Racial and ethnic disparities in post-traumatic stress and illness coherence in breast cancer survivors with comorbid diabetes.
Racial and ethnic disparities in post-traumatic stress and illness coherence in breast cancer survivors with comorbid diabetes.
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DOI：
10.1002/pon.5747
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发表时间：
2021-10
期刊：
影响因子：
3.6
通讯作者：
Lin JJ
中科院分区：
文献类型：
--
作者：
Mazor M;Wisnivesky JP;Goel M;Harris YT;Lin JJ
乳腺癌幸存者(BC)合并糖尿病(DM)和种族和少数民族地位的人患癌症相关创伤后应激障碍(PTS)和严重疾病信念的风险更高。这些情感和认知结果影响慢性病患者的自我管理和治疗依从性，但关于这些过程在不同的BCS合并糖尿病中的相互作用知之甚少。这项研究的目的是：1)描述与癌症相关的PTS和疾病知觉的种族和民族差异；2)检验BCS合并DM患者PTS和疾病知觉之间的关系。患有糖尿病的女性BCS完成了癌症相关压力(事件影响量表-修订)和癌症和糖尿病疾病认知(疾病认知问卷-修订)的测量。Logistic回归分析用于评估PTS、种族和疾病知觉之间的关联。在135名合并糖尿病的BCS中，平均年龄(SD)为65.3(7.1)岁，其中38%是黑人，31%是非西班牙裔白人(NLW)，13%是西班牙裔/拉丁裔，18%是其他。少数族裔女性更有可能报告与癌症相关的PTS(p<；0.01)。在调整后的分析中，PTS与癌症的慢性化(优势比[OR]=9.79，p=0.005)、时间周期(OR=6.71p=0.001)、负面后果(OR=3.95p=0.018)和负面情绪影响(OR=12.63p<；0.001)相关。与NHW幸存者相比，患有糖尿病的少数BCS报告了更高的癌症相关PTS发生率和更低的癌症疾病一致性。癌症相关的PTS影响人们对癌症和糖尿病疾病的看法。需要对文化敏感的护理来改善少数族裔BCS的这些结果。这篇文章介绍了一个研究不足的横断面队列的结果，该人群是患有糖尿病的不同种族和民族的乳腺癌幸存者。结果表明，PTS在种族和少数民族妇女中的发生率明显更高，并与更严重的疾病感知密切相关。
Breast cancer survivors (BCS) with comorbid diabetes mellitus (DM) and of racial and ethnic minority status are at higher risk of cancer-related post-traumatic stress (PTS) and severe illness beliefs. These affective and cognitive outcomes influence self-management and treatment adherence in patients with chronic conditions, yet little is known regarding the interplay of these processes in diverse BCS with comorbid DM. The purposes of this study were to 1) describe racial and ethnic differences in cancer-related PTS and illness perceptions; and 2) examine the relationship between PTS and illness perceptions in BCS with comorbid DM. Female BCS with DM completed measures of cancer related stress (Impact of Events Scale-Revised) and cancer and DM illness perception (Illness Perception Questionnaire-Revised). Logistic regression analyses were used to assess the association between PTS, race and illness perceptions. Of the 135 BCS with comorbid DM, the mean (SD) age was 65.3 (7.1) years, 38% were Black, 31% Non-Hispanic White (NLW), 13% Hispanic/Latina, and 18% were ‘other’. Minority women were more likely to report cancer-related PTS (p<0.01). In adjusted analyses, PTS was associated with chronicity (odds ratio [OR]=9.79, p=0.005), time-cycle (OR=6.71, p=0.001), negative consequences (OR=3.95, p=0.018), and negative emotional impact (OR=12.63, p<0.001) of cancer. Minority BCS with comorbid DM report higher rates of cancer-related PTS and lower cancer illness coherence relative to NHW survivors. Cancer-related PTS influences cancer and DM illness perceptions. Culturally sensitive care is needed to improve these outcomes in minority BCS. This article presents findings from a cross sectional cohort of an understudied population of racially and ethnically diverse breast cancer survivors with comorbid diabetes. The results indicate that the occurrence of PTS is significantly higher in racial and ethnic minority women and is strongly associated with more severe illness perceptions.
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DOI：
10.1177/0884217505278296
发表时间：
2005-07-01
影响因子：
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作者：
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DOI：
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2017-04
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The lancet. Psychiatry
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Spiegel D
影响因子：
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