Immigrant Health and Cancer Disparities, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, New York, NY, 10017, USA.
Silberman School of Social Work, Hunter College City University of New York, New York, NY, 10021, USA.
Support Care Cancer. 2021 Oct;29(10):5753-5762. doi: 10.1007/s00520-021-06113-z. Epub 2021 Mar 18.
Coping behaviors may play a mediating role in producing the negative health outcomes observed in financially burdened cancer patients and survivors.
Exploratory factor and latent class analysis of survey data.
A total of 510 people completed the survey, ages ranged from 25 to over 75 [over half greater than 55 years old (57.8%)]. Most respondents identified as female (64.7%), white (70.8%), or African American (18.6%). A four-factor model of financial coping was revealed: care-altering, lifestyle-altering, self-advocacy, and financial help-seeking. Respondents grouped into three financial coping classes: low burden/low coping (n = 212), high self-advocacy (n = 143), and high burden/high coping (n = 155). African American respondents were at far greater odds than white respondents of being in the high burden/high coping class (OR = 5.82, 95% CI 3.01-6.64) or the self-advocacy class (OR = 1.99, 95% CI 1.19-2.80) than the low burden/low coping class. Compared to respondents aged 65 years and older, those 35-44 were more likely in the high burden/high coping class (OR = 12.27, 95% CI 7.03-19.87) and the high self-advocacy class (OR = 7.08, 95% CI 5.89-8.28) than the low burden/low coping class.
One-third of respondents were in the high burden/high coping class. Age and race/ethnicity were significantly associated with class membership. Some coping strategies may compromise health and well-being. Program and policy interventions that reduce the odds that patients will use strategies that undermine treatment outcomes and increase patient use of protective strategies are needed.
应对行为可能在产生经济负担重的癌症患者和幸存者所观察到的负面健康结果中起中介作用。
对调查数据进行探索性因子和潜在类别分析。
共有 510 人完成了调查，年龄从 25 岁到 75 岁以上[超过一半（57.8%）大于 55 岁]。大多数受访者是女性（64.7%）、白人（70.8%）或非裔美国人（18.6%）。揭示了一个财务应对的四因素模型：改变护理、改变生活方式、自我倡导和寻求财务帮助。受访者分为三类财务应对类：低负担/低应对（n = 212）、高自我倡导（n = 143）和高负担/高应对（n = 155）。非裔美国人被归类为高负担/高应对类（OR = 5.82，95%CI 3.01-6.64）或自我倡导类（OR = 1.99，95%CI 1.19-2.80）的可能性远远大于白人受访者，而被归类为低负担/低应对类的可能性则较小。与 65 岁及以上的受访者相比，35-44 岁的受访者更有可能被归类为高负担/高应对类（OR = 12.27，95%CI 7.03-19.87）和高自我倡导类（OR = 7.08，95%CI 5.89-8.28），而不是低负担/低应对类。
三分之一的受访者属于高负担/高应对类。年龄和种族/民族与类别成员显著相关。一些应对策略可能会损害健康和福祉。需要制定方案和政策干预措施，降低患者使用破坏治疗结果和增加患者使用保护策略的可能性。
