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Zhu M, Patel RD, Dave P, Ohmann E, Laudano M, Lowe F, Donnelly J, Maria P, Sankin A, Small AC, Watts KL. Health-related Internet Use Among New Urology Clinic Patients. Urology 2024:S0090-4295(24)00898-7. [PMID: 39395456 DOI: 10.1016/j.urology.2024.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 09/15/2024] [Accepted: 10/06/2024] [Indexed: 10/14/2024]
Abstract
OBJECTIVE To assess internet usage among new patients seen by urologists and impact on post-consultation understanding for 4 common conditions: kidney stones, elevated prostate-specific antigen, male voiding, and female voiding. METHODS We performed a prospective study of new urology patients at our diverse urban, academic urology practice for the above conditions over a 1-year period. A voluntary questionnaire assessed patients' internet use related to referred conditions prior to encounters. Questions evaluated quality of information and patient understanding of symptoms/condition at baseline, after online searches, and after their urology visit. A patient-reported Likert scale of 1 (poor) to 10 (excellent) was used and internet "searchers" were compared to "non-searchers." RESULTS Two hundred fifteen patients participated. Most respondents were Latino (41%) or Black (35%) and English-speaking (81%). Cohorts comprised 130 searchers (60%) and 85 non-searchers (40%). Searchers were significantly younger (median 53 vs 63 years, P <.001), more likely to have home internet access (P <.001), and more general medical internet use (P <.001). Overall, patients' understanding of visit diagnoses increased after their encounters (median pre-visit rating 5 vs post-visit rating 10). Searchers reported a greater post-visit understanding compared to non-searchers (median rating 10 vs 9, P <.001), and a greater change in understanding from baseline (median +4 vs +3, P = .02). CONCLUSION Internet use is common amongst younger patients referred to urologists and may be associated with improved understanding of their condition after urologic consultation. Continued investigation of patient uses and attitude towards popular online resources can help urologists curate resources to benefit patients and providers alike.
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Affiliation(s)
- Michael Zhu
- Albert Einstein College of Medicine, Bronx, NY
| | - Rutul D Patel
- Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Priya Dave
- Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Erin Ohmann
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Melissa Laudano
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Franklin Lowe
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Jillian Donnelly
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Pedro Maria
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Alex Sankin
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Alexander C Small
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY
| | - Kara L Watts
- Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Department of Urology, Bronx, NY.
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Gillis A, Zmijewski P, Mcleod MC, Lindeman B, Fazendin J, Chen H, Bhatia S. Racial implications of time to surgery in disparities in thyroid cancer survival. Am J Surg 2024; 234:85-91. [PMID: 38519403 DOI: 10.1016/j.amjsurg.2024.02.002] [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: 07/25/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION The influence of time to surgery on racial/ethnic disparities in papillary thyroid carcinoma (PTC) survival remains unstudied. MATERIALS AND METHODS The National Cancer Database (2004-2017) was queried for patients with localized PTC. Survival data was compared by time to surgery, patient demographics, and multivariable Cox regression was performed. RESULTS Of 126,708 patients included, 5% were Black, 10% Hispanic. Of all patients, 85% had no comorbidities. Non-Hispanic White (NHW) patients had a shorter median time to surgery than Black and Hispanic patients (36 vs. 43 vs. 42 days, respectively p < 0.001). In multivariable analysis, longer time to surgery (>90 days vs < 30 days) and Black race vs NHW, were associated with worse survival (HR: 1.56, (95%CI, 1.43-1.70), p < 0.001 and HR: 1.21, (1.08-1.36), p = 0.001), respectively. CONCLUSION Delaying surgery for thyroid cancer is associated with worse survival. However, independent of time to surgery and other confounders, there remains a disparity as black patients have poorer outcomes.
