The Symptom Experience, Management and Outcomes According to Race and Social Determinants of Health (SEMOARS) during Breast Cancer Chemotherapy

项目摘要摘要 摘要：基于种族和社会的症状体验、处理和结果 决定因素(SEMOARS) 背景：美国患有乳腺癌的黑人女性5年存活率低于白人 用于分期匹配的疾病。我们过去和正在进行的工作以及其他人的工作表明， 癌症相关的痛苦和无效的沟通导致了减少剂量和早期剂量的种族差异 终止治疗。 目标：1)检查和比较随时间推移接受的化疗/开出的化疗以及总计 配对的黑人和白人女性给她们开了BC化疗。2)检查并比较症状 发病率、痛苦和处理、临床遭遇，包括以病人为中心的护理和 配对的黑人和白人妇女长期接受BC化疗的管理经验。(2a) 配对黑人的症状发生率、痛苦和管理经验的相关性 和接受BC化疗的白人女性的目标是探索健康的社会决定因素的影响 包括年龄、收入、教育程度、邮政编码和目标1、2和3的终生压力暴露。 假设：黑人和黑人之间的固有差异，包括种族和可能的社会健康决定因素 白人女性在乳腺癌期间症状的体验、感知、沟通和结果 化疗会干扰化疗的依从性。 方法：纵向频繁重复测量(18个数据集合)、对比、混合方法 (门诊访问的录音带)对来自西区6个地点的179名白人和179名黑人妇女的描述性设计 在宾夕法尼亚州和俄亥俄州东北部的化疗过程中。 创新：对症状、痛苦、生活质量和临床遭遇的紧张评估 按种族和社会健康决定因素比较的多项重复测量 剂量化疗以患者为中心，具有创新性。 意义/公共卫生：如果这些关系和种族差异得到证实， 被确定为可操作目标的因素，这些信息将填补质量护理文献中的关键空白， 提高对乳房静态种族生存差距的认识和潜在缓解策略 癌症。这些确定的目标对公共卫生具有影响。

Project Summary Abstract Abstract: The Symptom Experience, Management and Outcomes According to Race and Social Determinants (SEMOARS) Background: Black women with breast cancer in the United States have a lower 5 year survival than whites for stage-matched disease. Our past and ongoing work and that of others suggests that symptom incidence, cancer related distress and ineffective communication contribute to racial disparity in dose reduction and early therapy termination. Aims:1) Examine and compare chemotherapy received/chemotherapy prescribed over time and in total of matched black and white women prescribed BC chemotherapy. 2) Examine and compare the symptom incidence, distress and management, clinical encounter including patient centeredness of care and management experience of matched black and white women receiving BC chemotherapy over time. 2a) Correlate the symptom incidence symptom incidence, distress and management experience of matched black and white women receiving BC chemotherapy to Aim 1. 3) Explore the effects of social determinants of health including age, income, education, zip code and lifetime stress exposure on Aims 1, 2 and 3. Hypothesis: Inherent differences including race and possibly social determinants of health between black and white women in the experience, perception, communication and outcomes of symptoms during breast cancer chemotherapy interfere with chemotherapy adherence. Methods: Longitudinal frequent repeated-measures (18 data collections), comparative, mixed methods (audiotapes of clinic visits) descriptive design of 179 white and 179 black women from 6 sites at Western Pennsylvania and Northeast Ohio over the course of chemotherapy. Innovation: The intense assessment of symptoms, distress and quality of life and the clinical encounter in multiple repeated measures as compared by race and social determinants of health on the ability to receive full dose chemotherapy is patient centered and innovative. Significance/Public Health: If these relationships and racial differences are confirmed and the mediating factors identified as actionable targets, this information will fill a critical gap in the quality care literature, advancing the understanding and potential mitigation strategies for the static racial survival disparity in breast cancer. These identified targets hold implication for public health.