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Smrke U, Abalde-Cela S, Loly C, Calbimonte JP, Pires LR, Lin S, Sánchez A, Tement S, Mlakar I. Quality of Life of Colorectal Cancer Survivors: Mapping the Key Indicators by Expert Consensus and Measures for Their Assessment. Healthcare (Basel) 2024; 12:1235. [PMID: 38921349 PMCID: PMC11203183 DOI: 10.3390/healthcare12121235] [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: 03/26/2024] [Revised: 05/15/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (physical and psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. The findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.
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Affiliation(s)
- Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
| | - Sara Abalde-Cela
- RUBYnanomed LDA, Praça Conde de Agrolongo, 4700-314 Braga, Portugal
| | - Catherine Loly
- Gastroenterology Department, University Hospital of Liège, 4000 Liège, Belgium
| | - Jean-Paul Calbimonte
- Institute of Informatics, University of Applied Sciences and Arts Western Switzerland HES-SO, 3960 Sierre, Switzerland
- The Sense Innovation & Research Center, 1007 Lausanne, Switzerland
| | - Liliana R. Pires
- RUBYnanomed LDA, Praça Conde de Agrolongo, 4700-314 Braga, Portugal
| | - Simon Lin
- Science Department, Symptoma GmbH, 5020 Vienna, Austria
- Department of Internal Medicine, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Alberto Sánchez
- Department of eHealth, Galician Research & Development Center in Advanced Telecommunications (GRADIANT), 26334 Vigo, Spain
| | - Sara Tement
- Department of Psychology, Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia
| | - Izidor Mlakar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
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R K, L S, P B, S G, R LP. Psychosocial experiences of breast cancer survivors: a meta-review. J Cancer Surviv 2024; 18:84-123. [PMID: 36854799 PMCID: PMC10866753 DOI: 10.1007/s11764-023-01336-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/15/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Advances in breast cancer care have led to a high rate of survivorship. This meta-review (systematic review of reviews) assesses and synthesises the voluminous qualitative survivorship evidence-base, providing a comprehensive overview of the main themes regarding breast cancer survivorship experiences, and areas requiring further investigation. METHODS Sixteen breast cancer reviews identified by a previous mixed cancer survivorship meta-review were included, with additional reviews published between 1998 and 2020, and primary papers published after the last comprehensive systematic review between 2018 and 2020, identified via database searches (MEDLINE, Embase, CINAHL, PsycINFO). Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and the CASP (Critical Appraisal Skills Programme Qualitative) checklist for primary studies. A meta-ethnographic approach was used to synthesise data. RESULTS Of 1673 review titles retrieved, 9 additional reviews were eligible (25 reviews included in total). Additionally, 76 individual papers were eligible from 2273 unique papers. Reviews and studies commonly focused on specific survivorship groups (including those from ethnic minorities, younger/older, or with metastatic/advanced disease), and topics (including return to work). Eight themes emerged: (1) Ongoing impact and search for normalcy, (2) Uncertainty, (3) Identity: Loss and change, (4) Isolation and being misunderstood, (5) Posttraumatic growth, (6) Return to work, (7) Quality of care, and (8) Support needs and coping strategies. CONCLUSIONS Breast cancer survivors continue to face challenges and require interventions to address these. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors may need to prepare for ongoing psychosocial challenges in survivorship and proactively seek support to overcome these.
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Affiliation(s)
- King R
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Stafford L
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Butow P
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Giunta S
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Laidsaar-Powell R
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia.
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Binkley JM, Gabram S, Finley J, Fowler D, VanHoose L, McCullough LE. Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums. J Cancer Surviv 2023:10.1007/s11764-023-01373-6. [PMID: 37040001 DOI: 10.1007/s11764-023-01373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/25/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation exist for all BC survivors but are magnified in Black BC survivors. The purpose of this qualitative research was to document patient, clinician, and researchers' perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship. METHODS A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues, and potential solutions surrounding racial disparity in BC survivorship. Forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or BC. RESULTS Three main themes were identified related to racial disparity in BC survivorship: (1) societal and cultural contributing factors, (2) contribution of healthcare providers and systems, and (3) models of care and research considerations. CONCLUSIONS The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Increased awareness related to racial disparity in BC survivorship among survivors, healthcare providers, and researchers will contribute to health equity and improved outcomes for Black individuals.