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Affiliation(s)
- Andrea Gillis
- University of Alabama At Birmingham, Department of General Surgery, USA.
| | - Polina Zmijewski
- University of Alabama At Birmingham, Department of General Surgery, USA
| | - M Chandler Mcleod
- University of Alabama At Birmingham, Department of General Surgery, USA
| | - Brenessa Lindeman
- University of Alabama At Birmingham, Department of General Surgery, USA
| | - Jessica Fazendin
- University of Alabama At Birmingham, Department of General Surgery, USA
| | - Herbert Chen
- University of Alabama At Birmingham, Department of General Surgery, USA
| | - S Bhatia
- University of Alabama At Birmingham, Department of General Pediatrics, USA
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Fisher Y, Zmijewski P, McLeod C, Patel A, Bahl D, Rosenblum F, Lin D, Gonzalez ML, Fazendin J, Chen H, Lindeman B, Gillis A. Evaluating Patients' Health Literacy to Improve Thyroid Pathology Reports. J Surg Res 2024; 299:34-42. [PMID: 38701702 PMCID: PMC11189726 DOI: 10.1016/j.jss.2024.03.003] [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: 08/21/2023] [Revised: 12/11/2023] [Accepted: 03/11/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION As our growing population demonstrates a significant increase in the incidence of thyroid cancer, so does patient access to their medical records. Poor health literacy and understanding of disease severity, underscores the importance of effective and accessible patient-doctor communication. No previous studies on patient understanding of thyroid pathology reports exist; therefore, we sought to characterize health literacy in this population. METHODS Using a modified Delphi technique, a 12-question multiple-choice survey regarding common pathology terms with possible definitions for each term was synthesized and administered to patients in a high-volume endocrine surgery clinic. Survey results, patient demographics, history of prior thyroid procedure (biopsy or surgery), and self-reported health literacy were collected. Data analysis included t tests, chi-squared, and multivariable linear regression using R. RESULTS The survey was completed by 54 patients (response rate: 69.8%). On univariate analysis, White race, previous thyroid procedure, and at least a high school level education were all more likely to score higher on the survey than their counterparts (P < 0.05). On multivariable logistic regression for predicting a higher survey score, only race (est: 2.48 [95% confidence interval: 1.01-3.96]) and higher educational attainment (est: 3.98 [95% confidence interval: 2.32-5.64]) remained predictive (P < 0.05). The remaining demographic groups (age, health literacy confidence, and previous thyroid procedure) did not show a statistically significant difference. CONCLUSIONS Overall, terms on a thyroid pathology report are poorly understood by patients. This is exacerbated by non-White race and low educational attainment. There is a need for patient-facing pathology education.
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Affiliation(s)
- Yasmin Fisher
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Polina Zmijewski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Chandler McLeod
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Anish Patel
- Department of Endocrinology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Deepti Bahl
- Department of Endocrinology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Frida Rosenblum
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Diana Lin
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Manuel Lora Gonzalez
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jessica Fazendin
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brenessa Lindeman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrea Gillis
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
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Lin X, Qulian G, Bai Y, Liu Q. Differences in the knowledge, attitudes, and needs of caregivers and healthcare providers regarding palliative care: a cross-sectional investigation in pediatric settings in China. BMC Nurs 2024; 23:386. [PMID: 38844953 PMCID: PMC11155171 DOI: 10.1186/s12912-024-02052-2] [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: 12/20/2023] [Accepted: 05/30/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Countries abroad have implemented pediatric palliative treatment for several years; however, complete pediatric palliative treatment guidelines and legal guidance remain lacking in China, making the implementation of palliative care difficult. PURPOSE This study aimed to understand the current situation, similarities, and differences in the knowledge, attitudes, and needs of caregivers and healthcare providers regarding palliative care for children. METHODS This cross-correlation study collected data from pediatric and neonatal intensive care units of four hospitals in China. The participants comprised 180 caregivers and 172 healthcare providers. The measurement tools included the palliative care knowledge scale, palliative care attitude scale, and pediatric palliative care needs scale. This study adhered to the STROBE reporting guidelines. RESULTS Significant differences in palliative care knowledge, attitudes, and needs were observed between caregivers and healthcare providers (p < 0.005). Pediatric healthcare providers demonstrated higher knowledge and positive attitudes regarding palliative care than caregivers. Needs for communication in general and relief from pain and other symptoms of caregivers were higher than those of healthcare providers (p < 0.001). Furthermore, palliative care attitude and needs of healthcare providers were positively correlated with each other (r = 0.212, p < 0.005). CONCLUSION Pediatric healthcare providers and caregivers demonstrated different perceptions of needs for palliative care. The results of this study can serve as a reference for the future development of guidelines related to children's needs and related interventions.
