African American Women Coping With Breast Cancer: A Qualitative Analysis

Phyllis D. Henderson

Shirley V. Gore

Bertha Lane Davis

Esther H. Condon

ONF 2003, 30(4), 641-647. DOI: 10.1188/03.ONF.641-647

Purpose/Objectives: To determine how African American women cope with breast cancer.

Design: Descriptive and exploratory study.

Sample/Setting: 66 African American women diagnosed with breast cancer were interviewed in the southeastern United States.

Methods: Data were collected through tape-recorded interviews using a semistructured interview guide. Data were analyzed by content analysis and frequency distributions.

Main Research Variables: Coping strategies used by women to adapt to a diagnosis of breast cancer.

Findings: Coping strategies described by African American women included relying on prayer, avoiding negative people, developing a positive attitude, having a will to live, and receiving support from family, friends, and support groups.

Conclusion: Spirituality played a major role in these African American women coping with breast cancer. Supportive networks also served as a vital asset throughout the breast cancer experience. Participants discussed the need for culturally sensitive breast cancer support groups.

Implications for Nursing: Nurses must recognize coping strategies that African American women with breast cancer use. Healthcare professionals need to develop culturally sensitive breast cancer support groups. Throughout the breast cancer experience, nurses must assess communication patterns among African American families. Nurses should serve as healthcare advocates for African American women with breast cancer.

Jump to a section


    American Cancer Society. (2003). Cancer facts and figures for African Americans, 2003-2004. Atlanta, GA: Author.

    Anderson, K.N., Anderson, L.E., & Glanze, W.D. (Eds.). (1998). Mosby's medical, nursing, and allied health dictionary (5th ed.). St. Louis, MO: Mosby.

    Ashing-Giwa, K. (1999). Quality of life and psychosocial outcomes in long-term survivors of breast cancer: A focus on African American women. Journal of Psychosocial Oncology, 17(3/4), 47-62.

    Ashing-Giwa, K., & Ganz, P. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15(2), 19-35.

    Astin, J.A., Anton-Culver, H., Schwartz, C.E., Shapiro, D.H., McQuade, J., Breuer, A., et al. (1999). Sense of control and adjustment to breast cancer: The importance of balancing control coping styles. Behavioral Medicine, 25, 101-109.

    Barg, F.K., & Gullatte, M.M. (2001). Cancer support groups: Meeting the needs of African Americans with cancer. Seminars in Oncology Nursing, 17, 171-178.

    Bourjolly, J.N. (1998). Differences in religiousness among black and white women with breast cancer. Social Work in Health Care, 28(1), 21-39.

    Bourjolly, J.N. (1999). Locus of control among black and white women with breast cancer: A preliminary study. Journal of Psychosocial Oncology, 17(1), 21-31.

    Bourjolly, J.N., & Hirschman, K.B. (2001). Similarities in coping strategies but differences in sources of support among African American and white women coping with breast cancer. Journal of Psychosocial Oncology, 19(2), 17-38.

    Brady, S.S., & Helgeson, V.S. (1999). Social support and adjustment to recurrence of breast cancer. Journal of Psychosocial Oncology, 17(2), 37-55.

    Burns, N., & Grove, S.K. (2001). The practice of nursing research: Conduct, critique, and utilization (4th ed.). Philadelphia: Saunders.

    Compas, B.E. (1998). An agenda for coping research and theory: Basic and applied developmental issues. International Journal of Behavioral Development, 22, 231-237.

    Compas, B.E., Connor, J.K., Osowiecki, D., & Welch, A. (1997). Effortful and involuntary responses to stress: Implications for coping with chronic stress. In B.H. Gottlieb (Ed.), Coping with chronic stress (pp. 105-130). New York: Plenum.

    Culver, J.L., Arena, P.L., Antoni, M.H., & Carver, C.S. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, Hispanics, and non-Hispanic whites. Psycho-Oncology, 11, 459-504.

    Farmer, B.J., & Smith, E.D. (2002). Breast cancer survivorship: Are African American women considered? A concept analysis. Oncology Nursing Forum, 29, 770-787.

    Fobair, P. (1997). Cancer support groups and group therapies: Part II: Process, organizational, leadership, and patient issues. Journal of Psychosocial Oncology, 15(3/4), 123-147.

    Frydenberg, E., & Lewis, R. (1991). Adolescent coping: The different ways in which boys and girls cope. Journal of Adolescence, 14, 119-133.

    Gall, T. (2000). Integrating religious resources within a general model of stress and coping: Long-term adjustment to breast cancer. Journal of Religion and Health, 39, 167-182.

    Garland, L., & Bush, C. (1982). Coping behaviors and nursing. Reston, VA: Reston Publishing.

    Gaston-Johansson, F., Fall-Dickson, J.M., Nanda, J., Ohly, K.V., Stillman, S., Krumm, S., et al. (2000). The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nursing, 23, 277-285.

