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Petry SE, Lara L, Boucher NA. Older Caregivers: Who They Are and How to Support Them. J Aging Soc Policy 2024; 36:589-602. [PMID: 35290168 DOI: 10.1080/08959420.2022.2051683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/12/2021] [Indexed: 10/18/2022]
Abstract
Caregivers play a crucial role in providing health and social supports to their family and friends. Older adults who take on caregiving roles are themselves uniquely vulnerable to negative health and financial effects due to their age and underlying health risks. Many caregivers do not receive adequate support - either formally or informally - exacerbating the strains of providing care. Racial and ethnic minority caregivers may be less likely to report receiving support in their role and face additional challenges. We describe these caregivers over 65 and the burdens they face. We recommend community health workers, direct compensation, and normalization of respite care to support these essential care workers in their role and as they age.
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Affiliation(s)
- Sarah E Petry
- Doctoral Student, Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
| | - Luz Lara
- Director of Senior Services, Union Settlement, New York, New York, USA
| | - Nathan A Boucher
- Doctoral Student, Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
- Health Research Specialist, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, North Carolina, USA
- Associate Professor, School of Medicine, Duke University, Durham, North Carolina, USA
- Core Faculty, Duke- Duke University, Durham, North Carolina, USA
- Senior Fellow, Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA
- Associate Research Professor, Sanford School of Public Policy, Duke University, Durham, USA
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Becevic M, Anbari AB, McElroy JA. It's Not Always Easy: Cancer Survivorship Care in Primary Care Settings. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1592-1599. [PMID: 37133797 DOI: 10.1007/s13187-023-02304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
By 2040, an anticipated 26.1 million people with a history of cancer will be part of the healthcare system. The purpose of this study was to explore Missouri-based non-oncology clinicians' perspectives on caring for patients with a history of cancer to identify needs of rural-based clinicians to optimize their patients' survivorship care. Using an interpretive qualitative descriptive approach, we conducted semi-structured interviews with 17 non-oncology clinicians. We encouraged clinicians to discuss their approach to caring for patients with a history of cancer and invited them to talk about what might help them increase their knowledge of survivorship care best practices. Through interpretive qualitative descriptive analysis methods including first level coding and constant comparison, we found there is consensus that cancer survivorship care is important; however, training that now guides our clinicians occurred mostly during residency, if at all. Clinicians relied on previous patient encounters and oncology notes combined with their patients' personal account of treatment history to inform the best next steps. Clinicians expressed strong interest in having a simple protocol of their patient's treatment with prompts of known long-term cancer treatment-related effects and a patient-centric follow-up monitoring schedule (mandatory vs recommended vs optional). Clinicians expressed interest in educational opportunities about cancer care and ability for curbside consults with oncologists. They consistently noted the limited resources available in rural areas and that rural patients may have different preferences and approaches to cancer survivorship. There is a clear opportunity to improve non-oncology clinicians' knowledge of the needs of people with a history of cancer as well as their own knowledge base and self-efficacy, especially in rural settings.
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Affiliation(s)
- Mirna Becevic
- Department of Dermatology, School of Medicine, University of Missouri, 1 Hospital Drive, MA111, Columbia, MO, 65212, USA.
- Missouri Telehealth Network, University of Missouri, 4215 Phillips Farm Road, Suite 121, MO, 65212, Columbia, USA.
- Institute for Data Science and Informatics, University of Missouri, 241 Naka Hall, Columbia, MO, 65211, USA.
| | - Allison B Anbari
- Sinclair School of Nursing, University of Missouri, 915 Hitt St., Columbia, MO, 65212, USA
| | - Jane A McElroy
- Family and Community Medicine, University of Missouri, Medical Sciences Building, 1 Hospital Drive, MA306, Columbia, MO, 65212, USA
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China.
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Evidence-Based Guidance for Breast Cancer Survivorship. Hematol Oncol Clin North Am 2023; 37:225-243. [PMID: 36435612 DOI: 10.1016/j.hoc.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breast cancer survivorship care includes management of lingering physical symptoms, supports to address the emotional toll exacted by a cancer diagnosis and cancer therapies, monitoring and optimization of cardiac and bone health, general wellness promotion, reproductive health care, surveillance for cancer recurrence, care coordination, and efforts to mitigate health disparities.
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Langer D, Tendler S, Bar-Haim Erez A. A broad perspective on breast cancer: Participation, quality of life and return to work throughout the recovery process. Work 2022; 75:325-337. [PMID: 36591684 DOI: 10.3233/wor-220085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Studies found that women with breast cancer struggle with significant physical and mental challenges that affect their participation in daily living, social and work activities. Although women express their need for rehabilitation, in Israel there has been scant research on the nature of these needs. OBJECTIVE To examine the implications of breast cancer for Israeli women in terms of their quality of life, body function, activities and participation in all facets of life, including work. METHODS The sample was composed of women diagnosed with breast cancer. The data were collected through: (a) an online electronic survey assessing cancer-related quality of life (QoL), function and disability, fatigue and sensory-motor functions, (n = 201) followed by (b) face-to-face interviews and assessments (n = 20), and a healthy control group (n = 61). RESULTS Women with breast cancer reported significantly lower QoL compared to the healthy control group. They reported higher levels of disability in areas such as, cognition, mobility, upper extremity, as well as overall difficulties in self-care, doing routine household activities and return to work. Roughly one-third of the women did not return to work. Interestingly, our sample did not perceive a decline in terms of their social support or networks, the women stated that family and social support were major enabling factors. CONCLUSION The results show that breast cancer has short and long-term functional effects on most facets of these women's life. The women's social support system served as an enabling factor. Many women expressed their frustration at the lack of rehabilitation services for their condition and needs in Israel.
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Affiliation(s)
- Danit Langer
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Shlomit Tendler
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Asnat Bar-Haim Erez
- Occupational Therapy Department, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel
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Thompson T, Davis M, Pérez M, Jonson-Reid M, Jeffe DB. "We're in this together": Perceived effects of breast cancer on African American survivors' marital relationships. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2022; 13:789-815. [PMID: 36687398 PMCID: PMC9850417 DOI: 10.1086/713478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective We examined married African American breast cancer survivors' perceptions of how cancer affected their marriage, social support from their spouses, and spouses' physical and mental health. Method We conducted a thematic analysis of semi-structured interviews with 15 married African American breast cancer survivors who had participated in a larger randomized controlled trial. Interviews were professionally transcribed and then independently coded by two coders. Results Themes emerged related to the challenges of maintaining mutually supportive relationships. There was variability in the perceived effects of cancer on relationships, as well as uncertainty about cancer's effects on their husbands' emotional and physical health and the adequacy of emotional and tangible support from their husbands. Participants described husbands' key role in promoting wives' positive body image, as well as the challenges of negotiating sexual activity. Participants were receptive to help from medical professionals in dealing with relationship issues. Conclusions Findings show variability in couples' responses to cancer, with some patients and couples adapting well and others needing additional support. During treatment and at follow-up, oncology social workers can assess patients' and family members' social support needs, provide mental health services, and provide patient navigation to help patients and caregivers access health care and community resources.