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Affiliation(s)
- Xi Lin
- Department of Pediatrics, Children Hematological Oncology and Birth Defects Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, 646000, Sichuan, P. R. China
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Guo Qulian
- Department of Pediatrics, Children Hematological Oncology and Birth Defects Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, 646000, Sichuan, P. R. China
| | - Yongqi Bai
- Department of Pediatrics, Children Hematological Oncology and Birth Defects Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China.
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Qin Liu
- Department of Pediatrics, Children Hematological Oncology and Birth Defects Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China.
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Chen DW, Ospina NS, Haymart MR. Social Determinants of Health and Disparities in Thyroid Care. J Clin Endocrinol Metab 2024; 109:e1309-e1313. [PMID: 38057150 PMCID: PMC10876391 DOI: 10.1210/clinem/dgad716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND There have been documented racial and ethnic disparities in the care and clinical outcomes of patients with thyroid disease. CONTEXT Key to improving disparities in thyroid care is understanding the context for racial and ethnic disparities, which includes acknowledging and addressing social determinants of health. Thyroid disease diagnosis, treatment, and survivorship care are impacted by patient- and system-level factors, including socioeconomic status and economic stability, language, education, health literacy, and health care systems and health policy. The relationship between these factors and downstream clinical outcomes is intricate and complex, underscoring the need for a multifaceted approach to mitigate these disparities. CONCLUSION Understanding the factors that contribute to disparities in thyroid disease is critically important. There is a need for future targeted and multilevel interventions to address these disparities, while considering societal, health care, clinician, and patient perspectives.
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Affiliation(s)
- Debbie W Chen
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
| | - Naykky Singh Ospina
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
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Chen DW, Lang BHH, McLeod DSA, Newbold K, Haymart MR. Thyroid cancer. Lancet 2023; 401:1531-1544. [PMID: 37023783 DOI: 10.1016/s0140-6736(23)00020-x] [Citation(s) in RCA: 108] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 04/08/2023]
Abstract
The past 5-10 years have brought in a new era in the care of patients with thyroid cancer, with the introduction of transformative diagnostic and management options. Several international ultrasound-based thyroid nodule risk stratification systems have been developed with the goal of reducing unnecessary biopsies. Less invasive alternatives to surgery for low-risk thyroid cancer, such as active surveillance and minimally invasive interventions, are being explored. New systemic therapies are now available for patients with advanced thyroid cancer. However, in the setting of these advances, disparities exist in the diagnosis and management of thyroid cancer. As new management options are becoming available for thyroid cancer, it is essential to support population-based studies and randomised clinical trials that will inform evidence-based clinical practice guidelines on the management of thyroid cancer, and to include diverse patient populations in research to better understand and subsequently address existing barriers to equitable thyroid cancer care.
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Affiliation(s)
- Debbie W Chen
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Brian H H Lang
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Donald S A McLeod
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Kate Newbold
- Thyroid Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Megan R Haymart
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
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Giovanni RE, Francesca B, Anna N, Cristina N, Marco P, Linda N, Pasquale GC, Fabio F, Rosaria F, Franco C, Mariella DS, Tommaso C, Chiara M, Irene S, Sonia B, Luigi DS, Filippo B, Francesca M, Cristina P, Alessandra S, Enrico T, Gianni A. Integrating conventional and complementary treatments in cancer care: The process within the public healthcare system of the region of Tuscany, Italy. Complement Ther Clin Pract 2023; 51:101738. [PMID: 36812736 DOI: 10.1016/j.ctcp.2023.101738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Affiliation(s)
- Rossi Elio Giovanni
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy.
