Date of Award

Spring 5-7-2011

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Margaret F. Moloney

Second Advisor

Cecelia Gatson Grindel

Third Advisor

Christine Rosenbloom

Abstract

Obesity is associated with higher death rates from breast and gynecological cancers. African American women(AAW) are more likely to be diagnosed with these cancers at later stages and have lower survival rates than Caucasian women. African American women are also disproportionately affected by obesity. Studies suggest that the healthcare experiences of obese women (primarily stigmatization), may contribute to their decisions to utilize healthcare services. However, these studies have largely comprised Caucasian women; there remains a paucity of studies addressing this issue in AAW. The purpose of this study was to explore the healthcare experiences of obese AAW and their utilization of preventive healthcare services.

Interpretive phenomenology, based on the work of Maxx van Manen, was used to describe and interpret the healthcare experiences of 15 obese AAW living in communities in Georgia. The women ranged in age from 23 to 62, with body mass index ranging from 35-55. The majority of the sample (83%) had adequate health insurance. This was a well educated sample with 87% having college degrees or some college education. Individual, audio-taped interviews were used to collect data.

Data were analyzed using interpretive phenomenological methods, with analysis and collection occurring concurrently. Data were analyzed as a whole then line by line to identify themes across transcripts. Two patterns and five themes were identified. Patterns were: They're not listening and Good or bad, it's my decision. Themes were: Attributing all problems to weight; They say lose weight but give us no tools; Stigmatization; Cancel my appointment please: I won't be back, and Empowerment.

The women recalled a pleothra of negative encounters with providers that they termed "demeaning" and "nastiness for no reason." Many women reacted by delaying or avoiding healthcare, some not returning for preventive health screens for many years. The significant association between obesity and mortality from cervical and breast cancers necessitates timely preventive screens by obese women. The results of this study can help to inform practice, education, and research. Recommendations for all three areas were deleneated in the study.

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Nursing Commons

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