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Choi E, Berkman AM, Battle A, Betts AC, Salsman JM, Milam J, Andersen CR, Miller KA, Peterson SK, Lu Q, Cheung CK, Livingston JA, Hildebrandt MAT, Parsons SK, Freyer DR, Roth ME. Psychological distress and mental health care utilization among Black survivors of adolescent and young adult cancer. Cancer 2024. [PMID: 38676935 DOI: 10.1002/cncr.35348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/05/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. METHODS National Health Interview Survey data (2010-2018) were analyzed that identified non-Hispanic Black (hereafter, Black) survivors of AYA cancer and age- and sex-matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. RESULTS The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR], 1.64; p < .001), use mental health care (OR, 1.53; p = .027), report an inability to afford mental health care (OR, 3.82; p < .001), and use medication for anxiety and/or depression (OR, 2.16; p = .001). Forty-one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18-39 years (vs. 40-64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. CONCLUSIONS A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy M Berkman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Aryce Battle
- McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA
| | - Andrea C Betts
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, University of California, Irvine, California, USA
| | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberly A Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Division of Cancer Prevention and Population Sciences, Department of Health Disparities Research, The University of Texas MD Anderson Cancer Institute, Houston, Texas, USA
| | | | - J A Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle A T Hildebrandt
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies and Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - David R Freyer
- Departments of Pediatrics, Medicine, and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael E Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Choi E, Berkman AM, Cheung CK, Betts AC, Salsman JM, Andersen CR, Ochoa-Dominguez CY, Miller K, Milam J, Shah A, Peterson SK, Lu Q, Livingston JA, Hildebrandt MAT, Parsons SK, Freyer D, Roth ME. Psychological distress and mental health care utilization among Hispanic/Latino survivors of adolescent and young adult cancer. Psychooncology 2023; 32:1918-1929. [PMID: 37955581 PMCID: PMC10872722 DOI: 10.1002/pon.6248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Survivors of adolescent and young adult (AYA) cancer experience psychological distress and insufficient access to mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes in this population. This study compared psychological distress, mental health care use, and inability to afford mental health care between Hispanic/Latino survivors of AYA cancer and Hispanic/Latino controls. METHODS The National Health Interview Survey data (2010-2018) were analyzed to identify Hispanic/Latino survivors of AYA cancer and Hispanic/Latino age- and sex-matched non-cancer controls. Sociodemographic, chronic health, modifiable factors, and psychological outcomes were compared using chi-square tests. Logistic regression models with survey weights were used to assess the log-odds of psychological distress in relation to covariates, along with the cancer group. Interactions were evaluated between each variable and cancer group. RESULTS The study included 370 Hispanic/Latino survivors of AYA cancer (mean time since diagnosis = 12.34 years) and 3700 Hispanic/Latino controls. Compared to controls, survivors were more likely to report moderate/severe distress (OR = 2.23, p < 0.001), use of mental health care (OR = 2.11, p < 0.001) and inability to afford mental health care (OR = 3.05, p < 0.001). Forty-one percent of survivors reported moderate/severe distress and only 16% utilized mental health care. Among survivors, having more than two chronic health conditions and public insurance (compared to private insurance) were associated with the presence of moderate/severe distress. Among survivors experiencing moderate/severe distress, lack of insurance was associated with decreased utilization of mental health care. CONCLUSIONS Having cancer as an AYA may exacerbate disparities in psychological health within the Hispanic/Latino population.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy M Berkman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Andrea C Betts
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carol Yesenia Ochoa-Dominguez
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, USA
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, California, USA
| | - Kimberly Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joel Milam
- Department of Epidemiology & Biostatistics, University of California, Irvine, California, USA
| | - Ashna Shah
- School of Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Institute, Houston, Texas, USA
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle A T Hildebrandt
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies and the Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - David Freyer
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael E Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Kim Y, Ritt-Olson A, Tobin J, Haydon M, Milam J. Beyond depression: correlates of well-being in young adult survivors of childhood cancers. J Cancer Surviv 2023; 17:1397-1404. [PMID: 35187609 DOI: 10.1007/s11764-022-01186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study investigated the correlates of well-being with psychosocial and clinical factors in young adult childhood cancer survivors (YACCS) above and beyond depressive symptoms. METHODS Participants were from the Project Forward Cohort, a population-based study of young adult survivors of childhood cancers. Participants (n = 1166, Mage = 25.1 years) were recruited through the Los Angeles Cancer Surveillance Program (Cancer Registry covering Los Angeles County). A majority received a diagnosis of leukemia (36.1%) or lymphoma (21.7%). Participants completed self-reported questionnaires at one timepoint. Multiple regression analyses were performed with well-being as the outcome variable and psychosocial and clinical variables (social support, sense of adulthood, posttraumatic growth, treatment intensity, and self-rated health) as the independent variables. Covariates included demographics (age, gender, relationship status, race/ethnicity) and depressive symptoms. RESULTS In the multivariable model, posttraumatic growth, social support, sense of adulthood, and self-rated health were significantly associated with well-being (all ps < .05), when controlling for depressive symptoms. Treatment intensity and years since diagnosis were not significantly associated with well-being, when controlling for depressive symptoms. CONCLUSIONS There are unique correlates of well-being above and beyond depressive symptoms among YACCS. This finding illuminates individual differences that may be associated with well-being and provides targets for intervention. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial interventions and survivorship care for YACCS should consider the broad aspects of well-being, independent of depressive symptoms.