| | - Bosinelli Francesca
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy
| | - Navari Anna
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy
| | - Noberasco Cristina
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy
| | - Picchi Marco
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy
| | - Nurra Linda
- Clinic for Complementary Medicine and Diet in Oncology, Local Health Unit Tuscany North West, Lucca, Italy
| | - Guido Carmelo Pasquale
- Center for Acupuncture and Traditional Chinese Medicine, Local Health Unit Central Tuscany, Firenze, Italy
| | - Firenzuoli Fabio
- Integrative Medicine Center, CERFIT, University Hospital of Careggi Hospital, Firenze, Italy
| | - Ferreri Rosaria
- Center for Integrative Medicine, Hospital of Pitigliano, Local Health Unit South East Tuscany, Grosseto, Italy
| | - Cracolici Franco
- Center for Integrative Medicine, Hospital of Pitigliano, Local Health Unit South East Tuscany, Grosseto, Italy
| | | | - Conti Tommaso
- Tuscan Regional Center for Integrative Medicine, Firenze, Italy
| | | | - Sacco Irene
- Tuscan Regional Center for Integrative Medicine, Firenze, Italy
| | - Baccetti Sonia
- Tuscan Regional Center for Integrative Medicine, Firenze, Italy
| | | | - Bosco Filippo
- Breast Unit, AOUP, University Hospital of Pisa, Italy
| | | | - Pennucci Cristina
- Oncology Department, Local Health Unit Tuscany North West, Carrara, Italy
| | | | - Tucci Enrico
- Oncology Department, Local Health Unit South East Tuscany, Arezzo, Italy
| | - Amunni Gianni
- Coordinator for the Tuscan Oncology Network, University Hospital of Careggi, Firenze, Italy
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Greaney ML, Xu F, Ward-Ritacco CL, Cohen SA, Ellis KA, Riebe D. Does Healthcare Provider Counseling for Weight Management Behaviors among Hispanic Adults Who Are Overweight/Obese Vary by Acculturation Level? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2778. [PMID: 36833475 PMCID: PMC9957032 DOI: 10.3390/ijerph20042778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
This cross-sectional study explored differences in the receipt of health care provider (HCP) counseling to control/lose weight and adopt weight-related lifestyle behavior changes among Hispanic respondents according to acculturation level. Differences in reported action regarding HCP counseling were also examined. Data from four National Health and Nutrition Examination Survey (NHANES) cycles (2011-2018) were analyzed, with the analytic sample limited to Hispanic respondents who were overweight/obese. Respondents' acculturation levels were derived from their reported country of origin and the primary language spoken at home. Respondents who reported speaking only Spanish or more Spanish than English at home were classified as primarily speaking Spanish at home. In contrast, those who reported speaking Spanish and English equally, more English than Spanish, or only English were categorized as primarily speaking English at home. Weighted multivariate logistic regression models were utilized to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to determine if differences in acculturation levels existed regarding the likelihood of receiving HCP counseling to (1) control/lose weight, (2) increase exercise/PA, and (3) reduce fat/calorie intake. Similar analyses examined differences in reported action regarding HCP counseling according to acculturation level. The analysis found no significant differences in receiving HCP counseling according to acculturation level. However, non-US-born respondents who primarily spoke Spanish at home were less likely than US-born respondents to report acting to control/lose weight (p = 0.009) or increase exercise/PA (p = 0.048), but were more likely to report having taken action to reduce fat/calorie intake (p = 0.016). This study revealed differences between acting on recommendations of health care professionals according to acculturation level, indicating a need for interventions tailored to acculturation levels.
