OBJECTIVES: To examine racial/ethnic disparities in older women's health-related quality of life (QoL) and type of breast cancer treatment as mediated by physician-level and individual-level variables. METHODS: A cross-sectional survey of a population-based, consecutive sample identified through the Los Angeles Cancer Surveillance Program of Latina (n = 99), African American (n = 66), and White (n = 92) women aged 55 years or older (N = 257) between 3 and 9 months after primary breast cancer diagnosis and at least 1 month posttreatment. An exploratory, empirically developed latent variable model tested the relationships among demographic and physician-related variables, patient attitudes, and health-related outcomes. Health-related outcomes included QoL measures and receipt of breast conserving surgery (BCS). RESULTS: Latinas reported less BCS and poorer QoL compared with Whites. Physician communication that can empower patients, in terms of patient efficacy in patient?physician interactions and breast cancer knowledge, mitigated racial/ethnic disparities in receipt of BCS. Physician emotional support was not related to patient cognitive empowerment and treatment outcomes. Medical mistrust in minority women was related to less self-efficacy and less positive coping, as well as, both directly and indirectly, to reduced QoL. Latinas reported poorer QoL in the tested model. CONCLUSION: Physician communication style, specifically information giving and participatory decision making, may empower older women with breast cancer and help mitigate racial/ethnic disparities in surgical treatment received.
OBJECTIVES: To examine racial/ethnic disparities in older women's health-related quality of life (QoL) and type of breast cancer treatment as mediated by physician-level and individual-level variables. METHODS: A cross-sectional survey of a population-based, consecutive sample identified through the Los Angeles Cancer Surveillance Program of Latina (n = 99), African American (n = 66), and White (n = 92) women aged 55 years or older (N = 257) between 3 and 9 months after primary breast cancer diagnosis and at least 1 month posttreatment. An exploratory, empirically developed latent variable model tested the relationships among demographic and physician-related variables, patient attitudes, and health-related outcomes. Health-related outcomes included QoL measures and receipt of breast conserving surgery (BCS). RESULTS: Latinas reported less BCS and poorer QoL compared with Whites. Physician communication that can empower patients, in terms of patient efficacy in patient?physician interactions and breast cancer knowledge, mitigated racial/ethnic disparities in receipt of BCS. Physician emotional support was not related to patient cognitive empowerment and treatment outcomes. Medical mistrust in minority women was related to less self-efficacy and less positive coping, as well as, both directly and indirectly, to reduced QoL. Latinas reported poorer QoL in the tested model. CONCLUSION: Physician communication style, specifically information giving and participatory decision making, may empower older women with breast cancer and help mitigate racial/ethnic disparities in surgical treatment received.
Authors: Nynikka R A Palmer; Erin E Kent; Laura P Forsythe; Neeraj K Arora; Julia H Rowland; Noreen M Aziz; Danielle Blanch-Hartigan; Ingrid Oakley-Girvan; Ann S Hamilton; Kathryn E Weaver Journal: J Clin Oncol Date: 2014-11-17 Impact factor: 44.544
Authors: Laura C Pinheiro; Cleo A Samuel; Katherine E Reeder-Hayes; Stephanie B Wheeler; Andrew F Olshan; Bryce B Reeve Journal: Breast Cancer Res Treat Date: 2016-09-01 Impact factor: 4.872
Authors: Felisa A Gonzales; Meera Sangaramoorthy; Laura A Dwyer; Salma Shariff-Marco; Amani M Allen; Allison W Kurian; Juan Yang; Michelle M Langer; Laura Allen; Bryce B Reeve; Stephen H Taplin; Scarlett Lin Gomez Journal: J Cancer Surviv Date: 2019-10-23 Impact factor: 4.442
Authors: Arno van Peperstraten; Willianne Nelen; Richard Grol; Gerhard Zielhuis; Eddy Adang; Peep Stalmeier; Rosella Hermens; Jan Kremer Journal: BMJ Date: 2010-09-30
Authors: Lixin Song; Jeannette T Bensen; Catherine Zimmer; Betsy Sleath; Bonny Blackard; Elizabeth Fontham; L Joseph Su; Christine S Brennan; James L Mohler; Merle Mishel Journal: Patient Educ Couns Date: 2013-01-15