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Affiliation(s)
- Yoonji Kim
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA.
| | | | - Jessica Tobin
- VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Marcie Haydon
- Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA
- Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
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Majdalani MP, Alazraqui M. Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.22132021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors’ health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied. Objective: To identify the predominant lines of research in the study of HRQOL in this population. Methods: An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases. Results: In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects. Conclusions: incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.
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Majdalani MP, Alazraqui M. Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review. CIENCIA & SAUDE COLETIVA 2022; 27:3063-3077. [PMID: 35894319 DOI: 10.1590/1413-81232022278.22132021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/30/2022] [Indexed: 11/22/2022] Open
Abstract
Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors' health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied. OBJECTIVE To identify the predominant lines of research in the study of HRQOL in this population. METHODS An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases. RESULTS In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects. CONCLUSIONS incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.
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Affiliation(s)
- María Pía Majdalani
- División de Medicina Interna General, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires. Buenos Aires Argentina.
| | - Marcio Alazraqui
- Instituto de Salud Colectiva, Universidad Nacional de Lanús. Buenos Aires Argentina
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6
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Wechsler AM, Bragado-Álvarez C, Hernández-Lloreda MJ, Lopes LF, Perina EM. Psychological Adjustment of Children with Cancer: Relapse and Survival Perspectives. PSICO-USF 2022. [DOI: 10.1590/1413-82712022270101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract In Brazil, few studies have investigated the psychological aspects of childhood cancer. The aim of this article was to compare the psychological adjustment of children with cancer from different survival perspectives with that of children without cancer, besides examining potential risk factors. The sample consisted of 179 participants (6-14 years-old) recruited in two Brazilian public hospitals and three schools, and divided in three groups (relapsed, survivors and control). Children answered orally the self-reported Behavior Assessment Scale for Children, the Revised Children’s Manifest Anxiety Scale and Piers-Harris’ Self-Concept Scale. No differences were found between groups regarding school and clinical maladjustment, personal adjustment, emotional symptoms and self-concept. Findings also showed positive associations between psychological maladjustment and gender, younger age, lower household income, single parenthood and lower levels of parental education. Conclusions indicate that children with cancer adapt well to the disease and do not present more psychological problems than controls.
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Baron Nelson M, Kim Y, Hamilton L, Dekker A, Miller K, Hamilton AS, Milam J. Factors Associated with Interest in Complementary and Alternative Medicine Among Young Adult Survivors of Childhood Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:30-39. [PMID: 35722868 PMCID: PMC9839309 DOI: 10.1177/27527530211059421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Use of complementary and alternative medicine (CAM) by those undergoing cancer treatment is common. While some childhood cancer survivors (CCS) may use CAM to treat late effects, others may lack information about available alternative therapies. We sought to determine characteristics associated with seeking more information about CAM among an ethnically diverse sample of young adult CCS. Methods: Young adult CCS were selected from the population-based Los Angeles SEER cancer registry and surveyed at ages 18 to 39 as part of the Project Forward Cohort. Associations between demographic, clinical, and other factors with seeking information on CAM were examined with t-tests, Chi Square analyses, and logistic regression. Results: Among 1106 participants surveyed, 182 (18%) reported interest in obtaining more information on CAM. Interest in CAM was highest among males, older (vs. younger) participants, those born outside the U.S., those with a history of relapsed/recurrent or second cancers, those with greater depressive symptoms, and those with poorer self-rated health. Among Hispanic/Latino/Latinx respondents, depressive symptoms, birth outside the U.S., and higher Latino culture orientation was positively associated with CAM interest. Discussion: Depressive symptoms and unresolved health problems are associated with a need for information about alternative forms of therapy, particularly in those with born outside the U.S. Healthcare providers caring for CCS can incorporate appropriate CAM information to help address unmet physical and mental health needs.
