Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors
Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors
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DOI：
10.1007/s11764-014-0420-0
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发表时间：
2015-09-01
影响因子：
3.7
通讯作者：
Sealy, Diadrey-Anne T.
中科院分区：
文献类型：
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作者：
Miller, Aria M.;Ashing, Kimlin Tam;Sealy, Diadrey-Anne T.
本研究探讨了系统和个人水平的背景因素与健康相关的生活质量（HRQOL）在一个队列的非裔美国人和拉丁裔乳腺癌幸存者（BCS）。基线问卷数据的320 BCS谁参加了HRQOL心理教育干预提取的母研究。分层回归分析检验了环境因素对HRQOL的独立影响。诊断为<2期（B = -a千分之1.38，p < 0.05），对他们的保健表示满意（B = 0.20，p < 0.001），合并症较少（B = -a欧千分率0.60，p < 0.001）和抑郁症状（B = -aEuro parts per thousand 0.30，p < 0.001），并实行健康饮食和锻炼习惯（B = 0.02，p < 0.05）。人口统计学和癌症相关因素占HRQOL方差的14%（F[6，274] = 7.25，p < 0.001）。社会文化背景（即，种族、生活压力、感知的社会支持）解释了HRQOL 20%的方差（F Delta[3，271] = 27.32，p < 0.001）。医疗保健系统背景对解释HRQOL的贡献率为8%（F Delta[1，270] = 34.88，p < 0.001）。健康状况和行为因素占方差的18%（F Delta[4，266] = 29.55，p < 0.001）。完整模型解释了HRQOL的59%的方差（F[14，266] = 27.76，p < 0.001）。少数民族BCS的HRQOL是多方面的，受癌症相关因素、社会文化因素、医疗保健系统因素、健康状况因素和行为环境因素的影响。因此，生存研究和实践必须解决广泛的多层次域，以实现公平和最佳的乳腺癌outcomes.To提高HRQOL，幸存者必须提供的知识和支持，以保持健康的生活方式和自我管理的做法。倡导者必须让护理团队考虑系统因素，包括生活压力和社区资源，以更加以患者为中心。
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).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.HRQOL was higher in BCS who: were diagnosed at < stage 2 (b = -aEuro parts per thousand 1.38, p < 0.05), expressed satisfaction with their health care (b = 0.20, p < 0.001), had fewer comorbidities (b = -aEuro parts per thousand 0.60, p < 0.001) and depressive symptoms (b = -aEuro parts per thousand 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 (F Delta[3, 271] = 27.32, p < 0.001). The health care system context contributed an additional 8 % to explaining HRQOL (F Delta[1, 270] = 34.88, p < 0.001). Health status and behavioral factors accounted for 18 % of the variance (F Delta[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).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.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.