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Affiliation(s)
- Jill M Binkley
- TurningPoint Breast Cancer Rehabilitation, Atlanta, GA, USA.
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA.
| | - Sheryl Gabram
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
- Georgia Center for Oncology Research and Education, Atlanta, GA, USA
| | - Janae Finley
- TurningPoint Breast Cancer Rehabilitation, Atlanta, GA, USA
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
| | | | - Lisa VanHoose
- Global Access to Breast Cancer Rehabilitation Community Partnership Initiative, Atlanta, GA, USA
- College of Saint Mary, Omaha, NE, USA
- The Ujima Center, Monroe, LA, USA
| | - Lauren E McCullough
- Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Establishing an Expert Consensus on Key Indicators of the Quality of Life among Breast Cancer Survivors: A Modified Delphi Study. J Clin Med 2022; 11:jcm11072041. [PMID: 35407649 PMCID: PMC8999421 DOI: 10.3390/jcm11072041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: The needs of cancer survivors are often not reflected in practice. One of the main barriers of the use of patient-reported outcomes is associated with data collection and the interpretation of patient-reported outcomes (PROs) due to a multitude of instruments and measuring approaches. The aim of the study was to establish an expert consensus on the relevance and key indicators of quality of life in the clinical practice of breast cancer survivors. (2) Methods: Potential indicators of the quality of life of breast cancer survivors were extracted from the established quality of life models, depicting survivors’ perspectives. The specific domains and subdomains of quality of life were evaluated in a two-stage online Delphi process, including an international and multidisciplinary panel of experts. (3) Results: The first round of the Delphi process was completed by 57 and the second by 37 participants. A consensus was reached for the Physical and Psychological domains, and on eleven subdomains of quality of life. The results were further supported by the additional ranking of importance of the subdomains in the second round. (4) Conclusions: The current findings can serve to optimize the use of instruments and address the challenges related to data collection and interpretation as the facilitators of the adaption in routine practice.
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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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Ceballos RM, Hohl SD, Molina Y, Hempstead B, Thompson-Dodd J, Weatherby S, Malen RC. Oncology provider and African-American breast cancer survivor perceptions of the emotional experience of transitioning to survivorship. J Psychosoc Oncol 2020; 39:35-53. [PMID: 32400316 PMCID: PMC8856584 DOI: 10.1080/07347332.2020.1752880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To examine the emotional experience of African American breast cancer survivors (BCS), and the information exchange between providers and patients, during transitioning to post-treatment survivorship. RESEARCH APPROACH We conducted a qualitative study using interviews and focus groups. PARTICIPANTS We sought perspectives of oncology providers (n = 27) and African-American breast cancer survivors (BCS) (n = 45) who provided and received care in three counties in Washington State. METHODS African-American community consultants conducted interviews and focus groups. Thematic coding and constant comparison were applied to identify emergent themes. FINDINGS Participants reported emotional health information and support were needed but not consistently provided, resulting in a sense of survivor isolation. Systemic challenges limited providers' ability to deliver emotional support information. Survivors and providers expressed similar understandings of the emotional impact of transition, but each group highlighted different, yet complementary priorities to address emotional needs of African-American BCS. CONCLUSIONS There is congruence between African-American BCS and oncology providers perceptions of the emotional experience of transitioning to post-treatment survivorship, but patients are not receiving adequate information and resources to help them adequately address their emotional needs. IMPLICATIONS FOR POLICY Improved care continuity, team-based approaches, and partnerships between health systems and community organization partnerships may help patients and providers recognize and address emotional needs during the transition.
