非裔美国人和白种裔美国癌症患者的感知歧视与生活质量：对微妙和明显的微侵犯的应对中介分析。
Perceived discrimination and quality of life for African American and Caucasian American cancer patients: a coping mediation analysis of subtle and overt microaggressions.
机构信息
Department of Psychology, University of Notre Dame, Notre Dame, IN, USA.
出版信息
Ethn Health. 2024 May-Jul;29(4-5):484-504. doi: 10.1080/13557858.2024.2347569. Epub 2024 May 2.
OBJECTIVE
Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for African American Cancer Patients (AACPs) only disengagement/denial coping mediated the PD-QOL relationship. In contrast, for Caucasian American Cancer Patients (CACPs), both agentic and disengagement/denial coping were mediators of the PD-QOL relationship. However, according to social constraint theory there may be a difference between subtle and overt PD in terms of the utility of certain coping mechanisms in relation to QOL, especially for AACPs.
METHOD
217 AACPs and 121 CACPs completed measures of PD, coping (agentic, disengagement/denial, adaptive disengagement) and QOL. PD items were classified as subtle or overt microaggressions. PD was mainly attributed to race/ethnicity by AACPs and to income, age, and physical appearance for CACPs.
RESULTS
: In both subtle and overt microaggression models with CACPs, agentic coping and disengagement/denial coping were significant mediators of PD-QOL. Like CACPs, for AACPs, agentic and disengagement/denial coping were significant in the context of subtle microaggressions. In contrast, for overt microaggression only disengagement/denial coping was a significant mediator of the PD-QOL relationship for AACPs. Adaptive disengagement was related to QOL only for AACPs.
CONCLUSIONS
: Whereas more research is needed, it appears that overt microaggressions for AACPs, that consist mainly of racial and ethnic maltreatment, constitute a class of social contexts that may raise above the threshold for serious threat and harm, and, as a result, disengagement/constraint may reduce negative consequences. This additional burden for AACPs contributes to disparities in QOL. Future research is needed on the utility of adaptive disengagement for AACPs in relation to PD.
目的
感知歧视（PD；例如种族主义、年龄歧视、性别歧视等）会对癌症患者的生活质量（QOL）产生负面影响。先前的研究已经确定，对于非裔美国癌症患者（AACPs），只有回避/否认应对方式在 PD-QOL 关系中起中介作用。相比之下，对于白种美国癌症患者（CACPs），能动性应对和回避/否认应对都是 PD-QOL 关系的中介。然而，根据社会约束理论，在与 QOL 相关的某些应对机制的效用方面，微妙和明显的 PD 之间可能存在差异，尤其是对于 AACPs 而言。
方法
217 名 AACPs 和 121 名 CACPs 完成了 PD、应对方式（能动性、回避/否认、适应性回避）和 QOL 的测量。PD 项目被归类为微妙或明显的微侵犯。AACPs 主要将 PD 归因于种族/民族，而 CACPs 将 PD 主要归因于收入、年龄和外貌。
结果
在 CACPs 的微妙和明显微侵犯模型中，能动性应对和回避/否认应对都是 PD-QOL 的重要中介。与 CACPs 一样，对于 AACPs，能动性应对和回避/否认应对在微妙微侵犯的情况下是显著的。相比之下，对于明显的微侵犯，只有回避/否认应对是 AACPs 的 PD-QOL 关系的重要中介。适应性回避仅与 AACPs 的 QOL 相关。
结论
尽管需要更多的研究，但对于 AACPs 来说，明显的微侵犯主要由种族和民族虐待构成，构成了一类可能超过严重威胁和伤害阈值的社会环境，因此，回避/约束可能会减轻负面后果。这种 AACPs 的额外负担导致了 QOL 的差异。需要进一步研究适应性回避对于 AACPs 与 PD 相关的效用。
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