Abstract
The breast cancer experiences of Punjabi immigrant women, who represent the most populace group of South Asians in Canada, need to be understood in order to inform culturally appropriate cancer services. The purpose of this qualitative study was to explore women’s stories of breast cancer in order to uncover how they made sense of their experiences. Interviews with twelve Punjabi immigrant women who had breast cancer within the last 8 years were available for this study. The four storylines that emerged from the ethnographic narrative analysis were: getting through a family crisis, dealing with just another health problem, living with never-ending fear and suffering, and learning a “lesson from God.” A minor theme, “being part of a close-knit family,” highlighted the family context as the most pronounced influence on the women’s experiences. These findings provide valuable insights into how women’s experiences of breast cancer were shaped by the intersections of culture, family, community, cancer treatments, and interactions with health care professionals.
Similar content being viewed by others
References
Statistics Canada [homepage on the Internet]. Immigrant population. 2001 Canadian Census. [accessed 2003 Oct 25] Available from: http://www.statcan.ca/english/Pgdb/popula.htm#imm.
Ahmed SM, Lemkau JP. Cultural issues in the primary care of South Asians. J Immigr Health 2000;2(2):89–96.
Choudhry UK. Health promotion among immigrant women from India living in Canada. J Nurs Scholarsh 1998;30(3):269–75.
Choudhry UK. Uprooting and resettlement experiences of South Asian immigrant women. West J Nurs Res 2001;23(4):376–93.
Choudhry UK, Jandu S, Mahal J, Singh R, Sohi-Pabla H, Mutta B. Health promotion and participatory action research with South Asian women. J Nurs Scholarsh 2002;34:75–82.
Clegg A. Older South Asian patient and carer perceptions of culturally sensitive care in a community hospital setting. J Clin Nurs 2003;12:283–90.
Grewal KS, Bottorff JL, Hilton BA. The influence of family on immigrant South Asian women’s health. J Fam Nurs 2005;11(3):242–63.
Grewal S, Bottorff JL, Balneaves LG. A pap test screening clinic in a South Asian community of Vancouver, British Columbia: challenges to maintaining utilization. Public Health Nurs 2004;21(5):412–8.
Johnson JL, Bottorff JL, Browne AJ, Grewal S, Hilton BA, Clarke H. Othering and being othered in the context of health care services. Health Commun 2004;16(2):253–71.
Nayar KE. The sikh diaspora in vancouver: three generations amid tradition, modernity, and multiculturalism. Toronto, Canada: University of Toronto Press Inc; 2004.
Neufeld A, Harrison MJ, Stewart MJ, Hughes KD, Spitzer D. Immigrant women: Making connections to community resources for support in family caregiving. Qual Health Res 2002;12(6):751–68.
Vydelingum V. South Asian patients’ lived experience of acute care in an English hospital: a phenomenological study. J Adv Nurs 2000;32(1):100–7.
Walker ARP, Halse J. Pattern of cancer in Indian patients hospitalized in Durban, South Africa. Eur J Cancer Prev 1999;8:247–54.
Winter H, Cheng KK, Cummins C, Maric R, Silcocks P, Varghese C. Cancer incidence in the South Asian population of England (1990–1992). Br J Cancer 1999;79:645–54.
Bottorff JL, Balneaves LG, Sent L, Grewal S, Browne AJ. Cervical cancer screening in ethnocultural groups: case studies in women-centered care. Women Health 2001;33(3/4):29–46.
Bottorff JL, Johnson J, Bhagat R, Grewal S, Balneaves LG, Clark H, et al. Beliefs related to breast health practices: the perceptions of South Asian women living in Canada. Soc Sci Med 1998;47(12):2075–84.
Choudhry UK, Srivastava R, Fitch MI. Breast cancer detection practices of South Asian women: Knowledge, attitudes and beliefs. Oncol Nurs Forum 1998;25(10):1693–701.
Gupta A, Kumar A, Stewart DE. Cervical cancer screening among South Asian women in Canada: the role of education and acculturation. Health Care Women Int 2002;23:123–34.
Johnson JL, Bottorff JL, Balneaves LG, Grewal S, Bhagat R, Hilton BA, et al. South Asian womens’ views on the causes of breast cancer: images and explanations. Patient Educ Couns 1999;37:243–54.
Sutton GC, Storer A, Rowe K. Cancer screening coverage of South Asian women in Wakefield. J Med Screen 2001;8(4):183–7.
Levine EG, Eckhardt J, Tang E. Changes in post traumatic symptoms following psychosocial treatment for breast cancer. Psychooncology 2005;14:618–35.
Smith MY, Redd WH, Peyser C, Vogel D. Post traumatic stress disorder in cancer: a review. Psychooncology 1999;8:421–537.
Payne DK, Sullivan MD, Massie MJ. Women’s psychological reactions to breast cancer. Semin Oncol 1996;23(1 Suppl 2):89–97.
Arman M, Rehnsfeldt A. The hidden suffering among breast cancer patients: a qualitative metasynthesis. Qual Health Res 2003;13(4):510–27.
Hilton BA. The phenomenon of coping with uncertainty for women with breast cancer. Ment Health Nurs 1988;9:217–38.
Nelson JP. Struggling to gain meaning: living with the uncertainty of breast cancer. ANS Adv Nurs Sci 1996;18(3):59–76.