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Affiliation(s)
- Rachel M. Ceballos
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Sarah D. Hohl
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Yamile Molina
- School of Public Health, University of Illinois-Chicago, Chicago, Illinois, USA
| | | | | | | | - Rachel C. Malen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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A meta-review of qualitative research on adult cancer survivors: current strengths and evidence gaps. J Cancer Surviv 2019; 13:852-889. [DOI: 10.1007/s11764-019-00803-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/19/2019] [Indexed: 12/22/2022]
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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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An Integrative Review of Psychosocial Concerns Among Young African American Breast Cancer Survivors. Cancer Nurs 2018; 41:139-155. [DOI: 10.1097/ncc.0000000000000477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Adorno G, Lopez E, Burg MA, Loerzel V, Killian M, Dailey AB, Iennaco JD, Wallace C, Sharma DKB, Stein K. Positive aspects of having had cancer: A mixed-methods analysis of responses from the American Cancer Society Study of Cancer Survivors-II (SCS-II). Psychooncology 2017. [PMID: 28637082 DOI: 10.1002/pon.4484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study focused on understanding positive aspects of cancer among a large, national sample of survivors, 2, 5, and 10 years' postcancer diagnosis, who responded to the American Cancer Society Study of Cancer Survivors - II (SCS-II) survey "Please tell us about any positive aspects of having cancer." METHODS A sequential mixed methods approach examined (1) thematic categories of positive aspects from cancer survivors (n = 5149) and (2) variation in themes by sociodemographics, cancer type, stage of disease, and length of survivorship. RESULTS Themes comprised 21 positive aspects within Thornton's typology of benefits that cancer survivors attribute to their illness: life perspectives, self, and relationships. New themes pertaining to gratitude and medical support during diagnosis and treatment, health-related changes, follow-up/surveillance, and helping others emerged that are not otherwise included in widely used existing benefit finding cancer scales. Gratitude and appreciation for life were the most frequently endorsed themes. Sociodemographics and stage of disease were associated with positive aspect themes. Themes were not associated with survivor cohorts. CONCLUSIONS No differences in perceived positive aspects across survivor cohorts suggest that positive aspects of cancer may exist long after diagnosis for many survivors. However, variation across sociodemographics and clinical variables suggests cancer survivors differentially experience positive aspects from their cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS This analysis provides new information about cancer survivors' perceptions of positive aspects from their cancer and factors associated with benefit finding and personal growth. This information can be useful in further refining quality-of-life measures and interventions for cancer survivors.
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Affiliation(s)
- Gail Adorno
- School of Social Work, University of Texas Arlington, Arlington, TX, USA
| | - Ellen Lopez
- Department of Psychology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Mary Ann Burg
- College of Health and Public Affairs, University of Central Florida, Orlando, FL, USA
| | - Victoria Loerzel
- College of Nursing, University of Central Florida College of Nursing, Orlando, FL, USA
| | - Michael Killian
- School of Social Work, University of Texas Arlington, Arlington, TX, USA
| | - Amy B Dailey
- Health Sciences, Gettysburg College, Gettysburg, PA, USA
| | | | - Cara Wallace
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | | | - Kevin Stein
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Barsevick AM, Leader A, Bradley PK, Avery T, Dean LT, DiCarlo M, Hegarty SE. Post-treatment problems of African American breast cancer survivors. Support Care Cancer 2016; 24:4979-4986. [PMID: 27543161 DOI: 10.1007/s00520-016-3359-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/18/2016] [Indexed: 01/04/2023]
Abstract
PURPOSE African American breast cancer survivors (AABCS) have a lower survival rate across all disease stages (79 %) compared with White survivors (92 %) and often have more aggressive forms of breast cancer requiring multimodality treatment, so they could experience a larger burden of post-treatment quality of life (QOL) problems. This paper reports a comprehensive assessment of the number, severity, and domains of problems faced by AABCS within 5 years after treatment completion and identifies subgroups at risk for these problems. METHODS A population-based random sample was obtained from the Pennsylvania Cancer Registry of African American females over 18 years of age who completed primary treatment for breast cancer in the past 5 years. A mailed survey was used to document survivorship problems. RESULTS Two hundred ninety-seven AABCS completed the survey. The median number of survivor problems reported was 15. Exploratory factor analysis of the problem scale revealed four domains: emotional problems, physical problems, lack of resources, and sexuality problems. Across problem domains, younger age, more comorbid conditions, and greater medical mistrust were risk factors for more severe problems. CONCLUSIONS The results demonstrated that AABCS experienced significant problem burden in the early years after diagnosis and treatment. In addition to emotional and physical problem domains that were documented in previous research, two problem domains unique to AABCS included lack of resources and sexuality concerns. At risk groups should be targeted for intervention. The study results reported in this manuscript will inform future research to address problems of AABCS as they make the transition from cancer patient to cancer survivor.
