IDENTIFYING THE STRESSORS
Both patients and providers identified the major stressors such as household finances and the cost of medications and medical care. The researchers found that patients were upset about poor communication with their cancer care providers and having received so little information about their treatment. “The side effects, they leave me weak, very weak … I wish there was more [information] in Spanish.”1
Information concerning side effects was sometimes nonexistent. For example, one comment reported “all they said was that I would lose my hair. They [doctors/nurses] did not tell me about the pain in the bones, the itching, the meds that cause weight gain, I didn’t like that … they cure one thing but damage another that is working.”1
Family issues also caused tremendous stress. Patients were concerned when they could not function well as mothers while suffering from the effects of the chemotherapy. Coping with a life-threatening illness is challenging enough, but to undergo arduous treatment far from home makes it so much more so. These women were also daughters, nieces, and sisters, and they missed their own families. A major source of stress was that their own mothers and others in their family network often could not support them because they were in another country.
Some patients did not even tell their family the details of their illness. They did not want to cause concern among family members who could do so little. Furthermore, some of the women had provided financial support for their dependent family back home, and that had to stop; they had enough of a financial burden just trying to work during and after treatment.
CULTURALLY SPECIFIC STRESS RELIEVERS
Despite having obvious causes of stress, 64% of patients said they had not received any information on stress management prior to their treatment. Lacking that, the women sought relief from the stress and constant anxiety they were feeling by reading the Bible and relying on their spirituality and faith. Staying connected with family in this country as well as talking on the phone with relatives in their native country was also comforting; however, that could also be a source of stress. One patient revealed in her interview that talking with her family in Argentina resulted in a phone bill of more than $700.
Most patients found it useful to maintain a normal daily routine whenever possible, while a few were able to use television, exercise, or reading to keep their anxiety down. Almost all of the women felt that having a tool kit on managing stress would have been invaluable.
The authors of this study emphasize that educational materials should be made available in the cancer patients’ native language, written by writers who are familiar with the culture, and take into account the regional and societal differences within the Latino community.1
Bette Weinstein Kaplan is a medical writer based in Tenafly, New Jersey.
1. Martinez Tyson DD, Jacobsen P, Meade CD. Understanding the stress management needs and preferences of Latinas undergoing chemotherapy [published online ahead of print May 8, 2015]. J Cancer Educ. 2015.