Stigma, social support, and spirituality: associations with symptoms among Black, Latina, and Chinese American cervical cancer survivors

DeJuana Coleman; Alejandra Hurtado-de-Mendoza; Abigail Montero; Sabrina Sawhney; Judy Huei-Yu Wang; Tania Lobo; Kristi D Graves

doi:10.1007/s11764-022-01283-z

Stigma, social support, and spirituality: associations with symptoms among Black, Latina, and Chinese American cervical cancer survivors

J Cancer Surviv. 2022 Nov 22:10.1007/s11764-022-01283-z. doi: 10.1007/s11764-022-01283-z. Online ahead of print.

Authors

DeJuana Coleman¹, Alejandra Hurtado-de-Mendoza², Abigail Montero², Sabrina Sawhney¹, Judy Huei-Yu Wang², Tania Lobo², Kristi D Graves³

Affiliations

¹ Georgetown University, 37th and O Streets, Washington, DC, NW, 20007, USA.
² Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA.
³ Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA. Kristi.Graves@georgetown.edu.

PMID: 36417116
PMCID: PMC10200827 (available on 2024-05-22)
DOI: 10.1007/s11764-022-01283-z

Abstract

Purpose: Few studies have examined experiences of stigma and factors associated with symptoms among cervical cancer survivors from diverse racial and ethnic backgrounds. We investigated survivorship experiences and patient-reported outcomes in the SPADE symptom cluster (sleep disturbance, pain interference, anxiety, depression, and energy/fatigue) among Black, Latina, and Chinese American women diagnosed with cervical cancer.

Methods: In two phases of research with cervical cancer survivors, we collected qualitative data through individual interviews (N=12; recruited through community referrals) and quantitative data from an observational cohort study (N=91; recruited through 4 national cancer registries). We coded interview transcripts to describe the survivors' experiences. We then evaluated associations between social support, spirituality, and SPADE symptom cluster domains using linear regression models.

Results: Qualitative analysis yielded four themes: perceptions of stigma, empowerment, physical and psychological effects, and social support. These concepts revolved around internal and external stigmas, emotional responses, strengthened faith, and different social support types. Quantitative analyses indicated that greater spirituality was associated with lower symptom burden on all five SPADE domains (p<0.01). We observed nuanced associations between specific types of social support and SPADE domains.

Conclusions: The survivorship experiences of Black, Latina, and Chinese American women with cervical cancer are negatively influenced by perceptions of stigma. Higher scores on spirituality and varied types of social support were significantly associated with fewer symptoms in the SPADE symptom cluster.

Implications for cancer survivors: Results suggest targets for future interventions to reduce symptom burden among women diagnosed with cervical cancer by leveraging spirituality and social support.

Keywords: Black; Cervical cancer; Chinese American; Latina; Quality of life; SPADE; Survivors; Symptoms.

Abstract

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