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Zamudio-Sánchez A, Camarero-Gómez P, Rodríguez-Manjón E, Iglesias-Parra MR, Gómez-Salgado J, Romero A. Needs and Expectations of Long-Term Cancer Survivors: Multi-Centre Study Protocol. J Pers Med 2024; 14:64. [PMID: 38248765 PMCID: PMC10817242 DOI: 10.3390/jpm14010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/11/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Cancer is a social issue as its outreach affects not only mortality (it is the second cause of death in our environment) but also the costs due to morbidity and the distress it causes, as well as the losses and consequences in personal, family, work, and even social areas. This study is trying to find out the health needs of long-term cancer survivors and their perceptions and expectations of the care they received during their survival stage. For this, a joint, cross-sectional descriptive study with a qualitative and quantitative approach has been designed. For the qualitative approach, we have used different focus groups representing different geographical areas of the Spanish territory. For the qualitative approach, we have used a validated questionnaire. This study will provide a better knowledge of the quality of life of these patients, as well as their level of unmet and even unexpressed needs, in order to develop effective strategies and interventions that allow for the implementation of adapted care plans that include such unexpressed needs. This study will also allow for the creation and development of assessment methods for health results from the patient's perspective and experience. These issues require a multidisciplinary, complex approach. These survivors may require not well-known health services, as the number of these patients has grown recently, and their survival time is also longer. This research explores a wider and more thorough perspective of long-term cancer survivors' needs, experiences, and expectations to be achieved.
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Affiliation(s)
- Antonio Zamudio-Sánchez
- Internal Medicine Clinical Management Unit, Hospital Regional Universitario of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, 29010 Malaga, Spain; (A.Z.-S.)
| | - Pilar Camarero-Gómez
- Malaga Guadalhorce Health District, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain
| | - Estefanía Rodríguez-Manjón
- Internal Medicine Clinical Management Unit, Hospital Regional Universitario of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, 29010 Malaga, Spain; (A.Z.-S.)
| | - María Rosa Iglesias-Parra
- Department of Nursing and Podiatry, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, 29010 Malaga, Spain (A.R.)
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work, and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Posgrade Program, Espíritu Santo University, Samborondón 09-01-952, Ecuador
| | - Adolfo Romero
- Department of Nursing and Podiatry, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, 29010 Malaga, Spain (A.R.)
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Acquati C, Chen TA, Martinez Leal I, Connors SK, Haq AA, Rogova A, Ramirez S, Reitzel LR, McNeill LH. The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413084. [PMID: 34948695 PMCID: PMC8702073 DOI: 10.3390/ijerph182413084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has had critical consequences for cancer care delivery, including altered treatment protocols and delayed services that may affect patients’ quality of life and long-term survival. Breast cancer patients from minoritized racial and ethnic groups already experience worse outcomes, which may have been exacerbated by treatment delays and social determinants of health (SDoH). This protocol details a mixed-methods study aimed at comparing cancer care disruption among a diverse sample of women (non-Hispanic White, non-Hispanic Black/African American, and Hispanic/Latina) and assessing how proximal, intermediate, and distal SDoH differentially contribute to care continuity and health-related quality of life. An embedded mixed-methods design will be implemented. Eligible participants will complete an online survey, followed by a semi-structured interview (with a subset of participants) to further understand factors that influence continuity of care, treatment decision-making, and self-reported engagement. The study will identify potentially modifiable factors to inform future models of care delivery and improve care transitions. These data will provide the necessary evidence to inform whether a subsequent, multilevel intervention is warranted to improve quality of care delivery in the COVID-19 aftermath. Additionally, results can be used to identify ways to leverage existing social resources to help manage and support patients’ outcomes.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX 77204, USA
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
- Correspondence: ; Tel.: +1-713-743-4343
| | - Tzuan A. Chen
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Isabel Martinez Leal
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Shahnjayla K. Connors
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
- Department of Social Sciences, University of Houston-Downtown, Houston, TX 77002, USA
| | - Arooba A. Haq
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Anastasia Rogova
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Stephanie Ramirez
- College of Natural Sciences and Mathematics, University of Houston, 3507 Cullen Blvd, Houston, TX 77204, USA;
| | - Lorraine R. Reitzel
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Lorna H. McNeill
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