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Affiliation(s)
- Mary Baron Nelson
- Departments of Pediatrics and Medical Education, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Yoonji Kim
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
| | - Lauren Hamilton
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
| | - Anneke Dekker
- Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kimberly Miller
- Departments of Preventive Medicine and Dermatology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Ann S. Hamilton
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
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Tobin J, Cockburn M, Unger JB, Finch BK, Hamilton AS, Ritt-Olson A, Milam JE. Acculturation, Mental Health, and Wellbeing Among Hispanic/Latinx Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2021; 11:223-228. [PMID: 34283659 DOI: 10.1089/jayao.2021.0029] [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: 11/13/2022] Open
Abstract
Purpose: Ethnic disparities in childhood cancer survivor (CCS) mental health have been identified, although prior survivorship research has focused predominantly on non-Hispanic/Latinx (H/L) white survivors. Methods: This study examined the association of acculturation with depressive symptoms and wellbeing among 582 young adult H/L CCS recruited to a population-based study of CCS in Southern California. Results: In multivariable regression models adjusted for covariates, greater identification with both the Hispanic and Anglo cultures was positively associated with wellbeing (p = 0.007 and p < 0.0001, respectively), and Hispanic cultural identification was associated with fewer depressive symptoms (p = 0.04). Conclusions: Greater understanding of unique protective factors among minority CCS may inform tailored interventions promoting mental health.
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Affiliation(s)
- Jessica Tobin
- VA Greater Los Angeles Health Care System, Los Angeles, California, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Brian K Finch
- Center for Economic and Social Research, Department of Sociology, Dornsife College of Letters, University of Southern California, Los Angeles, California, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Anamara Ritt-Olson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joel E Milam
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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9
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Tobin JL, Thomas SM, Freyer DR, Hamilton AS, Milam JE. Estimating cancer treatment intensity from SEER cancer registry data: methods and implications for population-based registry studies of pediatric cancers. Cancer Causes Control 2020; 31:881-890. [PMID: 32757117 PMCID: PMC7537342 DOI: 10.1007/s10552-020-01328-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 07/24/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The Intensity of Treatment Rating (ITR) Scale condenses treatment and clinical characteristics into a single measure to study treatment effects on downstream health outcomes across cancer types. This rating was originally developed for clinicians to determine from medical charts. However, large studies are often unable to access medical charts for all study participants. We developed and tested a method of estimating treatment intensity (TI) using cancer registry and patient self-reported data. METHODS We estimated two versions of TI for a cohort of pediatric cancer survivors-one utilized information solely available from cancer registry variables (TIR) and the other included registry and self-reported information (TIS) from survey participants. In a subset of cases (n = 135) for whom the gold standard TI (TIC) was known, both TIR and TIS were compared to TIC by calculating percent agreement and weighted Cohen's kappa, overall and within cancer subtypes. RESULTS In comparison to TIC, 71% of TI scores from both methods were in agreement (k = 0.61 TIR/0.54 TIS). Among subgroups, agreement ranged from lowest (46% TIR/39% TIS) for non-defined tumors (e.g., "Tumor-other"), to highest (94% TIR/94% TIS) for acute lymphoblastic leukemia (ALL). CONCLUSIONS We developed a methodology to estimate TI for pediatric cancer research when medical chart review is not possible. High reliability was observed for ALL, the most common pediatric cancer. Additional validation is needed among a larger sample of other cancer subgroups. The ability to estimate TI from cancer registry data would assist with monitoring effects of treatment during survivorship in registry-based epidemiological studies.
