Learning Objective #1: Compare psychosocial adjustment outcomes between U.S. and Brazilian women with breast cancer

Learning Objective #2: Identify culturally competent care strategies to facilitate positive adjustment to breast cancer in women from the U.S. and Brazil

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Problem/Objective: Breast cancer is a significant health problem among women. Approximately 1 million new cases occur annually worldwide and in developing countries the incidence is increasing (WHO, 2003). Despite treatment advances and a growing number of survivors, the psychosocial impact of breast cancer is still profound. Women often journey through a maze of treatment alternatives with a wide array of physical, emotional, interpersonal and social implications. Reactions to a breast cancer diagnosis and subsequent adjustment may reflect cultural values. Although there is a growing body of knowledge describing factors associated with breast cancer adjustment in U.S. women, the literature is sparse about adjustment among women from other cultures. In this secondary analysis of data sets from two similar studies, social support, symptom distress and psychosocial adjustment to breast cancer outcomes are compared between women from the U.S. and Brazil.

Methods: The first data set is from a study of 101 U.S. women with breast cancer, 6-8 weeks post surgery (Budin, 1998). The second data set is from a sample of 120 Brazilian women receiving post-surgical treatment for breast cancer (Lima, 2004). All participants completed the same inventories: Psychosocial Adjustment to Breast Cancer Factor of the Psychosocial Adjustment to Illness Scale (PAIS) (Derogatis, 1983); Social Support Network Inventory (Flaherty et al., 1983); Symptom Distress Scale (SDS) (McCorkle & Young, 1978). Descriptive statistics and t-tests were used to compare adjustment outcomes between groups.

Findings/Conclusions: Although there were no significant differences between groups in levels of social support, the Brazilian women did score significantly higher in psychosocial adjustment problems and symptom distress. Symptoms that the Brazilian women reported as significantly more distressful were pain intensity, appearance, concentration, mobility, and outlook. Implications for nurses to provide culturally competent care to facilitate positive adjustment to breast cancer and directions for future studies are suggested.