University of Delaware, Newark, DE, 19716, USA.
University of Pennsylvania, Philadelphia, PA, 19104, USA.
J Cancer Educ. 2020 Oct;35(5):923-929. doi: 10.1007/s13187-019-01543-0.
The purpose of this study was to explore determinates of health that impact survivorship of urban Hispanic breast cancer survivors who are at risk for experiencing poorer outcomes than others. Some challenges have been characterized, but gaps in our knowledge of the impact of some of the social determinates of health remain. Challenges likely exist prior to a diagnosis of cancer and may amplify in intensity during survivorship, potentially shortening survival and quality of life of these women. A narrative, focus group was conducted with a group of urban Hispanic breast cancer survivors. A series of linked vignettes describing survivorship challenges and late effects of breast cancer pathology and treatment were used to stimulate discussion. Three themes impacting survivorship were identified. The themes included communication (health literacy), isolation, and social support and financial cost. Communication issues resulted in delays in treatment denial of services. While these themes in cancer survivors are independent of residence (rural, suburban, or urban) and across ethnic groups, some unique issues were identified in urban Hispanic breast cancer survivors. Members of the healthcare team are in a unique position to enhance survivor's health literacy, advocate for programmatic efforts to enhance navigation roles in the hospital and communities, decrease delays in initiating care, and decrease the rate of patients lost.
本研究旨在探讨影响城市西班牙裔乳腺癌幸存者生存状况的健康决定因素,这些患者的预后可能比其他人差。虽然已经确定了一些挑战,但我们对一些健康社会决定因素的影响的了解仍存在差距。这些挑战可能在癌症诊断之前就存在,并在生存期间加剧,可能会缩短这些女性的生存时间和生活质量。对一群城市西班牙裔乳腺癌幸存者进行了叙述性焦点小组讨论。使用一系列描述生存挑战和乳腺癌病理及治疗晚期影响的相关病例来激发讨论。确定了三个影响生存的主题。这些主题包括沟通(健康素养)、孤立和社会支持以及经济成本。沟通问题导致治疗延误和服务拒绝。虽然这些癌症幸存者的主题与居住地点(农村、郊区或城市)和族裔群体无关,但在城市西班牙裔乳腺癌幸存者中发现了一些独特的问题。医疗保健团队成员具有独特的地位,可以提高幸存者的健康素养,倡导在医院和社区中增强导航作用的计划努力,减少开始治疗的延迟,并降低患者流失率。