The experiences of South Asian women with breast cancer and the complexities of whole person care

Abstract

This study investigates the experiences of South Asian women being treated for breast cancer within a British system of health and social care that recognises racialised inequalities in care and is striving to provide culturally sensitive care to an increasingly diverse population. The research was conducted in a National Health Service (NHS) Trust in an outer London suburb. It is a qualitative exploratory study based on eighteen in- depth interviews and participant observation of interactions between women with breast cancer and health care professionals. The interviews were conducted in three languages: English, Gujarati and Hindi.

In examining whole person care from the perspectives of both health care professionals and South Asian women, this thesis demonstrates how ethnicity as both a category of social difference and a process of social identification can present significant challenges for holistic care at different stages of the patient pathway. The concept of othering is used to make sense of the complicated relationships between health care professionals and South Asian women and to examine the extent to which care is responsive to differences of ethnicity, culture and faith.

The findings from participant observation and qualitative interview data suggest that health professionals can often reduce the complex experiences of South Asian women to cultural difference. Such thinking can serve to compromise therapeutic relationships in which mutual power sharing and decision making is inhibited. However, cultural stereotyping is not a uniform process and can be transformed in situ so that some women are able to access personalised and holistic care. Whilst recognising that the needs of South Asian are complex evidence from this study suggests that othering can be a central process through which health care professionals contribute to the marginalisation of South Asian women within health care services.

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