The problem to be addressed in this study is that individuals who are diagnosed with cancer often face a broad and very complex healthcare system whose interrelated and independent systems make it challenging to communicate and receive high quality and effective care after diagnosis. Studies have indicated that to receive high quality and effective care after diagnosis, cancer patients must navigate this healthcare system and communicate with a wide variety of individuals (Shankar et al., 2020) to make informed decisions about their treatment choices (Papautsky & Hamlish, 2020; Richards et al., 2020), side effect management, daily life activities, (Zavala et al., 2021) plans for the future, and continued survivorship or death (van de Haar et al., 2020). Specifically, African Americans continue to express concerns that United States healthcare systems have failed to facilitate communication with patients who experience a cancer diagnosis due to the absence of reliable and effective macro-level communication channels (Yabroff et al., 2019). Literature has indicated that over 28%% of individuals diagnosed with cancer have been unable to reap anticipated care benefits from the region’s healthcare organizations due to the failure of healthcare communication systems utilized in Honolulu hospitals (Lai et al., 2020).
Researchers have covered the intra- and inter-personal dynamics of cancer patient communication (Alcaraz et al., 2020; Ginsburg et al., 2020; Strickland, 2019). However, there is no current research focusing on systems-based communication approaches that are necessary to integrate the intra- and inter-personal dynamics of cancer patient communication into the bigger picture of care for African Americans diagnosed with cancer. It is important to understand the macro-level aspects of the healthcare system that could impede effective cancer communication for members of this particular population (Moran et al., 2020; Pilevarzadeh et al., 2019) and consequently deny African Americans diagnosed with cancer the quality care they deserve.
Purpose Statement
The purpose of this qualitative phenomenological study is to explore the lived experiences of African Americans who are diagnosed with cancer in relation to the communication challenges they encounter after diagnosis when dealing with the inter-related and independent healthcare system and how the challenges influence the quality and effective care.
Research Question
RQ1. What are the lived experiences of African Americans diagnosed with cancer with regard to healthcare systems that impede communication and influence the quality and effectiveness of care?
References
Alcaraz, K. I., Wiedt, T. L., Daniels, E. C., Yabroff, K. R., Guerra, C. E., & Wender, R. C. (2020). Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA: A Cancer Journal For Clinicians, 70(1), 31-46. https://doi.org/10.3322/caac.21586
Ginsburg, O., Yip, C. H., Brooks, A., Cabanes, A., Caleffi, M., Dunstan Yataco, J. A., … & Anderson, B. O. (2020). Breast cancer early detection: A phased approach to implementation. Cancer, 126, 2379-2393. https://doi.org/10.1002/cncr.32887
Lai, A. G., Pasea, L., Banerjee, A., Hall, G., Denaxas, S., Chang, W. H., & Hemingway, H. (2020). Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ open, 10(11), e043828. http://dx.doi.org/10.1136/bmjopen-2020-043828
Moran, H. K., Brooks, J. V., & Spoozak, L. (2020). Undergoing active treatment for gynecologic cancer during COVID-19: a qualitative study of the impact on healthcare and social support. Gynecologic Oncology Reports, 34, 100659. https://doi.org/10.1016/j.gore.2020.100659
Papautsky, E. L., & Hamlish, T. (2020). Patient-reported treatment delays in breast cancer care during the COVID-19 pandemic. Breast Cancer Research and Treatment, 184, 249-254. https://doi.org/10.1007/s10549-020-05828-7
Pilevarzadeh, M., Amirshahi, M., Afsargharehbagh, R., Rafiemanesh, H., Hashemi, S. M., & Balouchi, A. (2019). Global prevalence of depression among breast cancer patients: A systematic review and meta-analysis. Breast Cancer Research And Treatment, 176, 519-533. https://doi.org/10.1007/s10549-019-05271-3
Richards, M., Anderson, M., Carter, P., Ebert, B. L., & Mossialos, E. (2020). The impact of the COVID-19 pandemic on cancer care. Nature Cancer, 1(6), 565-567. https://doi.org/10.1038/s43018-020-0074-y
Shankar, A., Saini, D., Roy, S., Jarrahi, A. M., Chakraborty, A., Bharati, S. J., & Taghizadeh-Hesary, F. (2020). Cancer care delivery challenges amidst coronavirus disease–19 (COVID-19) outbreak: specific precautions for cancer patients and cancer care providers to prevent spread. Asian Pacific Journal Of Cancer Prevention: APJCP, 21(3), 569. https://doi.org/10.31557%2FAPJCP.2020.21.3.569
Strickland, E. (2019). IBM Watson, heal thyself: How IBM overpromised and underdelivered on AI health care. IEEE Spectrum, 56(4), 24-31. https://doi.org/10.1109/MSPEC.2019.8678513
van de Haar, J., Hoes, L. R., Coles, C. E., Seamon, K., Fröhling, S., Jäger, D.,& Voest, E. E. (2020). Caring for patients with cancer in the COVID-19 era. Nature Medicine, 26(5), 665-671. https://doi.org/10.1038/s41591-020-0874-8
Yabroff, K. R., Gansler, T., Wender, R. C., Cullen, K. J., & Brawley, O. W. (2019). Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system. CA: A Cancer Journal For Clinicians, 69(3), 166-183. https://doi.org/10.3322/caac.21556
Zavala, V. A., Bracci, P. M., Carethers, J. M., Carvajal-Carmona, L., Coggins, N. B., Cruz-Correa, M. R., … & Fejerman, L. (2021). Cancer health disparities in racial/ethnic minorities in the United States. British Journal Of Cancer, 124(2), 315-332. https://doi.org/10.1038/s41416-020-01038-6