    Gates, M.F., Lackey, N.R., & Brown, G. (2001). Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: An ethnographic, photographic study. Oncology Nursing Forum, 28, 529-537.

    Gore, S. (1999). African American women's perceptions of weight: Paradigm shift for advanced practice. Holistic Nursing Practice, 13(4), 71-79.

    Hilton, B.A. (1996). Getting back to normal: The family experience during early stage breast cancer. Oncology Nursing Forum, 23, 605-614.

    Hilton, B.A., Crawford, J., & Tarko, M. (2000). Men's perspectives on individual and family coping with their wives' breast cancer chemotherapy. Western Journal of Nursing Research, 22, 438-459.

    Lackey, N.R., Gates, M.F., & Brown, G. (2001). African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer. Oncology Nursing Forum, 28, 519-527.

    Lazarus, R.S. (1993). Coping theory and research: Past, present, and future. Psychosomatic Medicine, 55, 2324-2347.

    Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Lugton, J. (1997). The nature of social support as experienced by women treated for breast cancer. Journal of Advanced Nursing, 25, 1184-1191.

    McHaffie, H.E. (1992). Coping: An essential element of nursing. Journal of Advanced Nursing, 17, 933-940.

    Monat, A., & Lazarus, R.S. (1991). Stress and coping: An anthology. New York: Columbia University Press.

    Moore, R. (2001). African American women and breast cancer: Notes from a study narrative. Cancer Nursing, 24, 35-42.

    Morgan, D.L. (1997). Focus groups as qualitative research (2nd ed.). Thousand Oaks, CA: Sage.

    Morgan, D.L., & Krueger, R.A. (1998). The focus group tool kit. Thousand Oaks, CA: Sage.

    Morse, S., & Fife, B. (1998). Coping with a partner's cancer: Adjustment at four stages of the illness trajectory. Oncology Nursing Forum, 25, 751-760.

    Navon, L. (1999). Cultural views of cancer around the world. Cancer Nursing, 22, 39-45.

    Osowiecki, D.M., & Compas, B.E. (1999). A prospective study of coping, perceived control, and psychological adaptation to breast cancer. Cognitive Therapy and Research, 23, 169-180.

    Radina, M.E., & Armer, J.M. (2001). Post-breast cancer lymphedema and the family: A qualitative investigation of families coping with chronic illness. Journal of Family Nursing, 7, 281-299.

    Reynolds, P., Hurley, S., Torres, M., Jackson, J., Boyd, P., Chen, V.W., et al. (2000). Use of coping strategies and breast cancer survival: Results from the black/white cancer survival study. American Journal of Epidemiology, 152, 940-949.

    Roy, C., & Andrews, H.A. (1999). The Roy adaptation model (2nd ed.). Norwalk, CT: Appleton and Lange.

    Samarel, N., Fawcett, J., Krippendorf, K., Piacentino, J., Eliasof, B., Hughes, P., et al. (1998). Women's perceptions of group support and adaptation to breast cancer. Journal of Advanced Nursing, 28, 1259-1268.

    Samarel, N., Fawcett, J., & Tulman, L. (1997). Effect of support groups with coaching on adaptation to early stage breast cancer. Research in Nursing and Health, 20, 15-26.

    Spiegel, D., & Bloom, J., & Yalom, I. (1981). Group support for patients with aietastatic cancer: A randomized prospective outcome study. Archives of General Psychiatry, 38, 527-533.

    Stanton, A.L., Danoff-Burg, S., Cameron, C.L., Bishop, M., Collins, C.A., Kirk, S.B., et al. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68, 875-882.

    Stevens, M.J., & Duttlinger, J.E. (1998). Correlates of participation in a breast cancer support group. Journal of Psychosomatic Research, 45, 263-275.

    Streubert, H., & Carpenter, D. (1999). Qualitative research in nursing: Advancing the humanistic imperative (2nd ed.). Philadelphia: Lippincott.

    Sullivan, C.F. (1997). Women's ways of coping with breast cancer. Women's Studies in Communication, 20(1), 60-81.

    Weisman, A. (1979). Coping with cancer. New York: McGraw-Hill.

    Williams-Brown, S., Baldwin, D.M., & Bakos, A. (2002). Storytelling as a method to teach African American women breast health information. Journal of Cancer Education, 17, 227-230.

    Wilmoth, M.C., & Sanders, L.D. (2001). Accept me for myself: African American women's issues after breast cancer. Oncology Nursing Forum, 28, 875-879.

    Wonghongkul, T., Moore, S.M., Musil, C., Schneider, S., & Deimling, G. (2000). The influence of uncertainty in illness, stress appraisal, and hope on coping in survivors of breast cancer. Cancer Nursing, 23, 422-429.

    Yates, P. (1999). Family coping: Issues and challenges for cancer nursing. Cancer Nursing, 22, 63-71.

    Zabalegui, A. (1999). Coping strategies and psychological distress in patients with advanced cancer. Oncology Nursing Forum, 26, 1511-1518.