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Schröders J, Dewi FST, Nilsson M, Nichter M, Sebastian MS. Effects of social network diversity in the disablement process: a comparison of causal inference methods and an outcome-wide approach to the Indonesian Family Life Surveys, 2007-2015. Int J Equity Health 2020; 19:128. [PMID: 32736632 PMCID: PMC7393827 DOI: 10.1186/s12939-020-01238-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social networks (SN) have been proven to be instrumental for healthy aging and function as important safety nets, particular for older adults in low and middle-income countries (LMICs). Despite the importance of interpreting health outcomes in terms of SN, in many LMICs - including Indonesia - epidemiological studies and policy responses on the health effects of SN for aging populations are still uncommon. Using outcome-wide multi-method approaches to longitudinal panel data, this study aims to outline more clearly the role of SN diversity in the aging process in Indonesia. We explore whether and to what degree there is an association of SN diversity with adult health outcomes and investigate potential gender differences, heterogeneous treatment effects, and effect gradients along disablement processes. METHODS Data came from the fourth and fifth waves of the Indonesian Family Life Survey fielded in 2007-08 and 2014-15. The analytic sample consisted of 3060 adults aged 50+ years. The primary exposure variable was the diversity of respondents' SN at baseline. This was measured through a social network index (SNI), conjoining information about household size together with a range of social ties with whom respondents had active contact across six different types of role relationships. Guided by the disablement process model, a battery of 19 outcomes (8 pathologies, 5 impairments, 4 functional limitations, 2 disabilities) were included into analyses. Evidence for causal effects of SN diversity on health was evaluated using outcome-wide multivariable regression adjustment (RA), propensity score matching (PSM), and instrumental variable (IV) analyses. RESULTS At baseline, 60% of respondents had a low SNI. Results from the RA and PSM models showed greatest concordance and that among women a diverse SN was positively associated with pulmonary outcomes and upper and lower body functions. Both men and women with a high SNI reported less limitations in performing activities of daily living (ADL) and instrumental ADL (IADL) tasks. A high SNI was negatively associated with C-reactive protein levels in women. The IV analyses yielded positive associations with cognitive functions for both men and women. CONCLUSIONS Diverse SN confer a wide range of strong and heterogeneous long-term health effects, particularly for older women. In settings with limited formal welfare protection, intervening in the SN of older adults and safeguarding their access to diverse networks can be an investment in population health, with manifold implications for health and public policy.
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Affiliation(s)
- Julia Schröders
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, University of Arizona, Tucson, AZ, USA
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Abstract
OBJECTIVE Low social integration and divorce/widowhood are chronic psychosocial stressors that may affect health. When assessed after cancer diagnosis, they have been associated with poorer survival, but their role in cancer development, particularly ovarian cancer (OvCA), is less understood. We investigated whether social integration and marital status were related to OvCA risk in a large population-based study. METHODS Women from the Nurses' Health Study completed the Berkman-Syme Social Network Index and reported their marital status every 4 years starting in 1992 (N = 72,206), and were followed up until 2012 (20-year follow-up period). Multivariate Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of OvCA risk, considering relevant potential confounders, in lagged analyses whereby psychosocial indicators were assessed 4 to 8 years (n = 436 cases) and 8 to 12 years (n = 306 cases) before diagnosis to account for the effects of prediagnostic symptoms on social measures. Secondary analyses evaluated the stability of and cumulative exposure to these social factors on OvCA risk. RESULTS Being socially isolated versus integrated was related to an increased OvCA risk 8 to 12 years later (HR = 1.51, 95% CI = 1.07-2.13), but not 4 to 8 years later. Compared with married women, OvCA risk was significantly higher in widowed but not in separated/divorced individuals, with both time periods (e.g., 8-12 years later: HRwidowed = 1.57 [95% CI = 1.15-2.14] versus HRseparated/divorced = 1.13 [95% CI = 0.74-1.72]). Estimates were comparable or stronger when investigating stability in and cumulative effects of social indicators. CONCLUSIONS Results suggest higher OvCA risk among socially isolated and widowed women, particularly when such psychosocial stressors were experienced a decade before diagnosis or were sustained over time.
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Molina Y, San Miguel LG, Tamayo L, Robledo C, Díaz CS, Lucio A, Coronado N, Ferrans CE. The "Empowering Latinas to Obtain Breast Cancer Screenings" study: Rationale and design. Contemp Clin Trials 2018; 71:1-8. [PMID: 29803815 DOI: 10.1016/j.cct.2018.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/08/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latinas suffer disproportionately from breast cancer (BC) in part due to lower guideline-concordant screening. Multiple intervention approaches have been developed to promote screening through direct patient education and empowerment approaches (i.e., training community members to share BC information). This study compares the relative effects of these approaches on: 1) women's BC screening; and, 2) women's dissemination of BC information within their social networks. DESIGN/METHODS Our quasi-experimental trial is being implemented in community venues in two predominantly Latino neighborhoods in South and West Chicago. Eligible participants: 1) are female; 2) are 52-74 years old; 3) have not obtained a mammogram in the past 2 years; and, 4) have not previously participated in health-related volunteerism. Based on their geographic location, participants are assigned to one of two group-based interventions. Both interventions consist of three two-hour sessions, which includes BC early detection education. The education intervention sessions also covers BC prevention (diet, physical activity), whereas the empowerment intervention covers sharing information with family/friends, and health volunteerism. Navigation is provided for all women who wish to obtain mammograms. Primary outcomes include: 1) receipt of BC screening; and, 2) participants' dissemination of BC information. Secondary outcomes include positive changes in 1) participants' self-reported psychosocial facilitators; and, 2) social network members' BC behaviors. DISCUSSION The design of our program allows for a preliminary comparison of the effectiveness of these two approaches. This work will inform larger comparativeness trials and offers a new approach to intervention evaluation via social network analysis.
