Cancer Screening Behaviors and Associations with Childhood Trauma, Resiliency, and Patient-Provider Relationships: Findings from an Exploratory Study of Appalachian Cervical Cancer Survivors.
JOURNAL OF APPALACHIAN HEALTH 2023;
5:22-37. [PMID:
38023113 PMCID:
PMC10629890 DOI:
10.13023/jah.0501.03]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction
Adverse childhood experiences (ACEs) are associated with increased cancer risk. ACEs may affect this risk in a variety of ways, including cancer screening compliance. ACEs can contribute to mistrust in the medical profession, inhibit patient-provider relationships and cause at-risk individuals to miss critical access points to preventive services. Protective factors may play an important role in mitigating ACE-related consequences by supporting resiliency.
Purpose
This study assesses the associations between ACEs, protective factors, patient-provider relationships, stage of cancer at diagnosis, and cancer screening behaviors for West Virginia (WV) cervical cancer survivors.
Methods
WV cervical cancer survivors diagnosed between 2000 and 2020 were mailed a survey which included questions on demographic information and cancer screening behaviors, alongside three scales to measure depth of patient-provider relationships, ACEs, and protective factors.
Results
Ninety participants completed the survey. ACEs were associated with weaker patient-provider relationships (p < .01) and fewer protective factors (p < .01). More protective factors were associated with stronger patient-provider relationships (p < .01), earlier stage of cancer at diagnosis (p < .05) and positive cancer screening behaviors. Positive cancer screening behaviors were associated with deeper patient-provider relationships (p < .05). A statistically significant model (p = .004) using ACE and resilience scores was able to account for 13% of the explained variability in depth of patient-provider relationships.
Implications
These findings suggest an important interplay between ACEs, protective factors, and patient-provider relationships on cancer screening behaviors. Future studies should consider these variables in different populations. In addition, interventions focused on enhancing patient-provider relationships and supporting acquisition of protective factors should be considered.
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