Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, USA.
Support Care Cancer. 2019 Apr;27(4):1383-1394. doi: 10.1007/s00520-018-4426-4. Epub 2018 Aug 22.
The aim of this study was to elucidate the prevalence of unmet supportive care needs in Hispanic/Latino cancer survivors and examine the association between unmet needs and patient-provider communication, satisfaction with cancer care, and cancer-specific symptom burden.
Hispanics/Latinos diagnosed with breast, prostate, or colorectal cancer within 15 months of treatment completion (n = 288) completed questionnaires as part of an NCI-funded project.
Hispanic/Latino cancer survivors reported greater unmet needs compared to previously published norms in primarily non-Hispanic/Latino white samples. Across the three cancer types, the two most common unmet needs were in the psychological domain: fear of metastasis (32.6%) and concern for close others (31.3%). However, unmet needs varied by cancer type. Factors associated with greater unmet needs included more recent cancer diagnosis (OR .98 [.96-.99]), younger age (OR .96-.97 [.93-.99]), female gender (OR 2.53-3.75 [1.53-7.36]), and being single (OR 1.82 [1.11-2.97]). Breast cancer survivors reported greater unmet needs than both prostate and colorectal cancer survivors (OR 2.33-5.86 [1.27-14.01]). Adjusting for sociodemographic and medical covariates, unmet needs were associated with lower patient-provider communication self-efficacy (B = - .18-- .22, p's < .01) and satisfaction with cancer care (B = - 3.57-- 3.81, p's < .05), and greater breast (B = - 4.18-- 8.30, p's < .01) and prostate (B = - 6.01-- 8.13, p's < .01) cancer-specific symptom burden.
Findings document unmet supportive care needs in Hispanic/Latino cancer survivors and suggest that reducing unmet needs in Hispanic/Latino cancer survivors may improve not only satisfaction with care, but also health-related quality of life.
本研究旨在阐明西班牙裔/拉丁裔癌症幸存者未满足的支持性护理需求的普遍性,并探讨未满足的需求与患者与提供者之间的沟通、对癌症护理的满意度以及癌症特异性症状负担之间的关联。
在治疗完成后 15 个月内被诊断患有乳腺癌、前列腺癌或结直肠癌的西班牙裔/拉丁裔(n=288)完成了作为 NCI 资助项目的一部分的调查问卷。
与主要是非西班牙裔/拉丁裔白人样本中的先前发表的标准相比,西班牙裔/拉丁裔癌症幸存者报告了更多的未满足的需求。在这三种癌症中,最常见的两个未满足的需求是在心理领域:对转移的恐惧(32.6%)和对亲近他人的担忧(31.3%)。然而,未满足的需求因癌症类型而异。与更大的未满足需求相关的因素包括最近的癌症诊断(OR.98 [.96-.99])、较年轻的年龄(OR.96-.97 [.93-.99])、女性性别(OR 2.53-3.75 [1.53-7.36])和单身(OR 1.82 [1.11-2.97])。乳腺癌幸存者比前列腺癌和结直肠癌幸存者报告了更多的未满足需求(OR 2.33-5.86 [1.27-14.01])。在调整社会人口统计学和医疗协变量后,未满足的需求与患者与提供者之间的沟通自我效能感降低相关(B=-.18--.22,p's<.01),与对癌症护理的满意度降低相关(B= -3.57--3.81,p's<.05),与更大的乳腺癌(B= -4.18--8.30,p's<.01)和前列腺癌(B= -6.01--8.13,p's<.01)特异性症状负担增加相关。
研究结果记录了西班牙裔/拉丁裔癌症幸存者未满足的支持性护理需求,并表明减少西班牙裔/拉丁裔癌症幸存者的未满足需求不仅可以提高护理满意度,还可以提高与健康相关的生活质量。