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Valencia O, Lopes G, Sánchez P, Acuña L, Uribe D, González J. Incidence and Prevalence of Cancer in Colombia: The Methodology Used Matters. J Glob Oncol 2017; 4:1-7. [PMID: 30241220 PMCID: PMC6180751 DOI: 10.1200/jgo.17.00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Incidence and prevalence are important factors in policy making and planning
in health care systems. The aim of this study was to compare two different
estimates of the incidence and prevalence of cancer in
Colombia—real-world data from the health care system and estimates
from cancer registries. Materials and Methods Data from all providers were aggregated by the High-Cost Diseases Office
(Cuenta de Alto Costo [CAC]). The real-world, age-standardized observed
incidence (OI) and observed prevalence (OP) rates were calculated using the
number of patients with a diagnosis of cancer who were cared for in the
national health system between 2014 and 2015. The registry estimated
incidence (EI) and estimated prevalence (EP) were extracted from GLOBOCAN
population fact sheets for 2012, which use data from four Colombian
city-based registries and extrapolate survival using the average for Asian
countries, together with registries from Uganda and Zimbabwe. Results A total of 130,441 patients were analyzed. The OI of cancer in Colombia was
69.2 and the OP was 479 (per 100,000 people) in early 2015, whereas the EI
was 175.2 and the 5-year EP was 501.2 (per 100,000 people), showing a higher
estimate from GLOBOCAN data for 2012 than was observed in early 2015 by the
CAC. Some differences were higher in specific cancers. Conclusion Because of differences in methodology, the EI and the EP are not comparable
to the OI and the OP. Policymakers need robust and current information to
prioritize disease prevention and control programs. In Colombia, the OI and
the OP—calculated by the CAC with data from the whole
country—offer an opportunity for a more precise real-world estimation
of patients with cancer in Colombia.
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Affiliation(s)
- Omaira Valencia
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Gilberto Lopes
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Patricia Sánchez
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Lizbeth Acuña
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Daniel Uribe
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Jaime González
- Omaira Valencia, Patricia Sánchez, Lizbeth Acuña, and Daniel Uribe, Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo; Jaime González, Asociación Colombiana de Hematologíay Oncológica, Bogotá, DC, Colombia; and Gilberto Lopes, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
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Salakari M, Pylkkänen L, Sillanmäki L, Nurminen R, Rautava P, Koskenvuo M, Suominen S. Social support and breast cancer: A comparatory study of breast cancer survivors, women with mental depression, women with hypertension and healthy female controls. Breast 2017; 35:85-90. [PMID: 28667868 DOI: 10.1016/j.breast.2017.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 06/20/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Among breast cancer (BC) survivors, inadequate social support (SS) is associated with a significant increase in cancer-related mortality and reduction in quality of life (QoL). The aim of the study was to explore perceived SS during BC trajectory by comparing BC survivors, women with depression, women with arterial hypertension, and healthy female controls to each other, and to compare perceived balance of receiving and providing SS. MATERIAL AND METHODS The data of ongoing prospective postal survey was linked with national health registries. Respondents with BC (n = 64), depression (n = 471), arterial hypertension (n = 841) and healthy controls (n = 6274) formed the study population. SS was measured by a Sarason's 6-item shortened version of the Social Support Questionnaire (SSQ). The modified Antonucci's (1986) social support convoy model of the network of individuals was used to measure the dominating direction of SS. RESULTS The main provider of SS for all participants combined was the spouse or partner (94.3%), close relative (12.0%) and friends (5.4%). In all groups, particularly in the BC and arterial hypertension group, spouse or partner was seen as the most important supporter. The group suffering from depression reported significantly less SS in each domain of appraisal (p < 0.001). In total, 24.6% of all respondents reported receipt dominance of SS. CONCLUSION SS is a well-known determinant of wellbeing. Our study lends support to the spouse's or the partner's central role during the recovery phase of BC. Identification of factors improving the overall QoL of BC survivors is an important public health challenge.
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Affiliation(s)
- Minna Salakari
- University of Turku, Department of Public Health, Joukahaisenkatu 3-5, 20520, Turku, Finland.
| | - Liisa Pylkkänen
- Cancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
| | - Lauri Sillanmäki
- University of Helsinki, Department of Occupational Health, Mannerheimintie 172, 00300, Helsinki, Finland.
| | - Raija Nurminen
- University of Applied Science Turku, Ruiskatu 8, 20740, Turku, Finland.
| | - Päivi Rautava
- Turku University Hospital, Kiinanmyllynkatu 4-8, 20520, Turku, Finland.
| | - Markku Koskenvuo
- University of Helsinki, Department of Occupational Health, Mannerheimintie 172, 00300, Helsinki, Finland.
| | - Sakari Suominen
- University of Turku, Department of Public Health, Joukahaisenkatu 3-5, 20520, Turku, Finland.
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