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What precipitates depression in African-American cancer patients? Triggers and stressors

Published online by Cambridge University Press:  22 March 2012

Amy Y. Zhang ,
Faye Gary  and
Hui Zhu
Amy Y. Zhang*
Affiliation:
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
Faye Gary
Affiliation:
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
Hui Zhu
Affiliation:
Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
*
Address correspondence and reprint requests to: Amy Y. Zhang, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904. E-mail: axz16@case.edu
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Abstract

Objective:

This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients.

Method:

The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress.

Results:

Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences.

Significance of results:

Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.

Keywords

DepressionStressCancerAfrican-AmericansHealth disparity
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 279 - 286
Copyright
Copyright © Cambridge University Press 2012

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