Ashing KT, Padilla G, Tejero J, Kagawa-Singer M. Understanding the breast cancer experience of Asian American women. Psychooncology 2003;12:38–58.
Avis NE, Crawford S, Manuel J. Psychosocial problems among younger women with breast cancer. Psychooncology 2004;13:295–308.
Chamberlain Wilmoth M. The aftermath of breast cancer: an altered sexual self. Cancer Nurs 2001;24(4):278–86.
Fallowfield LJ, Baum M, Maguire P. Effects of breast conservation on psychological morbidity associated with diagnosis of early breast cancer. BMJ 1986;293:1331–4.
Fallowfield LJ, Clark A. Breast cancer: the experience of illness series. London: Routledge;1991.
Fallowfield LJ, Hall A. Psychosocial and sexual impact of diagnosis and treatment of breast cancer. Br Med Bull 1991;47:388–399.
Howard AF, Bottorff JL, Balneaves LG. Experiences of breast cancer in ethnocultural groups: A qualitative meta-study. Cancer Nurs (In Press).
Thomas-McLean R. Understanding breast cancer stories via Frank’s narrative types. Soc Sci Med 2004;58:1647–57.
Frank A. The wounded storyteller: body, illness, and ethics. Chicago, IL: The University of Chicago Press; 1995.
Mathews HF, Lannin DR, Mitchell JP. Coming to terms with advanced breast cancer: Black women’s narratives from eastern North Carolina. Soc Sci Med 1994;38(6):789–800.
Moore RJ. African American women and breast cancer: notes from a study of narrative. Cancer Nurs 2001;24(1):35–43.
Cortazzi M. Narrative analysis in ethnography. In: Atkinson P, Coffey A, Delamont S, Lofland J, Lofland L, editors. Handbook of ethnography. Thousand Oaks, CA: Sage Publication;2001. p. 384–394.
Mishler EG. Research interviewing context and narrative. Cambridge, MA: Harvard University Press; 1986.
Riessman CK. Narrative analysis. Qualitative research methods series. Newbury Park, CA: Sage Publications; 1993.
Balneaves LG, Bottorff JL, Grewal SK, Naidu P, Johnson JL, Howard AF. Family support of immigrant Punjabi women with breast cancer. Family Commun Health 2007;30(1):16–28.
Ashbury FD, Cameron C, Mercer SL, Fitch M, Nielsen E. One-on-one peer support and quality of life for breast cancer patients. Patient Educ Couns 1998;35:89–100.
Cunningham AJ, Edmonds CV, Jenkins GP, Pollack H, Lockwood GA, Warr DA. A randomized controlled trial of the effects of group psychological therapy on the survival of women with metastatic breast cancer. Psychooncology 1998;7:508–17.
Edelman S, Lemon J, Bell DR, Kidman AD. Effects of group CBT on the survival time of patients with metastatic breast cancer. Psychooncology 1999;8:474–81.
Goodwin PJ, Molyn L, Ennis M, Koopmans J, Vincent L, Guther H, et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med 2001;345(24):1719–26.
Chamberlain Wilmoth M, Sanders LD. Accept me for myself: African American women’s issues after breast cancer. Oncol Nurs Forum 2001;28(5):875–9.
Henderson PD, Gore SV, Lane Davis B, Condon EH. African American women coming with breast cancer: a qualitative analysis. Oncol Nurs Forum 2003;30(4):641–7.
Beaver K, Luker KA, Owens RG, Leinster SJ, Degner LF, Sloan JA. Treatment decision making in women newly diagnosed with breast cancer. Cancer Nurs 1996;19(1):8–19.
Bruera E, Willey JS, Palmer JL, Rosales M. Treatment decisions for breast carcinoma: patient preferences and physician perceptions. Cancer 2002;94(7):2076–80.
Degner LF, Kristjanson LJ, Bowman D, Sloan JA, Carriere KC, O’Neil J, Bilodeau B, Watson P, Mueller B. Information needs and decisional preferences in women with breast cancer. JAMA 1997;277(18):1485–93.
Hack TF, Degner LF. Coping with breast cancer: a cluster analytic approach. Breast Cancer Res Treat 1999;54:185–94.
Keating NL, Guadagnoli E, Landrum MB, Borbas C, Weeks JC. Treatment decision making in early-stage breast cancer: should surgeons match patients’ desired level of involvement? J Clin Onc 2002;20(6):1473–79.
Garro LC, Mattingly C. Narrative as construct and construction. In: Mattingly C, Garro L, editors. Narrative and the cultural construction of illness and healing. Berkley, CA: University of California Press;2000. p. 1–49.
Acknowledgments
This research was supported by a grant from the Canadian Breast Cancer Research Alliance, a Michael Smith Foundation for Health Research Junior Scholarship to Ms. Howard, a CIHR Investigator Award to Dr. Bottorff, and a Canadian Cancer Society Research Scientist Award (supported by the NCIC Prostate Cancer Research Initiative) to Dr. Balneaves. The authors wish to thank Dr. Joy Johnson for her input and guidance in completing this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Howard, A.F., Bottorff, J.L., Balneaves, L.G. et al. Punjabi Immigrant Women’s Breast Cancer Stories. J Immigrant Minority Health 9, 269–279 (2007). https://doi.org/10.1007/s10903-007-9044-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10903-007-9044-z