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Affiliation(s)
- Tess Thompson
- Brown School of Social Work, Washington University in St. Louis
| | - Maxine Davis
- School of Social Work, The University of Texas at Arlington
| | - Maria Pérez
- School of Medicine, Washington University in St. Louis
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Grimm M, Radcliff L, Giles M, Nash R, Holley E, Panda S, Brophy L, Williams N, Cherian M, Stover D, Gatti-Mays ME, Wesolowski R, Sardesai S, Sudheendra P, Reinbolt R, Ramaswamy B, Pariser A. Living with Advanced Breast Cancer: A Descriptive Analysis of Survivorship Strategies. J Clin Med 2022; 11:jcm11143992. [PMID: 35887755 PMCID: PMC9319697 DOI: 10.3390/jcm11143992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Survivors of advanced breast cancer (ABC), also known as metavivors, are often left with fewer treatment options in the landscape of a cure culture. Metavivors have unique psychosocial and physical needs distinct from patients with early-stage breast cancer. This analysis delves into side effects commonly experienced by patients with ABC, such as fatigue, anxiety, and cardiotoxicity; how these side effects impact caregiver support, financial toxicity, emotional strain, and spiritual and emotional distress; as well as current strategies for mitigation, including nutrition, exercise, and participation in clinical research. Overall, this analysis is a mandate for additional research to explore novel treatments and implement strategies to maintain and improve patients’ quality of life.
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Affiliation(s)
- Michael Grimm
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lindsey Radcliff
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mariann Giles
- Family Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Ryan Nash
- Center for Bioethics and Medical Humanities, The Ohio State University, Columbus, OH 43210, USA;
| | - Erin Holley
- Nutrition and Dietetics, The Ohio State University, Columbus, OH 43210, USA;
| | - Shannon Panda
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lynne Brophy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Nicole Williams
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mathew Cherian
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Daniel Stover
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Margaret E. Gatti-Mays
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Robert Wesolowski
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Sagar Sardesai
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Preeti Sudheendra
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Raquel Reinbolt
- Internal Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Bhuvaneswari Ramaswamy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Ashley Pariser
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
- Correspondence: ; Tel.: +1-614-293-6401
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Psychosocial protective interventions associated with a better quality of life and psychological wellbeing for African American/Black female breast cancer survivors: an integrative review. Support Care Cancer 2022; 30:1093-1114. [PMID: 34417643 PMCID: PMC8787847 DOI: 10.1007/s00520-021-06425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/08/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE This integrative review provides an overview of current psychosocial interventions and qualitative studies exploring African American Breast Cancer Survivors (AABCS)' psychosocial wellbeing. METHODS We conducted a search of five databases: PubMed, Academic Search Ultimate, CINAHL, PsycINFO, and Web of Science. Peer-reviewed articles written in English and published from 2011 to May 26, 2021 were included. We critically appraised intervention studies and qualitative studies using established frameworks. RESULTS Of the 633 unique studies identified, seven interventions and twenty-one qualitative studies were included. Analysis of the interventions revealed the importance of alleviating structural barriers and facilitating peer support for AABCS. Analysis of the qualitative studies revealed seven themes: (1) spirituality/religion, (2) social support, (3) cultural perceptions of BC, (4) lack of representation, (5) negative impacts of treatment, (6) healthcare system experience, and (7) barriers to psychosocial care. CONCLUSIONS This review highlights the dearth of psychosocial interventions created specifically for AABCS. The qualitative literature in this review elucidates the unique psychosocial challenges that AABCS experience, providing rich data to inform the creation of future culturally competent interventions in this population. IMPLICATIONS FOR CANCER SURVIVORS This review found spirituality and social support to be protective factors for AABCS' psychosocial wellbeing. Further research using rigorous methodologies is needed to further evaluate how to most effectively alleviate structural barriers that AABCS face in obtaining long-term support.
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Wells KJ, Drizin JH, Ustjanauskas AE, Vázquez-Otero C, Pan-Weisz TM, Ung D, Carrizosa C, Laronga C, Roetzheim RG, Johnson K, Norton M, Aguilar RC, Quinn GP. The psychosocial needs of underserved breast cancer survivors and perspectives of their clinicians and support providers. Support Care Cancer 2022; 30:105-116. [PMID: 34231040 PMCID: PMC8639634 DOI: 10.1007/s00520-021-06286-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/09/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Breast cancer survivors (BrCS) experience many psychosocial difficulties following treatment, leading to an increased risk of psychological distress compared to the general population. This is especially true for underserved BrCS whose unmet supportive care needs can result in worse physical and mental health outcomes. This qualitative study compared healthcare and support providers' perceptions of BrCS' needs to survivors' perceptions of their own needs. METHODS Semi-structured in-depth interviews were conducted with 25 underserved BrCS and 20 cancer survivorship stakeholders identified using purposeful sampling. Using the constant comparison method and content analysis, data were analyzed via an iterative process of coding and discussion. Data were summarized according to three intermediate and proximal themes mentioned by both stakeholders and survivors: (1) psychosocial needs of cancer survivors, (2) support, and (3) benefit finding/positive feelings about cancer. Demographic data were analyzed by calculating descriptive statistics. RESULTS There was consistency in providers' and survivors' perceptions of post-treatment mood changes, financial burden, familial stress, and physical changes. Providers and survivors differed in perceptions of BrCS' preferred sources of care and support, effects of cancer treatment on body image, the effects of fear of cancer recurrence on follow-up care, and benefit finding. CONCLUSIONS This study provides valuable insight into areas in which healthcare and support providers' perceptions may differ from underserved BrCS' lived experiences. Results from this study can be used to develop interventions and inform healthcare and support providers on how to provide high-quality care to underserved BrCS.
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Affiliation(s)
- Kristen J. Wells
- San Diego State University, San Diego, CA, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Julia H. Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Amy E. Ustjanauskas
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tonya M. Pan-Weisz
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | | | | | | | - Gwendolyn P. Quinn
- Departments of OB-GYN, Population Health, Grossman School of Medicine, New York University, NY, NY
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Shani P, Walter E. Acceptability and Use of Mind-Body Interventions Among African American Cancer Survivors: An Integrative Review. Integr Cancer Ther 2022; 21:15347354221103275. [PMID: 35786041 PMCID: PMC9251965 DOI: 10.1177/15347354221103275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mind-body interventions have been shown to improve physical and mental health outcomes among cancer survivors, and African Americans have one of the highest cancer mortality rates of all racial/ethnic groups, while often facing considerable barriers to quality healthcare. African American cancer survivors report difficulty accessing mind-body practices, and few studies have focused exclusively on African American populations. This integrative review aims to explore the acceptability and use of mind-body interventions among African American cancer survivors. This review seeks to determine if current research indicates that mind-body interventions may be helpful in improving outcomes for African American cancer survivors. The literature search resulted in 284 studies, of which 14 met the inclusion criteria. Inclusion criteria were articles published in or after 2016, written in the English language, addressing mind-body modalities, and including a study population of ≥50% African American cancer survivors. Other reviews, meta-analyses, or studies without results were excluded. Results indicate that African American cancer survivors have expressed receptiveness to interventions incorporating mindfulness, meditation, yoga, Tai Chi, and other mind-body or complimentary/alternative medicine interventions. Still, few studies have offered such interventions exclusively to African American cancer survivors. This review indicated that African American cancer survivors across demographic backgrounds are interested in and view mind-body practices as an acceptable way to improve quality of life, pain interference, fatigue, anxiety, depression, and physical health; however, the interventions should be culturally appropriate and accessible. In conclusion, despite a growing interest in mind-body interventions, African American communities are often unaware of opportunities to engage in these practices in their communities, and mind-body practices are inaccessible due to cost or geographical location. Additional research that offers such interventions specific to African American cancer survivors is warranted.