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Affiliation(s)
- Mary L. Greaney
- Department of Health Studies, University of Rhode Island, Kingston, RI 02881, USA
| | - Furong Xu
- School of Education, University of Rhode Island, Kingston, RI 02881, USA
| | | | - Steven A. Cohen
- Department of Health Studies, University of Rhode Island, Kingston, RI 02881, USA
| | - Kerri A. Ellis
- College of Nursing, University of Rhode Island, Kingston, RI 02881, USA
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA
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Genere N, Papaleontiou M. Setting the Tone-Pretreatment Understanding Is Associated With Treatment-Related Expectations Among Thyroid Cancer Survivors. JAMA Otolaryngol Head Neck Surg 2023; 149:120-121. [PMID: 36580317 DOI: 10.1001/jamaoto.2022.4110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Natalia Genere
- Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St Louis, Missouri
| | - Maria Papaleontiou
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor.,Institute of Gerontology, University of Michigan, Ann Arbor
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Abstract
Thyroid disease affects an estimated 20 million Americans, with 1 in 8 women developing a thyroid disorder during her lifetime. Although most patients with thyroid cancer have a good prognosis and effective treatments for benign thyroid disease are available, disparities exist in thyroid care and result in worse outcomes for racial and ethnic minorities. Inequities in the diagnosis and treatment of thyroid disease are due to the complex interplay of systems-, physician-, and patient-level factors. Thus, innovative strategies that take an ecological approach to addressing racial disparities are needed to achieve equitable care for all patients with thyroid disease.
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Affiliation(s)
- Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI 48106, USA.
| | - Michael W Yeh
- Section of Endocrine Surgery, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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Jackson Levin N, Zhang A, Reyes-Gastelum D, Chen DW, Hamilton AS, Zebrack B, Haymart MR. Change in worry over time among Hispanic women with thyroid cancer. J Cancer Surviv 2021; 16:844-852. [PMID: 34633638 DOI: 10.1007/s11764-021-01078-8] [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: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to assess change in worry over time in Hispanic women with thyroid cancer. METHODS Worry about recurrence, quality of life, family at risk, death, and harm from treatments was assessed in 273 Hispanic women with thyroid cancer diagnosed in 2014-2015. Subjects were recruited from Surveillance, Epidemiology, and End Results (SEER) Los Angeles. Participants were surveyed at two points in time (time 1: 2017-2018 and time 2: 2019). Multivariable logistic regression was used to determine correlates with high worry (somewhat, quite a bit, very much) versus low worry (not at all, a little) at time 2. RESULTS For the five worry items, 20.1-39.6% had high worry at both time 1 and time 2. An additional 7.6-13.4% had low worry at time 1 that became high worry at time 2. In multivariable logistic regression controlling for age, recurrence status, education level, and number of complications or side effects symptoms, younger age (20-39) as compared to older (40-79) was associated with high worry about thyroid cancer recurrence (OR 2.16, 95% CI 1.12-4.17). History of recurrent or persistent disease was associated with high worry about harms from treatment (OR 2.94, 95% CI 1.29-6.67). Greater number of complications or side effects of symptoms was associated with more worry across all five items. CONCLUSIONS Some Hispanic women with thyroid cancer have persistently high worry, with young adult Hispanic women vulnerable to worry about recurrence. IMPLICATIONS FOR CANCER SURVIVORS Hispanic women with thyroid cancer may benefit from targeted psychosocial support during survivorship, with interventions informed by patient and cancer characteristics.
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Affiliation(s)
- Nina Jackson Levin
- School of Social Work and Department of Anthropology, University of Michigan, 1080 S. University Ave, Room B660, Ann Arbor, MI, 48109, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, 1080 S. University, Room 3704, Ann Arbor, MI, 48109, USA
| | - David Reyes-Gastelum
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Bldg. 16, 400S-20, MI, 48109, Ann Arbor, USA
| | - Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Domino's Farms (Lobby C, Suite 1300), 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI, 48106, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., SSB318E, MC9239, Los Angeles, CA, 90089-9239, USA
| | - Bradley Zebrack
- School of Social Work, University of Michigan, 1080 S. University, Room 2778, Ann Arbor, MI, 48109, USA
| | - Megan R Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA.
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