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Affiliation(s)
- Jessica L Tobin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Stefanie M Thomas
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, USA
| | - David R Freyer
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joel E Milam
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Bourque CJ, Bonanno M, Dumont É, Gaucher N, Lacoste-Julien A, Gomez-Tyo M, Langlet MF, Sultan S. The Integration of Resource Patients in Collaborative Research: A Mixed Method Assessment of the Nesting Dolls Design. PATIENT EDUCATION AND COUNSELING 2020; 103:1830-1838. [PMID: 32418681 DOI: 10.1016/j.pec.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This is a quality assessment of a research design developed for a collaborative study on adolescents and young adults who survived a brain tumor. METHODS A descriptive and critical mixed methods approach was used to assess the design itself, the quality and information power of the database and the integration of collaborators. Project documentation, field notes and transcripts from focus groups interviews(n = 19) were used for the evaluation, which was based on the Consolidated Criteria for Reporting Qualitative Research. RESULTS The design proved to be pertinent to resolve methodological stakes in a "fragile field". The mobilisation of collaborators as members of a "Sherpa team" in all phases of the project helped the team create a progressive focus approach well-adapted for data gathering and analysis as well as produce a high-quality database. CONCLUSION The Nesting Dolls Design including the didactic approach developed along the deployment of the project helped researchers, clinicians and resource patients/parents understand the research procedures and the roles of all collaborators. This fostered a meaningful engagement in the project. PRACTICE IMPLICATIONS Resources and time for training, communication and supervision are necessary to reach the objectives of collaborative research involving novices and are worth the time and efforts.
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Affiliation(s)
- Claude Julie Bourque
- Sainte-Justine University Hospital (CHUSJ) Research Center, Department of Pediatrics, University of Montréal, Montréal, Canada.
| | - Marco Bonanno
- Division of Hematology-Oncology, Sainte-Justine University Hospital, Montréal, Canada
| | - Émilie Dumont
- Department of Psychology, University of Montréal, Montréal, Canada
| | - Nathalie Gaucher
- Department of Pediatrics, University of Montréal, Division of Emergency Medicine, Sainte-Justine University Hospital, Montréal, Canada
| | | | - Mathias Gomez-Tyo
- Leucan (Québec association for parents of children with cancer), Montréal, Canada
| | - Marie-France Langlet
- Patients-Families-Providers Partnership Office, Sainte-Justine University Hospital, Montréal, Canada
| | - Serge Sultan
- Psycho-Oncology Center, Sainte-Justine University Hospital, Montréal, Canada
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11
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Calidad de Vida: a systematic review of quality of life in Latino cancer survivors in the USA. Qual Life Res 2020; 29:2615-2630. [PMID: 32430782 DOI: 10.1007/s11136-020-02527-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer is the leading cause of death among Hispanics/Latinos. Thus, understanding health-related quality of life (HRQOL) needs among this diverse racial/ethnic group is critical. Using Ferrell's multidimensional framework for measuring QOL, we synthesized evidence on HRQOL needs among Hispanic/Latino cancer survivors. METHODS We searched MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO, for English language articles published between 1995 and January 2020, reporting HRQOL among Hispanic/Latino cancer survivors in the USA. RESULTS Of the 648 articles reviewed, 176 met inclusion criteria, with 100 of these studies focusing exclusively on breast cancer patients and no studies examining end-of-life HRQOL issues. Compared with other racial/ethnic groups, Hispanics/Latinos reported lower HRQOL and a higher symptom burden across multiple HRQOL domains. Over 80% of studies examining racial/ethnic differences in psychological well-being (n = 45) reported worse outcomes among Hispanics/Latinos compared with other racial/ethnic groups. Hispanic/Latino cancer survivors were also more likely to report suboptimal physical well-being in 60% of studies assessing racial/ethnic differences (n = 27), and Hispanics/Latinos also reported lower social well-being relative to non-Hispanics/Latinos in 78% of studies reporting these outcomes (n = 32). In contrast, reports of spiritual well-being and spirituality-based coping were higher among Hispanics/Latinos cancer survivors in 50% of studies examining racial/ethnic differences (n = 15). DISCUSSION Findings from this review point to the need for more systematic and tailored interventions to address HRQOL needs among this growing cancer survivor population. Future HRQOL research on Hispanics/Latinos should evaluate variations in HRQOL needs across cancer types and Hispanic/Latino subgroups and assess HRQOL needs during metastatic and end-of-life disease phases.
