对LGBTQI+癌症幸存者在整个生命历程中自我认知、人际关系和健康认知方面与癌症相关变化的内容分析：来自“出柜：全国癌症调查”的结果
A Content Analysis of Cancer-Related Changes in Perceptions of Self, Relationships, and Health Among LGBTQI+ Cancer Survivors Across the Life Course: Findings From OUT: The National Cancer Survey.
作者信息
Waters Austin R, Jones Shaun R, Uppalapati Manuela, Gududuru Akshay, Bono Madeline H, Hecht Hillary K, Scout N F N, Kent Erin E
机构信息
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.
出版信息
Psychooncology. 2024 Dec;33(12):e70044. doi: 10.1002/pon.70044.
BACKGROUND
The LGBTQI+ population makes up at least 7.6% of the US population. LGBTQI+ populations are at increased risk of experiencing LGBTQI+-related discrimination and cis-heteronormativity in healthcare leading to poorer health outcomes throughout the cancer care continuum. We aimed to explore LGBTQI+ cancer survivors' perspectives of how cancer has changed their perceptions of self and relationships using data from OUT: The National Cancer Survey.
METHODS
We conducted an inductive qualitative content analysis of responses to four open-ended questions from OUT: The National Cancer Survey. Data were collected from September 2020 to April 2021. Eligible participants were 18 years of age or older at time of survey, had been previously diagnosed with cancer, identified as LGBTQI+, and currently lived in the US. Open-ended survey questions asked about the impact of cancer on LGBTQI+ cancer survivors' perceptions of self and relationships. To maximize inter-rater reliability, 20% of the survey responses were double coded. Chi-squared tests assessed differences in changes across the life-course.
RESULTS
Of the participants in the OUT survey (N = 2382), 86.9% (N = 2069) provided responses to at least one of the four open-ended questions. The content analysis sample participants were primarily aged 40-59 (39.3%) and 60-79 (49.4%), gay (54.7%), cisgender men (59.4), White (89.7%), and not on active treatment (77.4%). A total of 5179 codes were applied to the 2069 responses. A total of 5 overarching categories and 18 sub-categories were identified. Themes included: (1) changes in perceptions of self; (2) changes to relationships; (3) changes to health and (4) LGBTQI+ specific unmet needs. The most commonly reported categories were changes in perceptions of self (77%, n = 1593) and changes to health (47%, n = 972). Most cancer-related changes were more frequently reported by young adult survivors.
CONCLUSIONS
This content analysis illuminates the unique challenges that the LGBTQI+ population faces while navigating through the cancer care continuum.
背景
LGBTQI+群体至少占美国人口的7.6%。LGBTQI+群体在医疗保健中面临与LGBTQI+相关的歧视和顺性别异性恋规范的风险增加，这导致在整个癌症护理连续过程中健康结果较差。我们旨在利用“走出困境：全国癌症调查”的数据，探讨LGBTQI+癌症幸存者对癌症如何改变他们对自我和人际关系认知的看法。
方法
我们对“走出困境：全国癌症调查”中四个开放式问题的回答进行了归纳性定性内容分析。数据收集于2020年9月至2021年4月。符合条件的参与者在调查时年满18岁，此前被诊断患有癌症，自我认定为LGBTQI+，且目前居住在美国。开放式调查问题询问了癌症对LGBTQI+癌症幸存者自我认知和人际关系的影响。为了最大限度地提高评分者间的可靠性，对20%的调查回复进行了双重编码。卡方检验评估了生命历程中变化的差异。
结果
在“走出困境”调查的参与者（N = 2382）中，86.9%（N = 2069）对四个开放式问题中的至少一个提供了回复。内容分析样本参与者主要年龄在40 - 59岁（39.3%）和60 - 79岁（49.4%），同性恋（54.7%），顺性别男性（59.4%），白人（89.7%），且未接受积极治疗（77.4%）。总共对2069条回复应用了5179个编码。总共确定了5个总体类别和18个子类别。主题包括：（1）自我认知的变化；（2）人际关系的变化；（3）健康状况的变化；以及（4）LGBTQI+特定的未满足需求。最常报告的类别是自我认知的变化（77%，n = 1593）和健康状况的变化（47%，n = 972）。大多数与癌症相关的变化在年轻成年幸存者中报告得更为频繁。
结论
这项内容分析揭示了LGBTQI+群体在整个癌症护理连续过程中面临的独特挑战。
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