSE The purposes of this pilot study were to describe the self-reported QOL (overall and global), disease-specific HRQOL, depressive symptoms, and disease-specific symptoms and experiences of patients with COPD and to examine the relationship among disease-specific HRQOL, depressive symptoms, disease-specific symptoms and experiences, and QOL (overall and global) in patients diagnosed with moderate to severe COPD. METHODS A descriptive correlational design was used. Thirty-six participants completed overall QOL, global QOL, disease-specific HRQOL, depressive symptoms, and disease-specific symptoms and experiences questionnaires. RESULTS Overall QOL was low; global QOL was at the median of scale range. Overall QOL scores were significantly correlated with the disease-specific St George Respiratory Questionnaire total score, symptoms and impact subscale, depressive symptoms, and 7 Bronchitis Emphysema Symptom Checklist subscales. CONCLUSION Findings provided partial support for the association between QOL and disease-specific HRQOL and the usefulness of disease-specific questionnaires when assessing QOL.

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women

This study examines the relationship between age, comorbidity, and breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N = 371) from Detroit, Michigan. The Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity on breast and cervical cancer literacy. The relationship between ACC and breast and cervical cancer screening, and group differences, were assessed. There was a statistically significant difference between breast cancer literacy scores. ACC had a greater impact on breast cancer literacy for African Americans.

Association between Family Communication and Health Literacy among Underserved Racial/Ethnic Women

Health literacy and the family can be used to promote cancer screenings. We examined the associations of socio-demographic factors, family communication, and cancer literacy in a diverse population. Baseline data from the Kin KeeperSM Cancer Prevention randomized controlled trial were analyzed for Black (n=216), Latino (n=65), and Arab (n=235) women. Key variables were based on the Family Adaptability and Cohesion Scale IV, and the Cancer Literacy Assessment Tool. Among Blacks, cervical cancer literacy was positively associated with family communication. Cancer literacy was associated with higher educational level, employment, and family self-rated health status among Black and Arab women. Among Latinas, who were the least educated and had the lowest literacy scores, family communication was inversely related to breast cancer literacy. Family-centered networks may be a viable resource for the transmission of health cancer literacy information, inform health care decision-making, and contribute to decreasing breast and cervical cancer mortality.

Declining Functional Status in Older Women With a History of Breast Cancer

Older breast cancer survivors are at risk for a decline in functional status, which is associated with increased risk for disability, increased health care costs and increased risk of nursing home placement. The comprehensive geriatric assessment is a useful tool for identifying women with a history of breast cancer who are at increased risk for decline in functional status. Use of the comprehensive geriatric assessment will allow nurses to identify functional care needs and develop care plans and interventions that are aimed at maintenance of functional status.