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12
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Depressive complaints and utilization of mental health services: Comparison of adult cancer survivors of different ethnic origin. J Psychosom Res 2020; 130:109915. [PMID: 31918358 DOI: 10.1016/j.jpsychores.2019.109915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/04/2019] [Accepted: 12/26/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate depressive symptoms and mental health care utilization in adult cancer survivors (CS) of different ethnic origin. METHODS Mental health care utilization in dependence of depression (Patient Health Questionnaire, PHQ-9 ≥ 10) was analyzed in native German CS (GE) and in CS with Turkish (TR) or Polish (PL) migration background, recruited by a cancer registry. Frequencies and odds ratios (OR) were calculated. RESULTS 135 native German and 50 CS belonging to the first migration generation (TR: n = 25 and PL: n = 25) participated. TR showed the highest rate of depression (36.0%), followed by PL (32.0%), while GE revealed the lowest frequency (20.9%). The frequency of the utilization of mental health services was 17.4% (TR), 4.5% (PL) and 8.1% (GE). After adjusting for sociodemographic and clinical variables, no significant differences between the migrants and German CS were detected for the risk of being depressed, however a tendency for an increased risk in the migrant group was observed (OR = 2.53, CI = 0.96-6.65, p = .061). Female gender (OR = 3.88, CI = 1.29-11.68, p = .016) and prior psychological/psychiatric treatment (OR = 4.35, CI = 1.86-10.18, p = .001) were significantly associated with a higher risk of being depressed. CONCLUSION Contrastingly to numerous surveys, our results indicate no substantial differences between migrants and native CS, when adjusted for important confounders. High levels of migrants´ acculturation (good language proficiency, German citizenship/unlimited residence permit, long duration of stay in Germany) may contribute to eliminate inequalities caused by migration status in depressive symptomatology and mental health care utilization in CS.
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Kim CJ, Park HR, Schlenk EA, Kang SW, Seo EJ. The moderating role of acculturation mode on the relationship between depressive symptoms and health-related quality of life among international students in Korea. Arch Psychiatr Nurs 2019; 33:192-197. [PMID: 31753227 DOI: 10.1016/j.apnu.2019.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/28/2019] [Accepted: 08/18/2019] [Indexed: 11/18/2022]
Abstract
We examined the moderating role of acculturation mode on the relationship between depressive symptoms and health-related quality of life (HRQoL) in international students. This cross-sectional study enrolled a convenience sample of 147 international students at a university in Korea. Participants' overall HRQoL was moderate (mean = 57.2 of 80). The main and interaction effects of depressive symptoms and selected acculturation modes explained 39.9% of the variance in HRQoL. For all acculturation modes except the integration mode, as depressive symptom scores increased, HRQoL decreased. Specifically, at high depressive symptoms levels, participants with the marginalization, separation, and assimilation modes had worse HRQoL than did the integration mode, while HRQoL was similar for all acculturation modes at low depressive symptom levels. These findings suggest that future prospective intervention strategies should be considered for not only depressive symptoms levels, but also for different acculturation modes to enhance HRQoL in this population.
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Affiliation(s)
- Chun-Ja Kim
- Ajou University College of Nursing and Research Institute of Nursing Science, Suwon, South Korea.
| | - Hyung-Ran Park
- Department of Nursing Science, Chungbuk National University, Cheongju, South Korea.
| | | | - Se-Won Kang
- Department of Nursing Science, Dongseo University, Busan, South Korea.
| | - Eun Ji Seo
- Ajou University College of Nursing and Research Institute of Nursing Science, Suwon, South Korea.
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Physical Fitness of School-Age Children after Cancer Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081436. [PMID: 31018493 PMCID: PMC6518261 DOI: 10.3390/ijerph16081436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 01/28/2023]
Abstract
The aim of the study was to assess physical fitness of school-age children after cancer treatment. The study was comprised of one hundred and fifty six children-children after cancer treatment (n = 71, mean age 11.22 ± 3.11 years) vs. healthy children previously untreated for cancer (n = 85, mean age 10.71 ± 1.22 years). Physical fitness was assessed indirectly based on a ball throw (assessment of strength, coordination, and upper limb speed), long jump (assessment of jumping ability, speed, and coordination), and a 60 m run (assessment of speed). The analysis was performed based on the Student's t-test for independent samples and the analysis of variance and the post-hoc least significant difference test (LSD test). Children from the study group threw the ball closer and had shorter long jump performance compared to the control group, i.e., 12.93 [m] vs. 19.79 [m], respectively (p < 0.001) and 2.46 [m] vs. 2.70 [m], respectively (p = 0.02). However, their mean running time was longer, i.e., 13.33 [s] vs. 11.73 [s], respectively (p = 0.01). Division according to sex showed additionally significantly shorter ball throw distance in the study group in both girls (p = 0.001) and boys (p < 0.001), significantly shorter jump length in the group of girls (p = 0.01), and significantly longer running time in the group of boys (p = 0.04). Children treated for cancer are characterized by decreased physical fitness, and motor ability is sex-dependent. Both groups showed decreased strength, coordination, and upper limb speed. Additionally, worse jumping ability was found in girls whereas decreased speed was observed in boys.
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