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Affiliation(s)
- Pinky Shani
- University of Houston College of Nursing, Sugar Land, TX, USA
| | - Eli Walter
- University of Houston College of Nursing, Sugar Land, TX, USA
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Jones R, Hirschey R, Campbell G, Cooley ME, Lally R, Somayaji D, Rueter EK, Gullatte MM. Update to 2019-2022 ONS Research Agenda: Rapid Review to Address Structural Racism and Health Inequities. Oncol Nurs Forum 2021; 48:589-600. [PMID: 34673760 PMCID: PMC8674842 DOI: 10.1188/21.onf.589-600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The Oncology Nursing Society (ONS) formed a team to develop a necessary expansion of the 2019-2022 ONS Research Agenda, with a focus on racism and cancer care disparities. METHODS A multimethod consensus-building approach was used to develop and refine the research priorities. A panel of oncology nurse scientists and equity scholars with expertise in health disparities conducted a rapid review of the literature, consulted with experts and oncology nurses, and reviewed priorities from funding agencies. RESULTS Critical gaps in the literature were identified and used to develop priority areas for oncology nursing research, practice, and workforce development. SYNTHESIS This is the first article in a two-part series that discusses structural racism and health inequities within oncology nursing. In this article, three priority areas for oncology nursing research are presented; in the second article, strategies to improve cancer disparities and equity and diversity in the oncology workforce are described. IMPLICATIONS FOR RESEARCH Research priorities are presented to inform future research that will provide methods and tools to increase health equity and reduce structural racism in oncology nursing practice, research, education, policy, and advocacy.
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Affiliation(s)
- Randy Jones
- Professor University of Virginia School of Nursing, Assistant Director of Community Outreach and Engagement UVA Emily Couric Cancer Center
| | - Rachel Hirschey
- Assistant Professor, University of North Carolina at Chapel Hill, School of Nursing, Associate Member, Lineberger Comprehensive Cancer Center
| | - Grace Campbell
- Assistant Professor, University of Pittsburgh School of Nursing
| | - Mary E. Cooley
- Lecturer, Psychiatry, Harvard Medical School, Nurse Scientist, Nursing and Patient Care, Dana-Farber Cancer Institute
| | - Robin Lally
- Interim Associate Dean for Research, Professor, University of Nebraska College of Nursing, Member Fred & Pamela Buffett Cancer Center
| | - Darryl Somayaji
- Assistant Professor, University at Buffalo, School of Nursing, Adjunct Assistant Professor of Oncology, Roswell Park Comprehensive Cancer Center
| | | | - Mary Magee Gullatte
- Corporate Director Nursing Evidence Based Practice and Research, Emory Healthcare and Adjunct Faculty Emory Nell Hodgson Woodruff School of Nursing
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Guo JW, Reblin M, Tay D, Ellington L, Beck AC, Cloyes KG. Patterns of stress and support in social support networks of in-home hospice cancer family caregivers. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2021; 38:3121-3141. [PMID: 34898795 PMCID: PMC8664070 DOI: 10.1177/02654075211024743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the ambivalent maximizer class reported more burden than caregivers in the supportive class (p = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.
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Affiliation(s)
- Jia-Wen Guo
- University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT, USA 84112
| | - Maija Reblin
- Moffitt Cancer Centre, Health Outcomes and Behavior, 12902 Magnolia Dr, Tampa, FL, USA 33612
| | - Djin Tay
- University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT, USA 84112
| | - Lee Ellington
- University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT, USA 84112
| | - Anna C. Beck
- 1. University of Utah School of Medicine, Medical Oncology, 30 North 1900 East, Salt Lake City, UT, USA 84132; 2. University of Utah Health Huntsman Cancer Institute, Supportive Oncology and Survivorship, 1950 Circle of Hope, Salt Lake City, UT, USA 84112
| | - Kristin G Cloyes
- University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT, USA 84112
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Strayhorn SM, Bergeron NQ, Strahan DC, Villines D, Fitzpatrick V, Watson KS, Khanna A, Molina Y. Understanding the relationship between positive and negative social support and the quality of life among African American breast cancer survivors. Support Care Cancer 2021; 29:5219-5226. [PMID: 33630156 PMCID: PMC8295223 DOI: 10.1007/s00520-021-06098-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/19/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Social support improves several quality of life (QOL) domains among African American breast cancer survivors. How different dimensions of social support are associated with QOL among African American breast cancer survivors may however differ from other populations. This study explores this hypothesis by examining associations of positive social support (supportive interactions that promote affection) and negative social support (non-supportive interactions wherein the provider of support may not have the best intended actions) with QOL among Chicago-based African American breast cancer survivors. METHODS Study participants were eligible if they (1) were identified as being an African American female, (2) were at least 18 years of age or older, and (3) were diagnosed with breast cancer during or after navigation was implemented at the study hospital. Participants completed validated questionnaires via telephone or in-person interviews. RESULTS Among our sample of 100 participants, positive support was associated with greater mental well-being in non-imputed (Std β=1.60, CI: 0.51, 2.69, p= 0.004) and imputed models (Std β= 1.67, CI: 0.68, 2.73, p=0.001). There was also a weaker inverse association with negative support and mental well-being when using non-imputed data (Std β=-0.82, CI:-1.65, 0.02, p= 0.05). CONCLUSIONS Our findings suggest that positive support, in particular, is highly influential for improving mental well-being among African American breast cancer survivors. Simultaneously, negative support appears to be an independent, albeit weaker, determinant of mental well-being.
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Affiliation(s)
- Shaila M Strayhorn
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA
| | - Nyahne Q Bergeron
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St. (MC 923), Chicago, IL, 60612, USA
| | - Desmona C Strahan
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA
| | - Dana Villines
- Advocate Aurora Research Institute, 3075 Highland Parkway, Downers Grove, IL, 60515, USA
| | - Veronica Fitzpatrick
- Advocate Aurora Research Institute, 3075 Highland Parkway, Downers Grove, IL, 60515, USA
| | - Karriem S Watson
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St. (MC 923), Chicago, IL, 60612, USA
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA
- Mile Square Health Center, 912 Wood Street, Chicago, IL, 60612, USA
| | - Aditya Khanna
- University of Chicago, 5841 S Maryland Ave MC 5065, Chicago, IL, 60637, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St. (MC 923), Chicago, IL, 60612, USA.
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA.
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Somayaji D, Melendez M, Kwon M, Lathan C. Access to Cancer Care Resources in a Federally Qualified Health Center: a Mixed Methods Study to Increase the Understanding of Met and Unmet Needs of Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:591-602. [PMID: 31828550 DOI: 10.1007/s13187-019-01669-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Assessing the met and unmet needs of cancer survivors is critical in optimizing access to cancer services especially in underserved populations. The purpose of this study is to expand our understanding of the priority needs for cancer survivorship within racial/ethnic and underserved populations that speak either English or Spanish and seek health care in a federally qualified health center (FQHC). A convergent mixed methods design integrating survey and focus group data was utilized for this study. A total of 17 participants were enrolled in the study. The meta-inferences were drawn by looking across the top ten matched survey and focus group met and unmet needs including psychological, informational, and health system as well as patient care and support. The preferred languages of participants were Spanish 53% (n = 9) and English 47% (n = 8), and the survival breakdown was 65% (n = 11) within 0-5 years with 17.5% (n = 3), 6-10 years and 17.5% (n = 3), and 17.5% (n = 3) > 11 years. The most frequently met needs included health care providers and hospital staff being attentive to their physical and emotional needs and feeling they were treated with respect. Unmet needs were often related to physical and daily living needs such as pain, fatigue, sadness, depression, and not being able to work. Providing a needs-based approach of cancer health services in a FQHC or similar community-based health center is critical to meet the needs of cancer survivors to improve health outcomes and quality of life.
