Disparities in barriers to follow-up care between African American and White breast cancer survivors.
Disparities in barriers to follow-up care between African American and White breast cancer survivors.
复制标题
DOI：
10.1007/s00520-015-2706-9
复制
发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Geiger AM
中科院分区：
文献类型：
--
作者：
Palmer NR;Weaver KE;Hauser SP;Lawrence JA;Talton J;Case LD;Geiger AM
尽管建议乳腺癌生存护理，非洲裔美国妇女不太可能得到适当的后续护理，这是由于其较高的死亡率令人担忧。这项研究描述了非洲裔美国人和白色乳腺癌幸存者之间的障碍，以后续护理的差异。我们对2009-2011年治疗后6-24个月（N=203）接受非转移性乳腺癌治疗的女性进行了邮寄调查。幸存者被问及后续护理的14个潜在障碍。我们使用逻辑回归来探索障碍和种族之间的关联，调整协变量。我们的参与者包括31名非洲裔美国人和160名白色幸存者。62%的人报告至少有一个后续护理障碍。与白色幸存者相比，非裔美国人更容易识别与自付费用（28% vs. 51.6%，p=0.01）、其他医疗费用（21.3% vs. 45.2%，p=0.01）、焦虑/担忧（29.4% vs. 51.6%，p=0.02）和交通（4.4% vs. 16.1%，p=0.03）相关的障碍。在调整协变量后，非裔美国人报告至少一个护理障碍的可能性是三倍（OR=3.3，95%CI=1.1-10.1）。护理障碍在乳腺癌幸存者中很常见，特别是非洲裔美国妇女。获得护理的财政障碍可能会阻碍少数群体和得不到充分服务的幸存者获得后续护理。提高保险覆盖率或解决自付费用可能有助于解决乳腺癌幸存者后续护理的财务障碍。旨在减少对复发的恐惧的心理社会护理对于改善非洲裔美国乳腺癌幸存者的获得也很重要。
Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009–2011, 6–24 months post-treatment (N=203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62%. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28% vs. 51.6%, p=0.01), other healthcare costs (21.3% vs. 45.2%, p=0.01), anxiety/worry (29.4% vs. 51.6%, p=0.02), and transportation (4.4% vs. 16.1%, p=0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (OR=3.3, 95%CI=1.1–10.1). Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors.