Chacón Liliana, Santoyo-Olsson Jasmine, Samayoa Cathy, Alhomsi Alia, Stewart Anita L, Ortiz Carmen, Escalera Cristian, Nápoles Anna María
Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Department of Biology, SF BUILD Health Equity Lab, San Francisco State University, San Francisco, California, USA.
Health Equity. 2021 Apr 26;5(1):245-252. doi: 10.1089/heq.2020.0152. eCollection 2021.
Cancer-related self-efficacy, a multidimensional construct, is the confidence that one can overcome challenges associated with cancer and its treatment; higher levels have been associated with better psychosocial outcomes of breast cancer survivors. Little is known about factors that influence it among Latina breast cancer survivors. Assess associations of several aspects of health care processes and of spirituality with self-efficacy for coping with breast cancer treatment among primarily Spanish-speaking Latina breast cancer survivors. We analyzed baseline data from a randomized controlled trial of a cognitive-behavioral stress management intervention that enrolled 151 Spanish-speaking Latinas within 1 year of breast cancer diagnosis. Multivariate linear regression models examined associations of health care processes (quality of breast cancer care and information, participating in medical care, difficulty engaging with doctors) and spirituality (meaning/peace, faith, acceptance) with self-efficacy for coping with breast cancer treatment. Mean age was 51 (standard deviation [SD]=11), 66% completed high school or less, and most reported financial hardship in the past year (78%). Average time since diagnosis was 3.8 months (SD=2.7). In bivariate analyses, all six determinants were significantly associated with self-efficacy for coping with breast cancer treatment; participating in medical care (=0.56, <0.001) and having a sense of meaning/peace (=0.76; <0.001) were independently associated, controlling for sociodemographic and treatment characteristics. Interventions that promote participation in treatment decisions and sense of meaning and peace could improve confidence in coping with breast cancer treatment, and potentially quality of life, among Latinas living with breast cancer (Trial Registration Number: NCT01383174 [ClinicalTrials.gov]).
癌症相关的自我效能感是一个多维概念，指的是一个人相信自己能够克服与癌症及其治疗相关的挑战；较高水平的自我效能感与乳腺癌幸存者更好的心理社会结果相关。对于拉丁裔乳腺癌幸存者中影响自我效能感的因素，我们所知甚少。本研究旨在评估医疗保健过程的几个方面以及灵性与主要讲西班牙语的拉丁裔乳腺癌幸存者应对乳腺癌治疗的自我效能感之间的关联。我们分析了一项认知行为压力管理干预随机对照试验的基线数据，该试验在乳腺癌诊断后1年内招募了151名讲西班牙语的拉丁裔女性。多变量线性回归模型检验了医疗保健过程（乳腺癌护理和信息质量、参与医疗护理、与医生沟通困难）和灵性（意义/平静、信仰、接纳）与应对乳腺癌治疗的自我效能感之间的关联。平均年龄为51岁（标准差[SD]=11），66%的人完成高中学业或更低学历，大多数人报告过去一年有经济困难（78%）。自诊断以来的平均时间为3.8个月（SD=2.7）。在双变量分析中，所有六个决定因素都与应对乳腺癌治疗的自我效能感显著相关；参与医疗护理（β=0.56，P<0.001）和有意义/平静感（β=0.76；P<0.001）在控制社会人口学和治疗特征后独立相关。促进参与治疗决策以及意义和平静感的干预措施可能会提高拉丁裔乳腺癌患者应对乳腺癌治疗的信心，并可能改善其生活质量（试验注册号：NCT01383174 [ClinicalTrials.gov]）。