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Affiliation(s)
- Darryl Somayaji
- School of Nursing, University at Buffalo, 3435 Main St, Wende Hall 201C, Buffalo, NY, 14214, USA.
| | | | - Misol Kwon
- School of Nursing, University at Buffalo, 3435 Main St, Wende Hall 201C, Buffalo, NY, 14214, USA
| | - Christopher Lathan
- Dana Farber/Harvard Cancer Center Medicine Department, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA
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"I Struggle with Breast Cancer and I Struggle with God": Insights from African American Breast Cancer Survivors. J Racial Ethn Health Disparities 2021; 9:566-575. [PMID: 33566333 DOI: 10.1007/s40615-021-00986-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Recognizing that spiritual and religious beliefs are personal and vary within communities, the purpose of this qualitative study was to explore the influence of these beliefs on experiences with breast cancer care and social support among African American Christian breast cancer survivors. METHODS Forty-seven African American breast cancer survivors participated in focus groups (n = 7) in three northeastern urban cities. We used thematic analyses to identify major themes. RESULTS Three themes emerged relating to how spirituality influenced participants' cancer journeys: (1) struggling with God, (2) reclaiming my power, and (3) needing religious social support. Participants described the rhythmic flow of their spiritual beliefs as they navigated their lived experiences during diagnosis, treatment, and post-treatment. Spirituality was intimately intertwined with their illness experience as they grappled with their health and well-being. CONCLUSIONS Participants used spirituality as an avenue to cope and navigate through their diagnosis and treatment. These spiritual relationships created "church families" and provided the survivors' access to cancer support groups, financial support, and therapeutic support. Our findings support faith-based approaches to health promotion and call for more studies to understand the influence of religion on health.
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Winters AC, Viramontes M, Buch A, Najarian L, Yum J, Yang L, Saab S. Older Patients With Hepatocellular Carcinoma Are Less Knowledgeable About Survivorship Issues: Outcomes from a Survey-based Study. J Clin Gastroenterol 2021; 55:88-92. [PMID: 33060439 DOI: 10.1097/mcg.0000000000001442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIMS As the incidence and survival for hepatocellular carcinoma increase, the number of patients having been treated for liver cancer would be expected to increase as well. Little is known about the experience of the survivors of hepatocellular carcinoma. METHODS The authors conducted a 3-tool survey of hepatocellular carcinoma survivors at a large, academic, and tertiary referral medical center to assess potential areas of disparities in the survivorship experience. The instruments aimed to assess knowledge of survivorship issues (Perceived Efficacy in Patient-Physician Interactions Questionnaire-1), preparedness for the survivorship experience (Perceived Efficacy in Patient-Physician Interactions Questionnaire-2), and self-efficacy in procuring medical information while navigating the patient-provider relationship (Perceived Efficacy in Patient-Physician Interactions Questionnaire). The authors compared mean test scores for each instrument, with higher scores indicating a more positive response, by patient characteristics and used s linear regression model to examine associations between sociodemographics and survey scores. RESULTS In total, 110 patients took at least 1 survey. In the multiple linear regression model, the authors found that for every increase in patient age by 10 years, knowledge of survivorship issues decreased by a total score of 1.3 (P=0.02). In this model, the authors found no significant differences between male and female respondents, English and non-English speakers, and liver transplant recipients and nonliver transplant recipients. Survivors who had completed a 4-year college degree had significantly higher knowledge of survivorship issues than those who did not use χ testing, but this finding did not maintain significance in the multiple linear regression model. CONCLUSIONS In a population of 110 ethnically diverse hepatocellular carcinoma survivors, the authors found older patients had gaps in knowledge of survivorship issues. Particular attention should be paid to older populations during liver cancer treatment.
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Affiliation(s)
| | - Matthew Viramontes
- Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA
| | - Adam Buch
- Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA
| | - Lisa Najarian
- Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA
| | - Jung Yum
- Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA
| | | | - Sammy Saab
- Departments of Medicine
- Surgery, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA
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17
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Travel distance and overall survival in hepatocellular cancer care. Am J Surg 2020; 222:584-593. [PMID: 33413878 DOI: 10.1016/j.amjsurg.2020.12.052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/07/2020] [Accepted: 12/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Our objective was to assess the relationship between overall survival (OS) and distance travelled to the treating facility for patients undergoing liver resection for hepatocellular carcinoma and to determine whether this relationship was dependent upon the structural factors of the treating facility. METHODS Using National Cancer Database, we focused on extremes of travel: Local (<12.5 miles to treating facility) and Travel (≥50 miles). We analyzed OS with Cox models; we estimated stratified models to assess interaction between distance and facility characteristics (volume, academic status). RESULTS We included 6860 patients. After correction for confounding, distance travelled was not associated with OS (p = 0.444). However, Travel patients treated at high-volume, academic centers had worse OS compared to Local patients (HR 1.54, 95%CI 1.07-2.21); this association was not seen for patients treated at low volume, academic centers (p = 0.708) high volume non-academic centers (p = 0.174) or low volume non-academic centers (p = 515). CONCLUSION For those patients treated at high-volume, academic centers, living far from the facility was associated with worse OS. The reasons for this association should be investigated further.
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Pérez M, Kreuter MW, Yan Y, Thompson T, Sefko J, Golla B, Margenthaler JA, Colditz G, Jeffe DB. Feasibility and Acceptability of an Interactive Cancer-Communication Video Program Using African American Breast Cancer Survivor Stories. JOURNAL OF HEALTH COMMUNICATION 2020; 25:566-575. [PMID: 33048635 PMCID: PMC8043508 DOI: 10.1080/10810730.2020.1821132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To examine the feasibility and acceptability of an interactive video program of African American breast cancer survivor stories, we explored story reactions among African American women with newly diagnosed breast cancer and associations between patient factors and intervention use. During a randomized controlled trial, patients in the intervention arm completed a baseline/pre-intervention interview, received the video intervention, and completed a post-intervention 1-month follow-up interview. Additional video exposures and post-exposure interviews occurred at 6- and 12-month follow-ups. Multivariable linear mixed-effects models examined interview and clinical data in association with changes in minutes and actions using the program. After Exposure1, 104 of 108 patients allocated to the intervention reported moderate-to-high levels of positive emotional reactions to stories and identification with storytellers. Exposure1 mean usage was high (139 minutes) but declined over time (p <.0001). Patients receiving surgery plus radiation logged about 50 more minutes and actions over 12-month follow-up than patients receiving surgery only (p <.05); patients reporting greater trust in storytellers logged 18.6 fewer actions over time (p =.04). Patients' topical interests evolved, with patients watching more follow-up care and survivorship videos at Exposure3. The intervention was feasible and evaluated favorably. New videos might satisfy patients' changing interests.