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Affiliation(s)
- Andrea M Barsevick
- Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA.
| | - Amy Leader
- Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA
| | | | | | | | - Melissa DiCarlo
- Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA
| | - Sarah E Hegarty
- Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA
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Murphy J, Mollica M. All Hands on Deck: Nurses and Cancer Care Delivery in Women's Health. Front Oncol 2016; 6:174. [PMID: 27500124 PMCID: PMC4956645 DOI: 10.3389/fonc.2016.00174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 07/07/2016] [Indexed: 12/04/2022] Open
Affiliation(s)
- Jeanne Murphy
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Michelle Mollica
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
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Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors. J Cancer Surviv 2015; 9:441-9. [PMID: 25576214 DOI: 10.1007/s11764-014-0420-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 12/06/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE This study explored the relationships between systemic- and individual-level contextual factors and health-related quality of life (HRQOL) in a cohort of African American and Latina breast cancer survivors (BCS). METHODS Baseline questionnaire data of 320 BCS who participated in a HRQOL psycho-educational intervention were abstracted from the parent study. Hierarchical regression analysis tested the independent effects of contextual factors on HRQOL. RESULTS HRQOL was higher in BCS who: were diagnosed at < stage 2 (b = -1.38, p < 0.05), expressed satisfaction with their health care (b = 0.20, p < 0.001), had fewer comorbidities (b = - 0.60, p < 0.001) and depressive symptoms (b = -0.30, p < 0.001), and practiced healthy diet and exercise habits (b = 0.02, p < 0.05). Demographic and cancer-related factors accounted for 14 % of the variance in HRQOL (F[6, 274] = 7.25, p < 0.001). The socio-cultural context (i.e., ethnicity, life stress, perceived social support) explained 20 % of the variance in HRQOL (FΔ[3, 271] = 27.32, p < 0.001). The health care system context contributed an additional 8 % to explaining HRQOL (FΔ[1, 270] = 34.88, p < 0.001). Health status and behavioral factors accounted for 18 % of the variance (FΔ[4, 266] = 29.55, p < 0.001). The full model explained 59 % of the variance in HRQOL (F[14, 266] = 27.76, p < 0.001). CONCLUSIONS HRQOL in ethnic minority BCS is multifaceted and is significantly influenced by cancer-related, socio-cultural, health care system, health status, and behavioral contextual factors. Therefore, survivorship research and practice must address broad multi-level domains to achieve equitable and optimal breast cancer outcomes. IMPLICATIONS FOR CANCER SURVIVORS To enhance HRQOL, survivors must be provided the know-how and support to maintain healthy lifestyle and self-management practices. Advocates must engage the care team to consider systemic factors, including life stress and community resources, to be more patient-centered.
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Ashing KT, Miller AM, Mitchell E, Martin V, McDowell K, Santifer R, Smith J, Brown S, Ragin C, Carrington A. Nurturing Advocacy Inclusion to Bring Health Equity in Breast Cancer among African American Women. BREAST CANCER MANAGEMENT 2014; 3:487-495. [PMID: 26913082 DOI: 10.2217/bmt.14.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This paper will present the multiple roles and the impact of cancer advocates. The emerging literature provides evidence for the consideration and integration of African American BC survivors as advocates in practice, policy and research relevant to cancer prevention and control. We present a practical outline for organizational assessment for the inclusion of advocates in these arenas. This assessment can be conducted by all levels of partners, including community advocacy and scientific organizations.
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Affiliation(s)
- Kimlin Tam Ashing
- Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Aria M Miller
- Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
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Seliktar N, Polek C, Brooks A, Hardie T. Cognition in breast cancer survivors: hormones versus depression. Psychooncology 2014; 24:402-7. [PMID: 25044780 DOI: 10.1002/pon.3602] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 05/12/2014] [Accepted: 05/19/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND OBJECTIVE Breast cancer survivors receiving hormone treatment and/or endorsing histories of receiving chemotherapy report changes in their cognitive capacity, which is often not supported by formal testing. To address these conflicting reports, this study examined survivors' applied cognitive capacity and its association with hormone treatment, depression, and selected demographics. METHODS A descriptive, correlational, cross-sectional survey design was employed. There were 357 women who completed a survey comprised of 69 questions. The survey included both investigator-developed questions and instruments from the PROMIS(®) system. RESULTS There were significant main effects for hormone therapy, race, and depression. Depression explained the largest portion of variance of the perceived decreases in cognitive function among breast cancer survivors. CONCLUSIONS Survivor complaints of changes in cognitive function may be a predictor for evaluating the presence of mood disorders and less a function of hormone therapy or chemotherapy history.
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Affiliation(s)
- Naomi Seliktar
- Interdisciplinary Research Unit, Drexel University, Philadelphia, PA, USA
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