Cancer-Related Symptom Management in American Indians: Focus Group Findings from Arizona

Cancer is the second leading cause of death among American Indians over the age of 45 years^{1, 2}. Cancer rates which were previously reported to be lower in Indian populations, have been shown to be increasing in the past twenty years^{1, 2}. Reported mortality rates are also higher than average3. This presentation describes the results of the first phase of a study designed to reduce or overcome barriers to cancer-related symptom management among American Indians residing in the Southwest region of Arizona. A series of focus groups were conducted with 120 male and female cancer patients/survivors. The focus group discussions explored the culturally-embedded meanings of cancer-related symptoms (e.g. pain, fatigue depression, their conceptualization, cultural constructs(s) and the pattern and strategies of their disclosure by American Indians. An explanatory model was formed to analyze cancer survivor's cancer symptom etiology, how these patients sought treatment, and how they managed their adverse symptoms. The use of a Cultural Committee to provide protection from ethnocentric interpretations of the data by reviewing and validating the emerging themes from the focus groups is also described. Finally, how the focus group findings provide the basis for the development of the symptom management scales to be used in the next phase of the study is explored.

1. US Department of Health and Human Services. Indian Health Service. Trends in Indian Health 1999-99. Rockville, MD: Department of Heath and Human Services, Indian Health Service;2000.

2. Cobb N, Paisano RE. Patterns of cancer mortality among Naitve Americans. Cancer 1998;83(11):2377-83.