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Affiliation(s)
- Maria Pérez
- School of Medicine, Department of Medicine, Washington
University in St. Louis, Saint Louis, Missouri, USA
| | - Matthew W. Kreuter
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Yan Yan
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Tess Thompson
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
| | - Julianne Sefko
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Balaji Golla
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
| | - Julie A. Margenthaler
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Graham Colditz
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Donna B. Jeffe
- School of Medicine, Department of Medicine, Washington
University in St. Louis, Saint Louis, Missouri, USA
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
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Lally R, Hydeman J, Brooks C, Akter H, Yoerg M. Experiences and Needs of African American Children and Adolescents in Supportive Care Roles for a Relative With Breast Cancer. Oncol Nurs Forum 2020; 47:165-176. [DOI: 10.1188/20.onf.165-176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Serrant L. Silenced Knowing: An Intersectional Framework for Exploring Black Women's Health and Diasporic Identities. FRONTIERS IN SOCIOLOGY 2020; 5:1. [PMID: 33869410 PMCID: PMC8022544 DOI: 10.3389/fsoc.2020.00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 01/10/2020] [Indexed: 06/06/2023]
Abstract
Understanding the needs of Black women within a cultural and medical framework which recognizes the impact on health and well-being on the spaces where culture, health, and expectation intersect remains a challenge. In the UK, Black women are often more likely to have poor prognosis, worse outcomes and greater morbidity from treatable and preventable health conditions than their white peers. UK researchers have struggled to find a culturally appropriate safe methodological framework to help explore the challenges faced by Black women and their families in safeguarding their health, particularly around sensitive issues such as sexual and reproductive health. This article presents a relatively new intersectional framework which has been use for conducting health research on culturally sensitive health issues. The Silences Framework introduces the notion of "Screaming Silences." Screaming Silences (or Silences) reflect the unsaid or unshared aspects of how beliefs, values and experiences of (or about) some groups affect their health and life chances. The article will explore how, the framework aligns with existing Intersectional approaches and how it could be used to expose intersectional nature of issues which influence and inform both individual and group understandings Black Women's health using examples relating to sexual health and life chances for Black women in the Diaspora.
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21
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Lewis GD, Xing Y, Haque W, Patel T, Schwartz MR, Chen AC, Farach A, Hatch SS, Butler EB, Chang JC, Teh BS. The impact of molecular status on survival outcomes for invasive micropapillary carcinoma of the breast. Breast J 2019; 25:1171-1176. [PMID: 31321854 DOI: 10.1111/tbj.13432] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 01/17/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) is an uncommon variant of breast cancer. Previous studies demonstrated this subtype is often hormone receptor (HR)-positive, resulting in survival outcomes similar to invasive ductal carcinoma. However, many of these studies were conducted prior to HER2 testing availability. We aim to determine the impact of molecular marker status (including HER2 status) on IMPC survival outcomes. The National Cancer Data Base (NCDB) was used to retrieve patients with biopsy-proven IMPC from 2007 to 2012. Only patients with known HR and HER2 status were included. Cox multivariate regression was used to determine prognostic factors. In total, 865 patients were included; median follow-up was 2.5 years. Overall, 651 patients (75.3%) had HR + HER2- disease, 128 (14.8%) had HR + HER2+ disease, 41 (4.7%) had HR-HER2 + disease, and 45 (5.2%) had triple negative disease. Patients with triple negative disease were more likely to have poorly differentiated histology (66.7%), lymphovascular invasion (73.3%), stage 3 disease (37.8%), undergone mastectomy (68.9%), and positive surgical margins (15.6%). On Cox multivariate regression, those with triple negative disease had worse overall survival (hazard ratio [HR] 7.28, P < 0.001). Other adverse prognostic factors included African-American descent (HR 2.24, P = 0.018), comorbidity score of 1 (HR 2.50, P = 0.011), comorbidity score ≥2 (HR 3.27, P = 0.06), and ≥3 positive lymph nodes (HR 3.23, P = 0.007). Similar to invasive ductal carcinoma, triple negative disease in IMPC results in worse survival outcomes. This is the largest and first study to characterize molecular status (including HER2 status) in patients with IMPC and its impact on survival outcomes.
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Affiliation(s)
- Gary D Lewis
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, Texas.,Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Yan Xing
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Waqar Haque
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Tejal Patel
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Mary R Schwartz
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Albert C Chen
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas
| | - Andrew Farach
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Sandra S Hatch
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - E Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Jenny C Chang
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
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22
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Lally RM, Bellavia G, Gallo S, Kupzyk K, Helgeson V, Brooks C, Erwin D, Brown J. Feasibility and acceptance of the CaringGuidance web-based, distress self-management, psychoeducational program initiated within 12 weeks of breast cancer diagnosis. Psychooncology 2019; 28:888-895. [PMID: 30803084 DOI: 10.1002/pon.5038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Limited clinical resources create barriers to quality management of cancer-related distress. CaringGuidance After Breast Cancer Diagnosis is a web-based, patient-controlled, psychoeducational program of cognitive-behavioral, coping and problem-solving strategies aimed at early post-diagnosis distress reduction without clinical resources. This study evaluated the feasibility of recruiting and retaining newly diagnosed women to 12 weeks of CaringGuidance and program acceptance. METHODS Women with stage 0 to II breast cancer diagnosed within the prior 3 months were recruited from clinics and communities in four states, from 2013 to 2015 and randomized to 12 weeks of CaringGuidance plus usual care (n = 57) or usual care alone (n = 43). Recruitment, retention, and program use were tracked. Using standard and study-derived measures, demographic and psychological variables were assessed at baseline and monthly and program satisfaction at 12 weeks. RESULTS Of 139 women screened, 100 enrolled, five withdrew, and 12 were lost to follow-up (83% retention rate). Total program engagement was positively associated with greater baseline intrusive/avoidant thoughts. Intervention participants (92%) believed CaringGuidance would benefit future women and was easy to use. Sixty-six percent believed CaringGuidance helped them cope. Women used program content to change thoughts (49%) or behaviors (40%). Stress in the previous year was positively associated with reports that CaringGuidance was reassuring and helpful. CONCLUSIONS Feasibility and acceptance of CaringGuidance was demonstrated pointing to the program's potential as a cancer-distress self-management intervention. Future research will explore program feasibility and acceptability in other regions of the United States, leading to clinical implementation trials.
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Affiliation(s)
- Robin M Lally
- University at Buffalo School of Nursing, Buffalo, New York.,University of Nebraska Medical Center College of Nursing, Omaha, Nebraska.,Fred & Pamela Buffett Cancer Center, Omaha, Nebraska
| | | | - Steven Gallo
- University at Buffalo, Center for Computational Research, Buffalo, New York
| | - Kevin Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | | | | | | | - Jean Brown
- University at Buffalo School of Nursing, Buffalo, New York
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Nicks SE, Wray RJ, Peavler O, Jackson S, McClure S, Enard K, Schwartz T. Examining peer support and survivorship for African American women with breast cancer. Psychooncology 2018; 28:358-364. [DOI: 10.1002/pon.4949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/25/2018] [Accepted: 11/21/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Shannon E. Nicks
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Ricardo J. Wray
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Olivia Peavler
- College for Public Health & Social Justice, Department of Health Management & PolicySaint Louis University St. Louis MO
| | | | - Stephanie McClure
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Kimberly Enard
- College for Public Health & Social Justice, Department of Health Management & PolicySaint Louis University St. Louis MO
| | - Theresa Schwartz
- Cancer Center, Department of Surgery, Breast Surgical OncologySaint Louis University St. Louis MO
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24
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Keeping us all whole: Acknowledging the agency of African American breast cancer survivors and their systems of social support. Support Care Cancer 2018; 27:2625-2632. [PMID: 30470890 DOI: 10.1007/s00520-018-4538-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 11/04/2018] [Indexed: 10/27/2022]
Abstract
While all cancer patients face a bewildering array of treatments, side effects, and emotions, several researchers have shown that African American women with breast cancer experience greater stress and burdens because of unmet supportive needs associated with psychological distress, financial distress, and lower physical/functional well-being. Social support has been shown to improve health outcomes for African American breast cancer patients. The purpose of this paper is to understand the meaning of social support among African American women diagnosed with breast cancer. A total of 47 African American women with breast cancer participated in the in-depth qualitative interviews. Key findings indicate that social support was received in the context of the stability of the extended family network. Moreover, social support was received in the context of distributing the social support received among many members in their personal networks and that social support was only received on patient's own terms. The findings of this paper provide an understanding to the inter-relational and cultural meanings of receiving support by diverse cancer patients. In addition, the findings of this paper have implications for health care professionals working with African American breast cancer patients in understanding how social support can be received.
