Health behavior changes in African American family members facing lung cancer: Tensions and compromises

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society Vol. 38; pp. 57 - 64
• Main Authors: McDonnell, Karen Kane, Owens, Otis L., Hilfinger Messias, DeAnne K., Heiney, Sue P., Friedman, Daniela B., Campbell, Callie, Webb, Lisa A.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.02.2019
• Subjects: Adaptation, Psychological; Adult; African Americans; African Americans - psychology; Aged; Cancer survivors; Cancer Survivors - psychology; Caregivers; Caregivers - psychology; Family - ethnology; Family - psychology; Family members; Female; Focus groups; Friends - psychology; Health Behavior - ethnology; Humans; Life Style - ethnology; Lifestyle behavior change; Lung neoplasm; Lung Neoplasms - ethnology; Lung Neoplasms - psychology; Lung Neoplasms - therapy; Male; Middle Aged; Nursing; Qualitative Research; Social Support; Caregivers; Qualitative research; Lifestyle behavior change; Cancer survivors; Lung neoplasm; African Americans; Focus groups; Family members
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2018.12.002

Behavioral interventions targeting cancer survivors often fail to address the clustering of unhealthy behaviors among family members and friends, and the impact of close relationships on behavior change. The study's aim was to identify factors associated with receptivity and preferences for lifestyle behavior change among family members of African-American survivors of lung cancer. Principles of social cognitive theory guided the design. A descriptive, qualitative study recruited 26 African-American family members of lung cancer survivors from two teaching hospitals in the southeastern United States. A 20-item Information Form collected demographic, health status, and health behavior information. Family members participated in one of three semi-structured focus group discussions. Four major themes emerged: family members and survivors both resisted the caregiver role; dramatic changes evoked by the diagnosis of lung cancer were facilitators and barriers to lifestyle choices; leaning on faith was the primary source of support; and these families live with a constant threat of multiple cancers. Findings emphasize the importance of meaningful conversations among health-care providers, survivors, and family members during the time of diagnosis, treatment, and recovery, so that family members are better prepared to cope with anticipated changes. This study highlights the stressors that affect family members and sheds light on their unique needs. The stressors limit their ability to change health behaviors. Family members need basic education, skills training, and support related to the lung cancer diagnosis and other cancers. Current methods to provide these services are limited in their accessibility, availability, and effectiveness. •Family members wanted to improve their health behavior in support of the survivors.•A lack of guidance about behaviors negatively impacted family members' confidence that they could change.•Caring for a survivor of lung cancer led to social isolation.•Implementing a healthier lifestyle was “possible with God's help.”.