“Save Our Breasts”: Breast Cancer Spirituality, Fatalism and Fear in African-American Women

Monday, 31 October 2011

Lynette M. Gibson, PhD, RN
Mary Black School of Nursing, University of South Carolina Upstate, Grenville, SC

Learning Objective 1: The learner will be able to discuss the effects of the “Save Our Breasts” forum on fatalism and fear in African-American women.

Learning Objective 2: The learner will be able to describe relationships among spirituality and fatalism and in African-American women.

Breast cancer is the most common cancer in African-American (AA) women and AA women under 45 have the highest incidence of any U.S. ethnic group. The breast cancer mortality rate is higher in AA women than that of all U.S. ethnic groups. Barriers to breast cancer mammography screening by  AA women include fatalism and fear. Spirituality is associated with health, and is important to many AA women. It is unclear as to whether spirituality is related to fatalism in AA women.  The Powe Fatalism Model was used as the theoretical basis. This pilot study tested a culturally appropriate intervention, "Save Our Breasts", a breast health forum, in 29 AA women using a quasi-experimental pre and post-test design. The forum included AA breast cancer survivors’ personal testimonies, prose, poetry, photographs, and quotations. Seventy-five AA women over 35 from churches and community organizations were invited to participate. A spirituality survey was administered prior to the intervention and surveys on fear and fatalism were adminstered prior to and immediately after. All surveys are reliable and have been validated in AA women. Nonparametric statistical analyses were used due to the skewed data and the small sample size. The Wilcoxon Signed Rank test was used to analyze the effect of the “Save Our Breasts” forum on fear and fatalism and the Spearman’s Rho test used to analyze the correlation between spirituality and fatalism. Although the fatalism and fear scores were lower after the intervention, the difference was not significant. There were negative correlations between spirituality and fatalism before and after the intervention with a stronger correlation evident after the intervention. This study should be continued with a larger sample to determine whether fear and fatalism are lessened after the “Save Our Breasts” forum and whether there is a significant relationship between spirituality and fatalism.