학술논문

Role, race, and place: Prostate cancer disparities in Patients' and Partners' health outcomes and psychosocial factors
Document Type
article
Source
Cancer Medicine, Vol 12, Iss 8, Pp 9857-9867 (2023)
Subject
area deprivation index (ADI)
health disparities
prostate cancer
psychosocial factors
quality of life
stress coping
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Language
English
ISSN
2045-7634
Abstract
Abstract Purpose This study aimed to examine the effects of participant role (patient vs. partner), race (white vs. non‐white), and place (less vs. more neighborhood deprivation) on health outcomes (quality of life [QOL] and symptoms) and stress‐coping‐related psychosocial factors (appraisals of illness and coping resources). Methods This descriptive study included 273 patients and their partners (dyads) who transitioned from PCa treatment to self‐management. We used established, psychometrically sound measures to assess health outcomes and psychosocial factors and conducted multilevel modeling analyses. Results Compared to partners, patients reported worse physical QOL; less frequent anxiety; less pain and fatigue; less bothersome hormonal problems; more bothersome urinary and sexual problems; greater self‐efficacy; and more instrumental support. Compared to their white counterparts, non‐white dyads reported better overall, emotional, and functional QOL; less depression; more positive appraisals, and greater self‐efficacy. Compared to dyads in low ADI neighborhoods, dyads in high ADI (more deprived) neighborhoods reported worse social QOL; more bothersome urinary, sexual, and hormonal symptoms; and less interpersonal support. White patients reported the highest emotional support among all groups, while white partners reported the lowest emotional support. Conclusion Our findings underscore the need to consider social determinants of health at multiple levels when investigating PCa disparities. Considering neighborhood‐level socioeconomic factors, in addition to race and role, improves our understanding of the PCa disparities in QOL, symptoms, and psychosocial factors among patients and partners. Targeted multilevel supportive care interventions should tailor to the needs of racially diverse PCa patients and partners residing in deprived neighborhoods are needed.