Role of Familismo in Latino Families Affected by Cancer: Implications for Culturally Tailored Occupational Therapy Services.

Abstract

Importance: Latino/a cancer survivors (LCSs) and their family caregivers (FCs) experience barriers to participation. The occupational therapy literature centered on Latinos affected by cancer is limited, including the examination of cultural values such as familismo.

Objective: To explore the impact of familismo on LCSs and their FCs during treatment and survivorship from the perspectives of several stakeholders.

Design: Qualitative, cross-sectional study using semistructured interviews with various stakeholders recruited via purposive sampling. A detailed audit trail and peer examination were used to enhance rigor. Thematic analysis was used to identify, analyze, and report major themes.

Setting: Urban Midwestern city.

Participants: Diverse stakeholders in cancer survivorship among Latino families-LCSs living in survivorship (n = 8) and FCs (n = 5)-and cancer care providers (n = 5).

Results: LCSs were primarily female breast cancer survivors (75%), and most FCs were men (60%); only 1 LCS received occupational therapy services. Providers were 2 occupational therapists and 3 social workers. Participants described familismo as facilitating the multilevel support needed for everyday participation. Despite these tight family bonds, survivors and caregivers felt emotionally distant and were disappointed when cultural expectations were not met.

Conclusions and relevance: Familismo plays a complex and nuanced role among Latino families affected by cancer because it is a strength that many families can draw from; however, it can also create a cycle of unexpressed needs and inadequate support. Future implications include examining culturally tailored occupational therapy services that infuse prominent cultural values and embrace cultural humility. Plain-Language Summary: The occupational therapy cancer research base primarily focuses on White survivors. The profession needs to learn from diverse populations how best to support them. Focusing on Latino families affected by cancer, this study showed that familismo, which prioritizes family needs over individual needs, is a cultural value that plays out in many ways. Both survivors and caregivers were supported by many biological and chosen family members. Because of the collectivistic nature of familismo, individuals often put their family's needs before their own. Despite close family relationships, survivors and caregivers felt distant and unsupported. We provide suggestions for how to incorporate familismo in practice. As occupational therapy's role in cancer care grows, it must put diverse communities at the forefront and intentionally put effort into developing culturally tailored services. Positionality Statements: Ricardo Ramirez is a first-generation, bilingual, and Latino occupational therapist with family experience of cancer. Susan Magasi is a White occupational therapy educator and scholar with family experience of cancer. She is a qualitative methodologist and cancer health equity researcher. In this article, the term Latino/a is used to honor the chosen language of participants with this background. We recognize that terms such as Latinx are considered to be gender-neutral, however, only 4% of the community uses this term (Noe-Bustamante et al., 2024). The term survivor is used throughout this article because it reflects the language that participants used to refer to themselves.