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Transition From Patient to Survivor in African American Breast Cancer Survivors

Mollica, Michelle MS, RN, OCN; Nemeth, Lynne PhD, RN

doi: 10.1097/NCC.0000000000000120

Background: Breast cancer is the most common cancer among African American (AA) women, with a survival rate of 79%, lower than for other ethnic and racial groups in the United States. Minorities experience disparities in timeliness of care, delivery of culturally sensitive care, and outcomes. Transition from active treatment to survivorship presents an opportunity for exploration.

Purpose/Objectives: This qualitative, grounded theory study examined the experiences and coping of AA women as they transition from being a breast cancer patient to being a breast cancer survivor.

Methods: This study included 15 community-based AA women aged 35 to 75 years in Charleston, South Carolina, and Buffalo, New York, who had completed treatment for primary breast cancer between 6 and 18 months prior. A semistructured interview explored experiences as they finished treatment, support from family, role of spirituality, physical and emotional concerns, needs of the survivor, as well as suggestions for possible interventions for other survivors. Two investigators reviewed transcripts and coding to confirm and refine the findings.

Results: Four main themes were identified: perseverance through struggles supported by reliance on faith, persistent physical issues, anticipatory guidance needed after treatment, and emotional needs as important as physical.

Conclusions: The transition from cancer patient to survivor is a pervasive time filled with stress, loss of safety net, and significant coping measures. Participants expressed the need to have support from another AA breast cancer survivor as they complete treatment.

Implications for Practice: Nurses and providers can assess and address stressors in transition. Nurses should design patient-centered interventions using peers as direct support to promote effective coping strategies.

Author Affiliations: College of Nursing, Medical University of South Carolina, Charleston (Ms Mollica and Dr Nemeth), and School of Nursing, D’Youville College, Buffalo, New York (Ms Mollica).

This study was approved by the institutional review board of the Medical University of South Carolina (study ID Pro00016967).

The authors have no funding or conflicts of interest to disclose.

Correspondence: Michelle Mollica, MS, RN, OCN, D’Youville College, 320 Porter Ave, Buffalo, NY 14201 (

Accepted for publication October 22, 2013.

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins