Perceived discrimination and ethnic identity among breast cancer survivors.

PURPOSE/OBJECTIVES To examine ethnic identity and socio-demographic factors in minority patients' perceptions of healthcare discrimination in breast cancer care. DESIGN Mixed methods. SETTING Participants' homes in the metropolitan areas of Phoenix and Tucson, AZ. SAMPLE 39 women treated for breast cancer in the past six years: 15 monolingual Spanish-speaking Latinas, 15 English-speaking Latinas, and 9 African Americans. METHODS Two questionnaires were administered. Individual interviews with participants were conducted by nurse researchers. Quantitative, qualitative, and matrix analytic methods were used. MAIN RESEARCH VARIABLES Ethnic identity and perceptions of discrimination. FINDINGS Eighteen women (46%) believed race and spoken language affected the quality of health care. Perceived dis-respect from providers was attributed to participant's skin color, income level, citizenship status, and ability to speak English. Discrimination was more likely to be described in a primary care context, rather than cancer care. Ethnic identity and early-stage breast cancer diagnosis were the only study variables significantly associated with perceived healthcare discrimination. CONCLUSIONS This article describes the first investigation examining ethnic identity and perceived discrimination in cancer care delivery. Replication of this study with larger samples is needed to better understand the role of ethnic identity and cancer stage in perceptions of cancer care delivery. IMPLICATIONS FOR NURSING Identification of ethnic-specific factors that influence patient's perspectives and healthcare needs will facilitate development of more effective strategies for the delivery of cross-cultural patient-centered cancer care.

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