Latina patient perspectives about informed treatment decision making for breast cancer

被引:96
作者
Hawley, Sarah T. [1 ,2 ]
Janz, Nancy K. [4 ]
Hamilton, Ann [3 ]
Griggs, Jennifer J. [5 ]
Alderman, Amy K. [6 ]
Mujahid, Mahasin [7 ]
Katz, Steven J. [1 ,2 ]
机构
[1] Univ Michigan, Dept Internal Med, Div Gen Med, Ann Arbor, MI 48109 USA
[2] Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA
[3] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA
[4] Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, Ann Arbor, MI 48109 USA
[5] Univ Michigan, Dept Hematol & Oncol, Ann Arbor, MI 48109 USA
[6] Univ Michigan, Dept Surg, Sect Plast Surg, Ann Arbor, MI 48109 USA
[7] Harvard Univ, Sch Publ Hlth, Robert Wood Johnson Clin Scholars Program, Cambridge, MA 02138 USA
关键词
Latina; Breast cancer; Surgical treatment; Decision making; Involvement;
D O I
10.1016/j.pec.2008.07.036
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: To evaluate Latina breast cancer patient perspectives regarding informed decision making related to surgical treatment decision making for breast cancer. Methods: 2030 women with non-metastatic breast cancer diagnosed From 8/05 to 5/06 and reported to the Los Angeles metropolitan SEER registries were mailed a Survey shortly after Surgical treatment. Latina and African-American women were over-sampled. We conducted regression Of four decision Outcome to evaluate associations between race/ethnicity, demographic and clinical factors, and mechanistic variables (i.e., health literacy) and decision outcomes. Results: Our analytic sample was 877 women: 24.5% Latina-Spanish speaking (Latina-SP), 20.5% Latina-English speaking, 24% African-American and 26.6% Caucasian. Approximately 28% of women in each ethnic group reported a surgeon-based, 36% a shared, and 36% a patient-based surgery decision. Spanish-preferent Latina women had the greatest odds of high decision dissatisfaction and regret controlling for other factors (OR 5.5. 95% Cl: 2.9, 10.5 and OR 4.1, 95% Cl: 2.2, 8.0, respectively). Low health literacy was independently associated with dissatisfaction and regret (OR 5.6, 95% 0:2.9, 11.1 and OR 3.5, 95% Cl 1.8, 7.1, respectively) and slightly attenuated associations between Latina-SP ethnicity and decision Outcomes,. Conclusion: Despite similar clinical outcomes, patients report very different experiences with treatment decision making. Latina women, especially those who prefer Spanish, are vulnerable to poor breast cancer treatment decision outcomes. Practice implications: Providers need to be aware of the role of ethnicity, acculturation and literacy in breast cancer treatment discussions. Published by Elsevier Ireland Ltd.
引用
收藏
页码:363 / 370
页数:8
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