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1.  Surgical Treatment Differences Among Latina and African American Breast Cancer Survivors 
Oncology nursing forum  2012;39(4):E324-E331.
Purpose/Objectives
To describe breast cancer treatment choices from the perspectives of Latina and African American breast cancer survivors.
Design
An interdisciplinary team conducted a mixed-methods study of women treated for stages I–IV breast cancer.
Setting
Participants’ homes in metropolitan areas.
Sample
39 participants in three groups: monolingual Spanish-speaking Latinas (n = 15), English-speaking Latinas (n = 15), and African American women (n = 9).
Methods
Individual participant interviews were conducted by racially and linguistically matched nurse researchers, and sociodemographic data were collected. Content and matrix analysis methods were used.
Main Research Variables
Perceptions of breast cancer care.
Findings
High rates of mastectomy were noted for early-stage treatment (stage I or II). Among the participants diagnosed with early-stage breast cancer, the majority of English-speaking Latinas (n = 9) and African American women (n = 4) received a mastectomy. However, the majority of the Spanish-speaking Latina group (n = 5) received breast-conserving surgery. Four factors influenced the choice of mastectomy over lumpectomy across the three groups: clinical indicators, fear of recurrence, avoidance of adjuvant side effects, and perceived favorable survival outcomes. Spanish-speaking Latinas were more likely to rely on physician treatment recommendations, and the other two groups used a shared decision-making style.
Conclusions
Additional study is needed to understand how women select and integrate treatment information with the recommendations they receive from healthcare providers. Among the Spanish-speaking Latina group, limited English proficiency, the use of translators in explaining treatment options, and a lack of available educational materials in Spanish are factors that influenced reliance on physician recommendations.
Implications for Nursing
Oncology nurses were notably absent in supporting the women’s treatment decision making. Advanced practice oncology nurses, coupled with language-appropriate educational resources, may provide essential guidance in clarifying surgical treatment choices for breast cancer among culturally and linguistically diverse populations.
doi:10.1188/12.ONF.E324-E331
PMCID: PMC3495184  PMID: 22750902
2.  Perceived Discrimination and Ethnic Identity Among Breast Cancer Survivors 
Oncology Nursing Forum  2012;39(2):E91-E100.
Purpose/Objectives
To examine ethnic identity and sociodemographic 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 disrespect 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.
doi:10.1188/12.ONF.E91-E100
PMCID: PMC3318960  PMID: 22374505
3.  COMPLEMENTARY THERAPY USE AMONG RACIAL/ETHNIC GROUPS 
doi:10.1016/j.nurpra.2010.05.001
PMCID: PMC2975464  PMID: 21072254
4.  Spirituality and Cultural Identification Among Latino and Non-Latino College Students 
The purposes of this study were to examine (a) differences in spiritual perspectives and practices of Latino and non-Latino young adults and (b) the cultural relevance of the Latino Spiritual Perspective Scale (LSPS). Studies indicate that spiritual perspectives are embedded within cultural group norms and vary significantly across ethnic groups. A cross-sectional survey design was used with a convenience sample of 223 Latino and non-Latino university students in the Southwestern United States. The Spiritual Perspective Scale (SPS), the LSPS, the Orthogonal Cultural Identification Scale, and a demographic questionnaire were used. Latinos scored significantly higher than non-Latinos in both measures of spiritual perspectives. Self-reported behavioral measures, such as frequency of personal prayer, were also higher among the Latino group. Latino cultural identification was the only significant predictor of LSPS scores. Findings from this study indicate that spirituality among Latinos has meanings specific to the cultural group context. These findings have implications for nursing research involving the conceptualization and measurement of spirituality among multiethnic groups.
Los propósitos de este estudio eran examinar: (a) diferencias en perspectivas espirituales y prácticas de jóvenes Latinos y no Latinos; y (b) la relevancia cultural de la Escala de la Perspectiva Espiritual Latina. Estudios indican que perspectivas espirituales están incrustadas entre normas culturales del grupo y varían considerablemente entre grupos étnicos. Un diseño transversal y de encuesta fue utilizado con una muestra de conveniencia de 233 estudiantes universitarios Latinos y no Latinos en el Suroeste de los Estados Unidos. La Escala de la Perspectiva Espiritual (EPE), la Escala de la Perspectiva Espiritual Latina (EPEL), la Escala Ortogonal de Identificación Cultural, y un cuestionario demográfico fueron utilizados. Los Latinos calificaron considerablemente más alto que los no Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos.
doi:10.1891/1540-4153.7.2.72
PMCID: PMC2822391  PMID: 20165566
spirituality; religious practices; cultural identification; instrumentation
5.  Spirituality Among Latinas/os Implications of Culture in Conceptualization and Measurement 
Despite growing transnational migration between the United States and Latin American countries, culturally relevant conceptualizations of spirituality among Latinas/os remain lacking in healthcare research. Grounded in Latina feminist theology, this article elucidates cultural values that influence spirituality and describes findings from a study using a new questionnaire to explore spirituality among Latinas in Puerto Rico and the US mainland. Results support the saliency of cultural values such as personalismo and familismo as the context for spiritual perspectives, which may function independently of the Catholic Church structure.
PMCID: PMC2758774  PMID: 16495689
instrumentation; Latinos; postcolonial; prayer; religion; spirituality
6.  Counternarratives of Mexican-Origin Women with Breast Cancer 
ANS. Advances in nursing science  2009;32(2):E57-E67.
Little is known about cancer health disparities among undocumented Latino immigrant populations, who represent a rapidly growing sector in the United States. Federal and state legislative reforms to control immigration have increased significantly over the past year. Although the effects of immigration reforms are being documented in housing, education, and public service industries, no data have been found examining the impact on the health of immigrant communities. In this article, we identify the consequences of recent immigration legislation enacted in Arizona, which has created barriers to accessing cancer treatment and continued follow-up care among a sample of Latina breast cancer survivors.
doi:10.1097/ANS.0b013e3181a3b47c
PMCID: PMC2712628  PMID: 19461222
access to care; breast cancer; health disparities; health policy; immigration; Latino; undocumented

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