农村和城市讲西班牙语的拉丁裔乳腺癌幸存者的经济压力、邻里凝聚力与健康相关生活质量。
Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors.
机构信息
University of California San Francisco, Division of Internal Medicine, 490 Illinois Street, 9th floor, Box 0856, San Francisco, CA, 94158, USA.
University of California Berkeley, School of Public Health, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720, USA.
出版信息
J Cancer Surviv. 2024 Aug;18(4):1275-1284. doi: 10.1007/s11764-023-01369-2. Epub 2023 Mar 29.
PURPOSE
Among Latina breast cancer survivors, explore associations between rural/urban residence and health-related quality of life (HRQL), and whether associations are moderated by financial strain and low neighborhood cohesion.
METHODS
We combined baseline data from two randomized controlled trials of a stress management intervention conducted among 151 urban and 153 rural dwelling Latinas with nonmetastatic breast cancer. Generalized linear models estimated associations between rural/urban status and HRQL (overall, emotional, social-family, physical, and functional well-being), and we examined moderation effects of financial strain and low neighborhood cohesion, controlling for age, marital status, and breast cancer characteristics.
RESULTS
Rural women reported better emotional (β = 1.85; 95% CI = 0.37, 3.33), functional (β = 2.23; 95% CI = 0.69, 3.77), and overall (β = 5.68; 95% CI = 1.12, 10.25) well-being than urban women, regardless of degree of financial strain or neighborhood cohesion; moderation effects were not statistically significant. Financial strain was inversely associated with emotional (β = -2.34; 95% CI = 3.63, -1.05), physical (β = -2.56; 95% CI = -4.12, -1.01), functional (β = -1.61; 95% CI = -2.96, -0.26), and overall (β = -6.67; 95% CI = -10.96, -2.98) well-being. Low neighborhood cohesion was inversely associated with emotional (β = -1.27; 95% CI = -2.50, -0.04), social-family (β = -1.72; 95% CI = -3.02, -0.42), functional (β = -1.63; 95% CI = -2.92, -0.34), and overall (β = -5.95; 95% CI = 9.76, -2.14) well-being.
CONCLUSIONS
Rural Latina breast cancer survivors reported better emotional, functional and overall well-being than their urban counterparts. Greater financial strain and less neighborhood cohesion were associated with worse HRQL on most domains regardless of rural/urban context.
IMPLICATIONS FOR CANCER SURVIVORS
Interventions that focus on increasing perceived neighborhood cohesion and reducing or better managing financial strain, could help improve Latina cancer survivors' well-being.
目的
在拉丁裔乳腺癌幸存者中，探讨城乡居住与健康相关生活质量（HRQL）之间的关系，以及这些关系是否受到经济压力和邻里凝聚力低的调节。
方法
我们将两项压力管理干预随机对照试验的基线数据进行了合并，这些试验是针对 151 名居住在城市和 153 名居住在农村的非转移性乳腺癌拉丁裔女性进行的。广义线性模型估计了城乡状况与 HRQL（整体、情感、社会家庭、身体和功能幸福感）之间的关联，我们还检验了财务压力和低邻里凝聚力的调节作用，同时控制了年龄、婚姻状况和乳腺癌特征。
结果
无论经济压力或邻里凝聚力程度如何，农村女性的情感（β=1.85；95%置信区间：0.37，3.33）、功能（β=2.23；95%置信区间：0.69，3.77）和整体（β=5.68；95%置信区间：1.12，10.25）幸福感均优于城市女性；调节效应不具有统计学意义。财务压力与情感（β=-2.34；95%置信区间：3.63，-1.05）、身体（β=-2.56；95%置信区间：4.12，-1.01）、功能（β=-1.61；95%置信区间：2.96，-0.26）和整体（β=-6.67；95%置信区间：10.96，-2.98）幸福感呈负相关。低邻里凝聚力与情感（β=-1.27；95%置信区间：-2.50，-0.04）、社会家庭（β=-1.72；95%置信区间：-3.02，-0.42）、功能（β=-1.63；95%置信区间：-2.92，-0.34）和整体（β=-5.95；95%置信区间：9.76，-2.14）幸福感呈负相关。
结论
农村拉丁裔乳腺癌幸存者报告的情感、功能和整体幸福感好于城市同龄人。无论城乡背景如何，更大的经济压力和更低的邻里凝聚力都与大多数领域的 HRQL 较差有关。
对癌症幸存者的影响
侧重于增加感知邻里凝聚力和减少或更好地管理经济压力的干预措施，可能有助于提高拉丁裔癌症幸存者的幸福感。
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