Ethnicity and Cancer: examining psychosocial transitions for older people

This study is funded by Dimbleby Cancer Care and conducted by a research team led by Professor Payne at the International Observatory on End of Life Care.

Primary Aim:

To investigate the cultural constructs of loss, transition and adaptation in the face of encountering a diagnosis of a life threatening illness.

Objective:

To make policy recommendations for improving cancer and palliative care services for older Chinese and white British people and to consider the extent to which guidelines are applicable and by highlighting educational opportunities for professionals.

Study design:

A longitudinal qualitative research study will be conducted over 2 years. The research methodology will be informed by a participatory model of qualitative research in which the mode of research conduct will be negotiated between researchers, the Chinese community and Cancer Support Groups.

Sample:

The sampling strategy will be informed by the principles of purposive sampling. 50 Chinese adults will be recruited via community based groups in Sheffield, Manchester, Plymouth and London. Working with community group leaders associated with the Chinese community, the Team will identify older Chinese people who have cancer. Fifty ‘white’ British people will function as a comparison group and they will be recruited from cancer support groups in each of the four areas.

Settings:

This research will be conducted in four areas of Britain. These areas reflect the two living patterns of Chinese communities highly dispersed (Sheffield, Plymouth) and highly concentrated (Manchester, London).

Data analysis:

The analysis aims to build an exhaustive theoretical description of the cultural constructs of loss, transition and adaptation in the face of encountering a diagnosis of cancer for older Chinese and British people. Therefore, three phases of analysis will be undertaken as following:

1. thematic analysis of the complete dataset to identity commonalities and differences. Using the principles of grounded theory, commonalities and differences both within the individual accounts and across the two groups (Chinese and British) will be identified
2. narrative analysis of a subgroup of 30 transcripts (15 Chinese, 15 British) will be undertaken. The subgroup will be selected to represent those Chinese people who have experienced migration(s) and other types of loss to determine the extent to which these experiences influence their perceptions of cancer diagnosis and care, and their choices such as returning to their country of origin
3. integration at the final phase will seek to explore the extent to which findings of the thematic analysis, where the research questions 'frame' the analytical process and the narrative analysis where new issues raised by participants, are congruent

Time span:

The study commenced in July 2006 and will be complete by end of July 2008