Angela R Bazzi1, Melissa A Clark2, Michael R Winter3, Al Ozonoff4,5, Ulrike Boehmer1. 1. 1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts. 2. 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Shrewsbury, Massachusetts. 3. 3 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts. 4. 4 Center for Patient Safety and Quality Research, Boston Children's Hospital , Boston, Massachusetts. 5. 5 Department of Pediatrics, Harvard Medical School , Boston, Massachusetts.
Abstract
PURPOSE: Resilience could help protect the psychosocial wellbeing of sexual minority women (SMW) experiencing stressors from both breast cancer and sexual minority status; however, little research has assessed resilience among breast cancer survivors of different sexual orientations. METHODS: From 2011 to 2012, we surveyed a national sample of breast cancer survivors matched on sexual orientation, age, and cancer status. RESULTS: Among heterosexual (n = 339) and sexual minority (n = 201) breast cancer survivors (n = 540 overall), multivariable regression analyses revealed that more social support (coefficient: 0.87; 95% confidence interval [CI]: 0.56-1.19), fighting spirit combined with helplessness/hopelessness (coefficient: 0.30; 95% CI: 0.13-0.47), and fatalism (coefficient: 0.40; 95% CI: 0.14-0.65) were associated with greater resilience. Mental health counseling before breast cancer diagnosis and anxious preoccupation following cancer diagnosis were associated with reduced resilience (coefficient: -2.50; 95% CI: -3.83 to -1.18; and -0.46; 95% CI: -0.60 to -0.32). Although sexual orientation was not independently associated with resilience, among SMW, those who were unemployed had reduced resilience compared with those who were employed (coefficient: -3.52; 95% CI: -5.75 to -1.28), whereas there was no association between employment and resilience among heterosexual women. CONCLUSION: These findings suggest that social support and other factors associated with resilience could be leveraged by interventions to improve the health and wellbeing of diverse cancer survivors.
PURPOSE: Resilience could help protect the psychosocial wellbeing of sexual minority women (SMW) experiencing stressors from both breast cancer and sexual minority status; however, little research has assessed resilience among breast cancer survivors of different sexual orientations. METHODS: From 2011 to 2012, we surveyed a national sample of breast cancer survivors matched on sexual orientation, age, and cancer status. RESULTS: Among heterosexual (n = 339) and sexual minority (n = 201) breast cancer survivors (n = 540 overall), multivariable regression analyses revealed that more social support (coefficient: 0.87; 95% confidence interval [CI]: 0.56-1.19), fighting spirit combined with helplessness/hopelessness (coefficient: 0.30; 95% CI: 0.13-0.47), and fatalism (coefficient: 0.40; 95% CI: 0.14-0.65) were associated with greater resilience. Mental health counseling before breast cancer diagnosis and anxious preoccupation following cancer diagnosis were associated with reduced resilience (coefficient: -2.50; 95% CI: -3.83 to -1.18; and -0.46; 95% CI: -0.60 to -0.32). Although sexual orientation was not independently associated with resilience, among SMW, those who were unemployed had reduced resilience compared with those who were employed (coefficient: -3.52; 95% CI: -5.75 to -1.28), whereas there was no association between employment and resilience among heterosexual women. CONCLUSION: These findings suggest that social support and other factors associated with resilience could be leveraged by interventions to improve the health and wellbeing of diverse cancer survivors.
Entities:
Keywords:
breast cancer; health disparities; resilience; sexual minority women
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