Abstract
Background: The aim of this study was to compare illness concepts and coping strategies among native German cancer patients and those with a Turkish migration background. Methods: Guideline-based, semi-structured interviews were conducted with 11 German (♂: 8, ♀: 3) and 11 Turkish (♂: 2, ♀: 9) cancer patients. The transcripts were evaluated using a qualitative content analysis in accordance with Mayring. Results: We identified eight categories of illness concepts: stressful life events, environmental influences, the will of God, medical factors, fate, trauma, health behaviour, and psychological causes. German patients frequently attributed their illness to environmental influences, persistent stress, or medical factors, whereas Turkish patients blamed persistent stress, the will of God, or trauma. The last two categories are not found among German patients. We classified the coping strategies into 11 main categories: social support, activity, patient competence, fighting spirit/positive thinking, use of health services/alternative healing methods, lifestyle, emotional coping, cognitive coping, religious coping, spiritual coping, and culture-specific methods for patients of Turkish origin. For German patients, activities as well as social support played primary roles in coping. Turkish patients also often used social support. However, in contrast to the German patients, they are less active and use much more religious coping and culture-specific means. In addition, negative emotions occur more often when processing the illness than in the German patients. Conclusion: Common illness representations and coping strategies could be found for Turkish and German patients, but also specific ones for the respective group. It is particularly noticeable that German patients attach more importance to medical factors and try more actively to cope with the illness. For Turkish patients, cultural and religious factors play an important role, which should also be considered in treatment.
Highlights
Cancer is the second most frequent cause of death in Germany [1], and the annual incidence is about 492,000 [2]
Differences could be observed regarding the frequency of reported illness beliefs between German and Turkish patients
Almost all Turkish cancer survivors belong to the first migration generation, so a high degree of external health locus of control may be postulated as a possible explanation for the above mentioned differences concerning the illness concepts compared to the German patients
Summary
Cancer is the second most frequent cause of death in Germany [1], and the annual incidence is about 492,000 [2]. Patients try to find explanations, and this leads to so-called “subjective concepts of illness” often emerging. The aim of this study was to compare illness concepts and coping strategies among native German cancer patients and those with a Turkish migration background. For German patients, activities as well as social support played primary roles in coping. In contrast to the German patients, they are less active and use much more religious coping and culture-specific means. Conclusion: Common illness representations and coping strategies could be found for Turkish and German patients, and specific ones for the respective group. It is noticeable that German patients attach more importance to medical factors and try more actively to cope with the illness. For Turkish patients, cultural and religious factors play an important role, which should be considered in treatment
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