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Bail J, Nolan TS, Vo JB, Gisiger-Camata S, Meneses K. Engaging an Urban African American Community to Deliver Cognitive Health Education to Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:870-874. [PMID: 28032260 DOI: 10.1007/s13187-016-1155-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Little is known about cognitive changes among African American (AA) breast cancer survivors (BCS). Here, we report our experience with engagement of leaders of urban AA churches in Birmingham, Alabama to deliver and evaluate Think Well: Healthy Living to Improve Cognitive Function, an educational cognitive health program for BCS. The Think Well team engaged leaders of urban AA churches using a 7-step process: 1) identify leaders, 2) develop connection with leaders, 3) assess AA community preferences, 4) tailor for cultural relevance, 5) plan seminars, 6) deliver seminars, and 7) evaluate cultural relevance and overall program quality. Program evaluation was via a 22-item survey and sociodemographic questionnaire. Data from AA participants were analyzed using SPSS. The engagement process resulted in sustained partnerships with three urban AA churches and delivery of three Think Well seminars to 172 participants. Of the 172 participants, 138 (80%) AA participants (40 BCS, 98 co-survivors) returned the program survey. Respondents reported Think Well to be culturally relevant (90%) and of high quality (94%). Think Well was developed and evaluated with the collaboration of urban AA church leaders. Engaging church leaders facilitated reach of AA BCS. Partnership facilitated a culturally relevant, high quality program for AA BCS and co-survivors.
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Affiliation(s)
- Jennifer Bail
- School of Nursing, University of Alabama at Birmingham, MT 504,1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA.
| | - Timiya S Nolan
- School of Nursing, University of Alabama at Birmingham, MT 504,1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Jacqueline B Vo
- School of Nursing, University of Alabama at Birmingham, MT 504,1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Silvia Gisiger-Camata
- University of Alabama at Birmingham, MT 504G,1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Karen Meneses
- School of Nursing, University of Alabama at Birmingham, MT 502H1,1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
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Grunberg PH, Dennis CL, Da Costa D, Zelkowitz P. Infertility patients' need and preferences for online peer support. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 6:80-89. [PMID: 30547107 PMCID: PMC6282097 DOI: 10.1016/j.rbms.2018.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/10/2018] [Accepted: 10/16/2018] [Indexed: 05/09/2023]
Abstract
This study sought to determine the level of interest in online peer support among infertility patients, factors associated with such interest, and preferences for features of an online peer support network. A sample of 236 men and 283 women (n = 519) seeking fertility treatment were recruited from four clinics in Ontario and Quebec, Canada. Participants completed an anonymous online questionnaire assessing demographics, perceived stress and fertility characteristics, in addition to interest in and preferences for online infertility peer support. Most men (80.1%) and women (89.8%) expressed interest in online peer support, with perceived stress being related to interest among both men and women. Non-White ethnicity and lower income were related to greater interest among men. Patients reported a preference for mobile accessibility, monitored peer-to-peer communication, and links to information. Men and women, particularly those with high levels of perceived stress, expressed interest in online peer support and shared similar preferences for features irrespective of fertility characteristics. Demographic characteristics and perceived stress were related to a desire for more personalized support options.
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Affiliation(s)
- Paul H. Grunberg
- McGill University, Department of Psychology, Montreal, Quebec, Canada
- Jewish General Hospital, Department of Psychiatry, Montreal, Quebec, Canada
| | - Cindy-Lee Dennis
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, Toronto, Ontario, Canada
| | - Deborah Da Costa
- McGill University, Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Jewish General Hospital, Department of Psychiatry, Montreal, Quebec, Canada
- McGill University, Department of Psychiatry, Montreal, Quebec, Canada
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
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Knobf MT, Erdos D, Jeon S. Healthy Sisters: A Feasibility study of a health behavior intervention for women of color breast cancer survivors. J Psychosoc Oncol 2018; 36:597-608. [PMID: 29847241 DOI: 10.1080/07347332.2018.1460004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
There is strong evidence for the need to educate and empower women of color breast cancer survivors (WCBCS) to adopt healthy lifestyle behaviors. The purpose of this study was to explore feasibility and preliminary efficacy of a culturally grounded lifestyle intervention on functional ability, quality of life, and health behaviors. A community-based sample of WCBCS was recruited from two inner cities, with encouragement to invite a partner. There were 30 WCBCS and 10 partners who participated in the 6-week interactive intervention. Data were collected at baseline, end of intervention and 3 and 6 months. There was significant improvement in healthy lifestyle behaviors (p = 0.041), physical activity (p = 0.003), nutrition (p = 0.007), and stress management (p = 0.010) for WCBCS and, for partners, improvements in healthy lifestyle behaviors (p = 0.041), nutrition (p = 0.007), and health responsibility (p = 0.034).
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Affiliation(s)
- M Tish Knobf
- a Yale University School of Nursing , Orange , Connecticut , USA
| | - Diane Erdos
- a Yale University School of Nursing , Orange , Connecticut , USA
| | - Sangchoon Jeon
- a Yale University School of Nursing , Orange , Connecticut , USA
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28
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Allicock M, Haynes-Maslow L, Johnson LS, Carpenter WR, Vines AI, Belle DG, Phillips R, Cherry MW. Peer Connect for African American breast cancer survivors and caregivers: a train-the-trainer approach for peer support. Transl Behav Med 2018; 7:495-505. [PMID: 28425087 DOI: 10.1007/s13142-017-0490-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Racial disparities in breast cancer survivorship are a major concern nationally. How survivors cope with cancer and re-frame their lives is a critical part of survivorship. Community-academic research partnerships may facilitate access to much-needed psychosocial support for African American survivors and caregivers in rural areas, but drivers of successful intervention implementation are not well understood. The purpose of this study was to describe the training and evaluation of Community Coaches and Guides (i.e., peer supporters) using the Peer Connect program for African American breast cancer survivors and caregivers. Community engagement strategies were used to implement the training component of Peer Connect, an evidence-based program grounded in the Diffusion of Innovation Theory utilizing motivational interviewing techniques (MI) and a "train-the-trainer" model. Quantitative and qualitative methods examined implementation outcomes of feasibility, MI fidelity, and acceptability-precursor outcomes that must be achieved before examining intervention impact vis-à-vis changes in support care. Training was feasible to implement and replicable by the trained Community Coaches. Beyond feasibility and replicability, success was modest regarding MI fidelity. Benefits (e.g., serving as role models and having safe sources of support) and lessons learned (e.g., need for additional quality control) were identified as both facilitators and barriers to implementation and as factors that could impact the effectiveness of community-engaged programs to improve survivorship outcomes. Peer Connect, like other programs that employ community-engagement strategies, holds promise to meet the psychosocial support needs of diverse rural cancer survivor populations.
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Affiliation(s)
- Marlyn Allicock
- School of Public Health, Department of Health Promotion and Behavioral Sciences, The University of Texas, 5323 Harry Hines, V8.112, Dallas, TX, 75390-9128, USA.
| | - Lindsey Haynes-Maslow
- Department of Youth, Family, and Community Sciences College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC, 27695, USA
| | - La-Shell Johnson
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | - Anissa I Vines
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Denise G Belle
- Rural Health Group, Inc, 500 Jackson St, Roanoke Rapids, NC, 27870, USA
| | - Ray Phillips
- Vidant Edgecombe Hospital, 111 Hospital Dr a, Tarboro, NC, 27886, USA
| | - Michele W Cherry
- Vidant Edgecombe Hospital, 111 Hospital Dr a, Tarboro, NC, 27886, USA
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Jones T, Duquette D, Underhill M, Ming C, Mendelsohn-Victor KE, Anderson B, Milliron KJ, Copeland G, Janz NK, Northouse LL, Duffy SM, Merajver SD, Katapodi MC. Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry. Breast Cancer Res Treat 2018; 169:141-152. [PMID: 29353367 DOI: 10.1007/s10549-018-4674-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/16/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices. METHODS Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms. RESULTS Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. CONCLUSIONS Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs. IMPLICATIONS Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.
