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

项目摘要 翻译后摘要：症状的经验，管理和结果，根据种族和社会 决定因素（SEMOARS） 背景：美国黑人乳腺癌患者的5年生存率低于白人 与疾病阶段相匹配的我们过去和正在进行的工作以及其他人的工作表明，症状发生率， 与癌症有关的痛苦和无效的沟通有助于减少剂量和早期治疗方面的种族差异。 治疗终止。 目的：1）检查和比较接受的化疗/处方的化疗随时间的推移和总的 匹配的黑人和白色女性接受BC化疗。2)检查并比较症状 发病率，痛苦和管理，临床遭遇，包括以病人为中心的护理， 随时间推移接受BC化疗的匹配黑人和白色女性的管理经验。2a） 将症状发生率、症状发生率、痛苦程度与治疗经验进行相关分析 而接受BC化疗的白色女性达到Aim 1。3)探索健康的社会决定因素的影响 包括年龄、收入、教育、邮政编码和终生承受的压力。 假设：黑人和黑人之间的内在差异，包括种族和可能的社会健康决定因素， 白色女性在乳腺癌期间症状的经历、感知、沟通和结果 化疗干扰化疗依从性。 方法：纵向频繁重复测量（18个数据收集），比较，混合方法 （门诊访视录音带）描述性设计，来自西部6个地点的179名白色和179名黑人妇女 宾夕法尼亚州和东北部俄亥俄州在化疗过程中。 创新：对症状、痛苦和生活质量的密集评估以及在 按种族和健康的社会决定因素比较的多重重复测量， 剂量化疗是以患者为中心和创新的。 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，这些信息将填补优质护理文献中的关键空白， 促进对乳腺癌静态种族生存差异的理解和潜在的缓解策略 癌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.