Understanding Canadian Punjabi-speaking South Asian women's experience of breast cancer: a qualitative study.

BACKGROUND: Knowledge of women's experience with breast cancer is based on studies on middle-class Caucasian women. Generalizations are drawn from the few studies of South Asian women such as lack of desire to discuss personal and family issues. The purpose of this qualitative study was to understand the experience of Canadian Punjabi-speaking South Asian women in order to inform health care practices.
DESIGN: Twenty women were recruited mainly through the local cancer center and word of mouth to participate in four focus groups conducted in Punjabi. All women spoke Punjabi and/or English, were involved in/or had completed cancer treatment and lived within driving distance of the local Cancer Center.
FINDINGS: The themes that emerged from focus group data were all psychosocial: spiritual beliefs, patient inclusion, family systems, psychosocial distress and emotional expression. All women: (1) formed a strong spiritual connection, believed that it was fate or karma and that their cancer diagnosis was the will of God and women used this strength of spirituality to help them cope and (2) women were distressed by the diagnosis and prior to being exposed to cancer believed that cancer equals death. There was in-group difference amongst the women with the remaining themes: being alone to hear the diagnosis alone versus having family members present and feeling supported by family members versus being stressed by family and degree of inclusion desired in the decision-making process. The key findings which are contrary to previous research, is the women's desire to discuss their experience openly and the variation in experience within the group. The implication for practice for all professionals is not to make assumptions regarding therapeutic interactions with patients but to individually assess the clients and learn about their specific values and beliefs and incorporate spirituality in health care delivery.