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Affiliation(s)
- Tarsha Jones
- Florida Atlantic University Christine E. Lynn College of Nursing, 777 Glades Road, Boca Raton, FL, 33431, USA
| | - Debra Duquette
- Feinberg School of Medicine, Northwestern University, Arkes Family Pavilion Suite 600, 676 N Saint Clair, Chicago, IL, 60611, USA
| | - Meghan Underhill
- The Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Chang Ming
- Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | | | - Beth Anderson
- Michigan Department of Health and Human Services, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA
| | - Kara J Milliron
- University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Glenn Copeland
- Michigan Cancer Surveillance Program, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA
| | - Nancy K Janz
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Laurel L Northouse
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
| | - Sonia M Duffy
- Ohio State University College of Nursing, 1585 Neil Ave, Columbus, OH, 43210, USA
| | - Sofia D Merajver
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.,School of Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Maria C Katapodi
- Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. .,University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA.
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Regnier Denois V, Querre M, Chen L, Barrault M, Chauvin F. Inequalities and Barriers to the Use of Supportive Care Among Young Breast Cancer Survivors: a Qualitative Understanding. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:790-798. [PMID: 27476073 DOI: 10.1007/s13187-016-1087-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The development of supportive care for cancer patients has been shown to have a positive impact on both mortality rates and many aspects of life after cancer, particularly in young women. Meanwhile, there are still numerous inequalities in terms of cancer mortalities and quality of life among cancer survivors in France. The processes leading to unequal access to supportive care services, and the impact this has on the post-treatment period, have been poorly documented, however. The goal of this study was to understand the barriers to using supportive care services among young women breast cancer survivors under the age of 50 and to find out how this can contribute to inequalities. Thirty-six young breast cancer survivors, one third of which deemed socially deprived, were interviewed using a qualitative, inductive approach at two comprehensive care centres in France. Our findings primarily show that there are still a number of barriers to accessing supportive care for a large number of patients. The way information about supportive services is delivered is a major cause of inequalities in the use of these services. The guidance provided does not take into account either the patients' needs or their capacity to integrate the information and anticipate problems. Certain specific post-treatment issues have yet to be addressed. Some systemic barriers could be lifted by changing the way information on supportive care services is currently organised and thereby prevent the survivorship plans now being implemented in cancer care settings from reinforcing health inequalities.
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Affiliation(s)
| | - Madina Querre
- REVeSS (Recherches et Etudes sur les Vulnérabilités Sociales et la Santé), Bordeaux, France
| | - Linjie Chen
- Decision & Information Sciences for Production Systems laboratory, INSA, Lyon, France
| | - Marion Barrault
- Institut Bergonié, 229 cours de l'Argonne, F-33000, Bordeaux, France
| | - Franck Chauvin
- HYGEE-ICLN, Université de Lyon, EA HESPER 7425, F-69003, Lyon, France
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31
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Thompson T, Pérez M, Kreuter M, Margenthaler J, Colditz G, Jeffe DB. Perceived social support in African American breast cancer patients: Predictors and effects. Soc Sci Med 2017; 192:134-142. [PMID: 28965004 DOI: 10.1016/j.socscimed.2017.09.035] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/04/2017] [Accepted: 09/20/2017] [Indexed: 01/13/2023]
Abstract
RATIONALE Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment. OBJECTIVE To examine changes in perceived social support in African American women during the two years following a new breast cancer diagnosis. METHODS This secondary analysis uses data collected from 2009 to 2015 from 227 newly diagnosed, African American women with breast cancer (mean age 56 [SD = 10], 59% household income < $25,000; 28% married/partnered, 72% early stage) participating in a randomized controlled trial testing the effects of a video-communication intervention on quality-of-life and follow-up care. Participants, all of whom received treatment in one metropolitan area of the Midwestern United States, completed five telephone interviews over 2-year follow-up; demographic, psychosocial, quality of life, and clinical data were collected. Growth curve models were used to examine change in perceived social support (measured by the Medical Outcomes Study Social Support Survey) as well as correlates of baseline levels of social support and predictors of change in individuals' social support. Additional analyses examined whether change in social support over the first year affected depressive symptoms (Center for Epidemiologic Studies Depression Scale) and general health perceptions (RAND SF-36 subscale) at two years. RESULTS Being married, reporting greater spirituality, and reporting fewer depressive symptoms at baseline were significantly associated with higher initial levels of perceived social support. Women whose social support declined during the first year after diagnosis reported more severe depressive symptoms and worse general health perceptions at two years. CONCLUSION Clinicians should periodically assess perceived social support among African American women with breast cancer to help find support resources for those who have low initial social support and for those whose support declines in the first year after diagnosis.
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Affiliation(s)
- Tess Thompson
- Health Communication Research Laboratory, Brown School of Social Work, Washington University in St. Louis, United States.
| | - Maria Pérez
- Washington University School of Medicine, Washington University in St. Louis, United States
| | - Matthew Kreuter
- Health Communication Research Laboratory, Brown School of Social Work, Washington University in St. Louis, United States
| | - Julie Margenthaler
- Washington University School of Medicine, Washington University in St. Louis, United States
| | - Graham Colditz
- Washington University School of Medicine, Washington University in St. Louis, United States
| | - Donna B Jeffe
- Washington University School of Medicine, Washington University in St. Louis, United States
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Adams N, Gisiger-Camata S, Hardy CM, Thomas TF, Jukkala A, Meneses K. Evaluating Survivorship Experiences and Needs Among Rural African American Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:264-271. [PMID: 26498472 DOI: 10.1007/s13187-015-0937-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Disparities in cancer survivorship exist among specific populations of breast cancer survivors, specifically rural African American breast cancer survivors (AA-BCS). While effective survivorship interventions are available to address and improve quality of life, interventions must be culturally tailored for relevance to survivors. Here, we report the results of our formative research using focus groups and in-depth interview to better understand unique rural AA-BCS survivorship experiences and needs in the Alabama Black Belt. Surveys were used to gather sociodemographic and cancer treatment data. Fifteen rural AA-BCS shared their experiences and concerns about keeping their cancer a secret, lack of knowledge about survivorship, lingering symptoms, religion and spirituality, cancer surveillance, and general lack of survivorship education and support. Rural AA-BCS were unwilling to share their cancer diagnosis, preferring to keep it a secret to protect family and friends. Quality-of-life issues like lymphedema body image and sexuality were not well understood. They viewed spirituality and religion as essential in coping and accepting cancer. Participants also discussed the importance of and barriers to maintaining health through regular check-ups. They needed social support from family and friends and health care providers. Overall, rural AA-BCS expressed their need for knowledge about survivorship self-management by providing a vivid picture of the realities of cancer survival based on shared concerns for survivorship support and education within the context of culture.
