The art of understanding each other's qualitative research on the experiences and needs of non-western immigrant women with breast cancer after treatment with chemotherapy

Abstract

Background: In the year 2000 a governmental report showed that the Dutch healthcare system did not meet the needs of the growing number of non-western immigrants. This report not only described the struggle of the Dutch health care system but also of immigrants themselves about the differences in views and experiences of disease between non-western cultures and the Dutch culture. Most outstanding difference between these cultures is the meaning of illness and in particular coping with cancer. Within families it is not clear in what way women struggle with their needs during illness such as cancer, next to the stress of living between two cultures in the Netherlands. This study explored the experiences and needs of non-western immigrant women with breast cancer after treatment with chemotherapy, as regards: the role of culture and religion in having breast cancer, and the professional and informal care they received and whether this care meet their needs. Method(s): A qualitative study was conducted through in-depth interviews among non-western immigrant women with breast cancer (n = 16). The verbatim transcribed interviews were analysed according to a thematic approach. Result(s): Women experienced problems with professionals such as poor and inadequate communication with healthcare providers and a lack of understanding of their religious and cultural principles. The family takes precedence in the choices for type of treatment above the women themselves. Women experienced the opinion of the partner as valuable, but help or understanding was often missed. Religion provided guidance and strength and gave meaning to the disease through the belief in destiny. Doubt was expressed about their own influence on development and treatment of their disease. In their perception lifestyle factors such as nutrition and physical activity have little or no influence on the presence of cancer. Cancer was often associated with death, especially when side effects of chemotherapy were visible, confrontation with cancer was inevitable. The loss of hair and, in case of a mastectomy, the breast was a shocking experience, as a loss of femininity. Conclusion(s): The Dutch health care system seemed not more culturally sensitive in adaption of the growing number of non-western immigrants comparing the situation in 2000. Added to this problem women experienced a lack of support from partner and family. Non-western immigrant women experienced tension between the wish to fulfil certain cultural and religious expectations and the recognition of their own feelings and needs. More organizations specifically targeting these women are needed.