Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, P.O. Box 980149, Richmond, VA, 23219, USA.
Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
J Racial Ethn Health Disparities. 2021 Jun;8(3):589-595. doi: 10.1007/s40615-020-00817-4. Epub 2020 Aug 18.
Although a number of factors contribute to racial disparities in breast cancer outcomes, perceived discrimination in healthcare may be a key factor that hinders positive interactions and negatively impacts patient outcomes. The goals of our study were to (1) assess the prevalence of perceived discrimination as reported by breast cancer patients and (2) identify factors related to discrimination in women overall as well as by race.
This study is a secondary analysis of a larger study, "Narrowing the Gaps in Adjuvant Therapy," where a convenience sample of 359 women completed one telephone survey assessing sociodemographics, and attitudes and beliefs concerning breast cancer treatments and care. Chi-square analysis was used to assess the relationship of categorical variables with perceived discrimination, while the F-test was employed for continuous variables. Logistic regression determined predictors of perceived discrimination, a dichotomous variable (none vs. any).
A majority of women were Black (58%), privately insured (85%), and had at least a Bachelor's degree (48%). Discrimination was reported by 32.4% of women, with significantly more Black women reporting discrimination than White women. Insurance status, attitudes toward treatment, and distress factors were significantly related to perceived discrimination. In the logistic model, women who were less trusting of their providers (OR = 0.863 [0.751, 0.993], p = .021) and Black women (OR = 7.241 [0.751, 0.993], p = .039) were more likely to report incidences of discrimination.
Our findings suggest a need to understand Black survivor's experiences with healthcare. Similarly, future work must focus on identifying ways to improve provider trust amongst breast cancer survivors.
尽管许多因素导致乳腺癌治疗结果存在种族差异,但医疗保健中感知到的歧视可能是阻碍积极互动并对患者结果产生负面影响的关键因素。我们的研究目的是:(1)评估乳腺癌患者报告的感知歧视的流行程度,以及(2)确定总体女性以及按种族感知歧视的相关因素。
这是一项名为“缩小辅助治疗差距”的更大研究的二次分析,其中,359 名女性完成了一项电话调查,评估了社会人口统计学、对乳腺癌治疗和护理的态度和信念。卡方分析用于评估分类变量与感知歧视之间的关系,而 F 检验用于连续变量。逻辑回归确定感知歧视的预测因素,这是一个二分变量(无 vs. 有)。
大多数女性为黑人(58%),私人保险(85%),至少拥有学士学位(48%)。32.4%的女性报告存在歧视,黑人女性报告歧视的比例明显高于白人女性。保险状况、对治疗的态度和困扰因素与感知歧视显著相关。在逻辑模型中,对提供者信任度较低的女性(OR=0.863[0.751,0.993],p=0.021)和黑人女性(OR=7.241[0.751,0.993],p=0.039)更有可能报告歧视事件。
我们的研究结果表明,需要了解黑人幸存者的医疗保健经历。同样,未来的工作必须侧重于确定如何提高乳腺癌幸存者对提供者的信任。