Health Related Quality of Life and Care Satisfaction Outcomes: Informing Psychosocial Oncology Care among Latina and African-American Young Breast Cancer Survivors

Abstract

Objective

When breast cancer occurs in young women, the medical, physical, psychosocial, and overall impacts can be more severe warranting targeted medical and psychosocial oncology care. Yet, despite their risk for poorer survival and survivorship outcomes, little research has focused on this group with critical gaps concerning ethnic minorities who are particularly medically vulnerable. Therefore, this preliminary study examined demographic characteristics and patient centered outcomes i.e., health related quality of life, quality care satisfaction to inform targeted psychosocial oncology care among African-American and Latinas young breast cancer survivors (YBCS).

Methods

116 African-American and Latina YBCS aged ≥21-50 years were recruited from cancer registries and community agencies. Based on prior research and the literature, Latinas were categorized into English language proficient (ELP) and Spanish language proficient (SLP) based on their choice of language to conduct the study including completion of the measures.

Results

SLP Latinas reported lower educational attainment and income (p<0.001); and were more likely to report having a mastectomy (p<0.01) but less likely to report breast reconstruction (p<0.05). Satisfaction with care was correlated with patient-provider communication and overall HRQOL (p<0.01) and physical, social/family, emotional and functional wellbeing (p<0.01). SLP Latinas had lower emotional wellbeing than African-American YBCS (p<0.01) and lower functional wellbeing than ELP Latina YBCS (p<0.05). SLP Latina YBCS were less satisfied with their care compared to African-American and ELP Latina YBCS (p<0.01). Financial toxicity seem to directly influence both access to care and quality care and survivorship outcomes.

Conclusions

Investigating demographic characteristics and medical outcomes including HRQOL outcomes and satisfaction with care among ethnic minority YBCS are needed to advance the science as well as assist health professionals with precision care delivery. Greater translational and patient-centered research must focus on at-risk population such as YBCS to inform precision psychosocial oncology care and reduce health disparities.

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