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Affiliation(s)
- Natasia Adams
- Department of Psychology, College of Liberal Arts & Sciences, University of Kansas, Lawrence, KS, 66046, USA.
| | - Silvia Gisiger-Camata
- Office of Research & Scholarship, School of Nursing, University of Alabama, Birmingham, USA
| | - Claudia M Hardy
- Deep South Network for Cancer Control, UAB Comprehensive Cancer Center, University of Alabama, Birmingham, USA
| | - Tammi F Thomas
- Division of Clinical Immunology & Rheumatology, University of Alabama, Birmingham, USA
| | - Angela Jukkala
- School of Nursing, University of Alabama, Birmingham, USA
| | - Karen Meneses
- School of Nursing, UAB Comprehensive Cancer Center, University of Alabama, Birmingham, USA
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Vadaparampil ST, Christie J, Donovan KA, Kim J, Augusto B, Kasting ML, Holt CL, Ashing K, Halbert CH, Pal T. Health-related quality of life in Black breast cancer survivors with and without triple-negative breast cancer (TNBC). Breast Cancer Res Treat 2017; 163:331-342. [PMID: 28258353 PMCID: PMC5568024 DOI: 10.1007/s10549-017-4173-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Black women are more likely to develop early-onset (≤50 years) breast cancer (BC) and have the lowest five-year, cause-specific survival rate of any United States (U.S.) racial or ethnic group. These disparities can be attributed partially to the higher rate of triple-negative BC (TNBC) in Blacks. Yet, little is known about health-related quality of life (HRQOL) among Black women with TNBC. METHODS Black women with invasive BC ≤ 50 years were recruited via the Florida Cancer Data System as part of a population-based case-only study of etiology and outcomes of early-onset invasive BC. Of 460 consented participants, a subset of 355 self-reported sociodemographic, clinical, and psychosocial variables. Descriptive analyses included participants with known TNBC (n = 85) or non-TNBC (n = 245) disease. Univariable and multivariable analyses were conducted to examine differences in factors associated with HRQOL. RESULTS In unadjusted analyses, TNBC participants had significantly lower FACT-B total scores (90.1 ± 27.9) compared to non-TNBC (98.5 ± 27.6) participants (p < 0.05). For the TNBC group, multivariable analyses indicated five individual-level, and three systemic-level factors explain 80% of the response variation in HRQOL. For the non-TNBC group, seven individual-level factors and three systemic-level factors account for 76% of the variation in HRQOL scores. CONCLUSIONS Compared to Black women with non-TNBC, TNBC women have worse HRQOL. There are key individual and systemic-level factors that are unique to both groups. Findings can inform future HRQOL interventions to support young Black BC survivors.
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Affiliation(s)
- Susan T Vadaparampil
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA.
| | - Juliette Christie
- University of Maryland, 4200 Valley Drive, Room 1242W, College Park, MD, 20742, USA
| | - Kristine A Donovan
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Jongphil Kim
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Bianca Augusto
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Monica L Kasting
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Cheryl L Holt
- University of Maryland, 4200 Valley Drive, Room 1242W, College Park, MD, 20742, USA
| | - Kimlin Ashing
- City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | | | - Tuya Pal
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
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Haynes-Maslow L, Allicock M, Johnson LS. Peer support preferences among African-American breast cancer survivors and caregivers. Support Care Cancer 2016; 25:1511-1517. [PMID: 28032217 DOI: 10.1007/s00520-016-3550-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Breast cancer mortality rates continue to improve due to advances in cancer control and treatment. However, gains in breast cancer survival rates vary by race. Psychosocial support systems can lead to improved health outcomes among cancer survivors. This study was a part of a larger study exploring the challenges that both African-American cancer survivors and caregivers face across the cancer continuum. The objective of this paper was to explore African-American breast cancer survivors' and caregivers' preferences regarding characteristics and qualities of Peer Connect guides to inform the development of a peer support program. METHODS Forty-one African-American cancer survivors and caregivers participated in five focus groups lasting approximately 90 min. Participants were asked about what qualities or characteristics they would prefer in a peer support guide to make them feel comfortable talking with them. Focus group transcripts were analyzed using thematic content analysis, an iterative coding process. Themes were identified based on the research team's integrated and unified final codes. RESULTS Twenty-two cancer survivors, 19 caregivers, and 3 individuals who were both survivors and caregivers participated in the focus groups. Participants discussed five preferences for peer support guides: (1) competency, (2) gender, (3) age, (4) cancer role status, and (5) relationship to participant. CONCLUSIONS This study highlights cancer survivors' and caregivers' perceptions of characteristics needed for peer support providers that in turn can influence whether and how they participate in cancer support programs.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA.
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas, Austin, USA
| | - La-Shell Johnson
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Austin, USA
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Dean LT, Zhang X, Latif N, Giuntoli R, Lin L, Haggerty A, Kim S, Shalowitz D, Stashwick C, Simpkins F, Burger R, Morgan M, Ko E, Schmitz K. Race-based disparities in loss of functional independence after hysterectomy for uterine cancer. Support Care Cancer 2016; 24:3573-80. [PMID: 27025595 DOI: 10.1007/s00520-016-3185-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/21/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE Racial disparities in uterine cancer-related outcomes have been reported. The goal of this study was to determine if race, pre-operative body mass index (BMI), and medical comorbidities are predictors of loss of functional independence after hysterectomy for uterine cancer. METHODS Loss of independence was defined as a change from pre-operative functional independence, to a post-operative requirement of discharge to a post-care facility, or death within the first 30 days following uterine cancer surgery. Demographic factors, comorbidities, BMI, intra-operative and post-operative outcomes, and discharge status were abstracted from the 2011 and 2012 American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Statistical analyses included multivariable logistic regression and Wald tests for interaction. RESULTS A total of 4005 patients had uterine cancer and were functionally independent pre-operatively. After adjusting for clinical features and comorbidities, Black women were not significantly more likely to lose functional independence than non-Black women. However, a significant interaction (OR = 1.17, p < 0.001) was found between race and BMI for loss of functional independence. Interaction plots revealed worsening functional outcomes for Black women with BMI >40 but not in non-Blacks. CONCLUSIONS The interaction suggests a 17 % increased odds of losing independence for each unit of BMI difference for Black uterine cancer patients, or 170 % increased odds of losing independence for a 10-point increase in BMI, given a linear association. To reduce the likelihood of losing post-operative functional independence, Black, high-BMI patients with or at risk for uterine cancer may especially benefit from weight loss or interventions to optimize physical function.
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Affiliation(s)
- Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Xiaochen Zhang
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Nawar Latif
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Giuntoli
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lilie Lin
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ashley Haggerty
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Kim
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - David Shalowitz
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Caitlin Stashwick
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fiona Simpkins
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Burger
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Morgan
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Ko
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn Schmitz
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Lee Smith J, Hall IJ. Advancing Health Equity in Cancer Survivorship: Opportunities for Public Health. Am J Prev Med 2015; 49:S477-82. [PMID: 26590642 PMCID: PMC4658651 DOI: 10.1016/j.amepre.2015.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/03/2015] [Accepted: 08/13/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Judith Lee Smith
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - Ingrid J Hall
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Coughlin SS, Yoo W, Whitehead MS, Smith SA. Advancing breast cancer survivorship among African-American women. Breast Cancer Res Treat 2015; 153:253-61. [PMID: 26303657 DOI: 10.1007/s10549-015-3548-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/12/2015] [Indexed: 12/20/2022]
Abstract
Advances have occurred in breast cancer survivorship but, for many African-American women, challenges and gaps in relevant information remain. This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African-American women. For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African-American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African-American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. There is a need for a better understanding of breast cancer survivorship among African-American women. Additional evaluations of interventions for improving the quality of life and survival of African-American breast cancer survivors are desirable.
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Affiliation(s)
- Steven S Coughlin
- Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Lowell, MA, USA,
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