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健康相关生活质量和护理满意度结果:为拉丁裔和非裔美国年轻乳腺癌幸存者的心理肿瘤学护理提供信息。

Health-related quality of life and care satisfaction outcomes: Informing psychosocial oncology care among Latina and African-American young breast cancer survivors.

机构信息

Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Psychooncology. 2018 Apr;27(4):1213-1220. doi: 10.1002/pon.4650. Epub 2018 Feb 13.

Abstract

OBJECTIVE

When breast cancer occurs in young women, the medical, physical, psychosocial, and overall impacts can be more severe warranting targeted medical and psychosocial oncology care. Yet, despite their risk for poorer survival and survivorship outcomes, little research has focused on this group with critical gaps concerning ethnic minorities who are particularly medically vulnerable. Therefore, this preliminary study examined demographic characteristics and patient centered outcomes, ie, health-related quality of life (HRQOL), quality care satisfaction to inform targeted psychosocial oncology care among African-American and Latinas young breast cancer survivors (YBCS).

METHODS

A total of 116 African-American and Latina YBCS aged ≥21 to 50 years were recruited from cancer registries and community agencies. Based on prior research and the literature, Latinas were categorized into English language proficient (ELP) and Spanish language proficient (SLP) based on their choice of language to conduct the study including completion of the measures.

RESULTS

SLP Latinas reported lower educational attainment and income (P < 0.001) and were more likely to report having a mastectomy (P < 0.01) but less likely to report breast reconstruction (P < 0.05). Satisfaction with care was correlated with patient-provider communication and overall HRQOL (P < 0.01) and physical, social/family, emotional and functional wellbeing (P < 0.01). SLP Latinas had lower emotional wellbeing than African-American YBCS (P < 0.01) and lower functional wellbeing than ELP Latina YBCS (P < 0.05). SLP Latina YBCS were less satisfied with their care compared with African-American and ELP Latina YBCS (P < 0.01). Financial toxicity seems to directly influence both access to care and quality care and survivorship outcomes.

CONCLUSIONS

Investigating demographic characteristics and medical outcomes including HRQOL outcomes and satisfaction with care among ethnic minority YBCS is needed to advance the science as well as assist health professionals with precision care delivery. Greater translational and patient-centered research must focus on at-risk population such as YBCS to inform precision psychosocial oncology care and reduce health disparities.

摘要

目的

当乳腺癌发生在年轻女性中时,其对身体、心理、社会和整体的影响可能更为严重,需要有针对性的医学和心理肿瘤学治疗。然而,尽管她们的生存和生存结果更差,但很少有研究关注这个群体,尤其是在少数民族群体中,他们的医疗风险更高。因此,本初步研究检查了人口统计学特征和以患者为中心的结果,即健康相关生活质量(HRQOL)和对高质量护理的满意度,以了解非裔美国人和拉丁裔年轻乳腺癌幸存者(YBCS)的针对性心理肿瘤学护理。

方法

从癌症登记处和社区机构招募了 116 名年龄在 21 岁至 50 岁之间的非裔美国人和拉丁裔 YBCS。根据先前的研究和文献,根据她们选择的语言进行研究,包括完成测量,将拉丁裔分为英语熟练(ELP)和西班牙语熟练(SLP)。

结果

SLP 拉丁裔报告的教育程度和收入较低(P<0.001),更有可能报告接受乳房切除术(P<0.01),但较少报告乳房重建(P<0.05)。对护理的满意度与医患沟通和整体 HRQOL 相关(P<0.01),以及身体、社会/家庭、情感和功能健康(P<0.01)。SLP 拉丁裔的情感健康状况差于非裔美国 YBCS(P<0.01),功能健康状况差于 ELP 拉丁裔 YBCS(P<0.05)。与非裔美国人和 ELP 拉丁裔 YBCS 相比,SLP 拉丁裔 YBCS 对其护理的满意度较低(P<0.01)。财务毒性似乎直接影响获得护理的机会和护理质量以及生存结果。

结论

需要调查少数族裔 YBCS 的人口统计学特征和医疗结果,包括 HRQOL 结果和对护理的满意度,以推进科学发展,并帮助卫生专业人员提供精准护理。必须开展更多的转化和以患者为中心的研究,关注高危人群,如 YBCS,以提供精准心理肿瘤学护理,减少健康差距。

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