Supportive care priorities of low-income Latina breast cancer survivors

  • Alix G. Sleight
  • Kathleen Doyle Lyons
  • Cheryl Vigen
  • Heather Macdonald
  • Florence Clark
Original Article

Abstract

Purpose

This study investigated the supportive care needs of a sample of low-income Latina breast cancer survivors.

Methods

Ninety-nine Spanish-speaking breast cancer survivors who self-identified as Latina and reported an income below the US Census Bureau low-income threshold were recruited from the oncology clinic of a major public safety net hospital. Eligible participants completed the supportive care needs survey (SCNS-SF34) and a demographic questionnaire.

Results

Ninety-three percent of respondents had unmet needs. The majority of frequently reported unmet needs involved (1) access to and delivery of health-related information and (2) physical function. These findings appear to contrast with those of other studies of supportive care needs in heterogeneous cancer survivors, most of which describe psychological concerns as most urgent.

Conclusions

Participants espoused information-related needs with a higher frequency than many other samples of cancer survivors. This study population may also require a particularly high level of assistance with overcoming participation restrictions. Further research is needed to understand these discrepancies and to address unmet needs across all domains.

Keywords

Hispanic Americans Breast cancer Needs assessment Socioeconomic factors 

Notes

Acknowledgements

This study was supported by a research grant from the California Foundation for Occupational Therapy. The authors thank Gabrielle Granados and Karina Cordova for their contributions to this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    American Cancer Society. Cancer facts and figures for Hispanics/Latinos 2015–2017. 2015. http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-046405.pdf. Accessed July 1, 2017
  2. 2.
    Nelson A (2002) Unequal treatment: confronting racial and ethnic disparities in health care. JAMA 94(8):666Google Scholar
  3. 3.
    Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, Ng W, King MT (2011) Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol 12(13):1240–1248CrossRefPubMedGoogle Scholar
  4. 4.
    Janz NK, Mujahid M, Lantz PM, Fagerlin A, Salem B, Morrow M, Deapen D, Katz SJ (2005) Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Qual Life Res 14(6):1467–1479CrossRefPubMedGoogle Scholar
  5. 5.
    Ricker CN, Hiyama S, Fuentes S, Feldman N, Kumar V, Uman GC, Nedelcu R, Blazer KR, MacDonald DJ, Weitzel JN (2007) Beliefs and interest in cancer risk in an underserved Latino cohort. Prev Med 44(3):241–245CrossRefPubMedGoogle Scholar
  6. 6.
    Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009 Aug 1) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17(8):1117–1128CrossRefPubMedGoogle Scholar
  7. 7.
    Molina Y, Thompson B, Espinoza N, Ceballos R (2013) Breast cancer interventions serving US-based Latinas: current approaches and directions. Women’s Health 9(4):335–350CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Park BW, Hwang SY (2012) Unmet needs and their relationship with quality of life among women with recurrent breast cancer. J Breast Cancer 15(4):454–461CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Akechi T, Okuyama T, Endo C, Sagawa R, Uchida M, Nakaguchi T, Akazawa T, Yamashita H, Toyama T, Furukawa TA (2011) Patient's perceived need and psychological distress and/or quality of life in ambulatory breast cancer patients in Japan. Psycho-Oncology 20(5):497–505CrossRefPubMedGoogle Scholar
  10. 10.
    O’Callaghan C, Schofield P, Butow P, Nolte L, Price M, Tsintziras S, Sze M, Thein T, Yiu D, Mireskandari S, Goldstein D (2016) “I might not have cancer if you didn’t mention it”: a qualitative study on information needed by culturally diverse cancer survivors. Support Care Cancer 24(1):409–418CrossRefPubMedGoogle Scholar
  11. 11.
    DeNavas-Walt C, Proctor BD (2015) Income and Poverty in the United States: 2014. US Census Bureau, Current Population ReportsGoogle Scholar
  12. 12.
    Roberts B, Povich D, Mather M (2013) Low-income working families: the growing economic gap. The Working Poor Families Project 301(3):657–1480Google Scholar
  13. 13.
    United States Census Bureau. Poverty thresholds. 2015 https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html. Accessed January, 2017
  14. 14.
    Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A (2000) Evaluation of an instrument to assess the needs of patients with cancer. Cancer 88(1):217–225CrossRefPubMedGoogle Scholar
  15. 15.
    McElduff P, Boyes A, Zucca A, Girgis A (2004) The supportive care needs survey: a guide to administration, scoring and analysis. Centre for Health Research, NewcastleGoogle Scholar
  16. 16.
    Doubova SV, Aguirre-Hernandez R, Gutiérrez-de la Barrera M, Infante-Castañeda C, Pérez-Cuevas R (2015) Supportive care needs of Mexican adult cancer patients: validation of the Mexican version of the short-form supportive care needs questionnaire (SCNS-SFM). Support Care Cancer 23(9):2711–2719CrossRefPubMedGoogle Scholar
  17. 17.
    Fu MR, Axelrod D, Guth AA, Cleland CM, Ryan CE, Weaver KR, Qiu JM, Kleinman R, Scagliola J, Palamar JJ, Melkus GD (2015) Comorbidities and quality of life among breast cancer survivors: a prospective study. J Pers Med 5(3):229–242CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Girgis A, Boyes A, Sanson-Fisher RW, Burrows S (2000) Perceived needs of women diagnosed with breast cancer: rural versus urban location. Aust N Z J Public Health 24(2):166–173CrossRefPubMedGoogle Scholar
  19. 19.
    Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88(1):226–237CrossRefPubMedGoogle Scholar
  20. 20.
    Lintz K, Moynihan C, Steginga S, Norman A, Eeles R, Huddart R, Dearnaley D, Watson M (2003) Prostate cancer patients' support and psychological care needs: survey from a non-surgical oncology clinic. Psych Onc 12(8):769–783CrossRefGoogle Scholar
  21. 21.
    Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A (2009) Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol 27(36):6172–6179CrossRefPubMedGoogle Scholar
  22. 22.
    Uchida M, Akechi T, Okuyama T, Sagawa R, Nakaguchi T, Endo C, Yamashita H, Toyama T, Furukawa TA (2010) Patients' supportive care needs and psychological distress in advanced breast cancer patients in Japan. Japanese J Clin Oncol 41(4):530–536CrossRefGoogle Scholar
  23. 23.
    Fiszer C, Dolbeault S, Sultan S, Brédart A (2014) Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psych Oncol 23(4):361–374CrossRefGoogle Scholar
  24. 24.
    Au A, Lam WWT, Kwong A, Suen D, Tsang J, Yeo W, Suen J, Ho WM, Yau TK, Soong I, Wong KY, Sze WK, Ng A, Girgis A, Fielding R (2011) Validation of the Chinese version of the short-form supportive care needs survey questionnaire (SCNS-SF34-C). Psycho-Oncology 20:1292–1300CrossRefPubMedGoogle Scholar
  25. 25.
    Pandey M, Thomas BC, SreeRekha P, Ramdas K, Ratheesan K, Parameswaran S, Mathew BS, Rajan B (2005) Quality of life determinants in women with breast cancer undergoing treatment with curative intent. World J Surg Oncol 3(1):63CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Au A, Lam W, Tsang J, Yau TK, Soong I, Yeo W, Suen J, Ho WM, Wong KY, Kwong A, Suen D (2013) Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer. Psych Onc 22(5):1144–1151CrossRefGoogle Scholar
  27. 27.
    Fielding R, Lam WW, Shun SC, Okuyama T, Lai YH, Wada M, Akechi T, Li WW (2013) Attributing variance in supportive care needs during cancer: culture-service, and individual differences, before clinical factors. PLoS One 8(5):e65099CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Hamilton AS, Katz SJ (2008) Racial/ethnic differences in adequacy of information and support for women with breast cancer. Cancer 113(5):1058–1067CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Baezconde-Garbanati L, Murphy ST, Moran MB, Cortessis VK (2013) Reducing the excess burden of cervical cancer among Latinas: translating science into health promotion initiatives. Californian J Health Promot 11(1):45–57Google Scholar
  30. 30.
    DuBard CA, Gizlice Z (2008) Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics. Am J Public Health 98(11):2021–2028CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Jacobs EA, Shepard DS, Suaya JA, Stone EL (2004) Overcoming language barriers in health care: costs and benefits of interpreter services. Am J Public Health 94(5):866–869CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Lor M, Xiong P, Schwei RJ, Bowers BJ, Jacobs EA (2016) Limited English proficient Hmong-and Spanish-speaking patients’ perceptions of the quality of interpreter services. Int J Nurs Stud 54:75–83CrossRefPubMedGoogle Scholar
  33. 33.
    Graham S, Brookey J (2008) Do patients understand? Permanente J 12(3):67CrossRefGoogle Scholar
  34. 34.
    Martin LT, Ruder T, Escarce JJ, Ghosh-Dastidar B, Sherman D, Elliott M, Bird CE, Fremont A, Gasper C, Culbert A, Lurie N (2009 Nov 1) Developing predictive models of health literacy. J Ger Intern Med 24(11):1211–1216CrossRefGoogle Scholar
  35. 35.
    Halbach SM, Ernstmann N, Kowalski C, Pfaff H, Pförtner TK, Wesselmann S, Enders A (2016) Unmet information needs and limited health literacy in newly diagnosed breast cancer patients over the course of cancer treatment. Patient Educ Couns 99(9):1511–1518CrossRefPubMedGoogle Scholar
  36. 36.
    Freeman HP (2006) Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health 83(2):139–141CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Dohan D, Schrag D (2005 Aug 15) Using navigators to improve care of underserved patients. Cancer 104(4):848–855CrossRefPubMedGoogle Scholar
  38. 38.
    Jean-Pierre P, Cheng Y, Wells KJ, Freund KM, Snyder FR, Fiscella K, Holden AE, Paskett ED, Dudley DJ, Simon MA, Valverde PA (2016) Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation. Cancer 122(7):1060–1067CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Hendren S, Chin N, Fisher S, Winters P, Griggs J, Mohile S, Fiscella K (2011) Patients’ barriers to receipt of cancer care, and factors associated with needing more assistance from a patient navigator. J Natl Med Assoc 103(8):701–710CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Livaudais JC, Coronado GD, Espinoza N, Islas I, Ibarra G, Thompson B (2010) Educating Hispanic women about breast cancer prevention: evaluation of a home-based promotora-led intervention. J Women's Health 19(11):2049–2056CrossRefGoogle Scholar
  41. 41.
    Moralez EA, Rao SP, Livaudais JC, Thompson B (2012) Improving knowledge and screening for colorectal cancer among Hispanics: overcoming barriers through a promotora-led home-based educational intervention. J Cancer Ed 27(3):533–539CrossRefGoogle Scholar
  42. 42.
    Hwang EJ, Lokietz NC, Lozano RL, Parke MA (2015) Functional deficits and quality of life among cancer survivors: implications for occupational therapy in cancer survivorship care. Am J Occ Ther 69(6):6906290010p1–6906290010p9CrossRefGoogle Scholar
  43. 43.
    Cheville AL, Troxel AB, Basford JR, Kornblith AB (2008) Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clinical Onc 26(16):2621–2629CrossRefGoogle Scholar
  44. 44.
    Griesser AC, Vlastos G, Morel L, Beaume C, Sappino AP, Haller G (2011) Socio-demographic predictors of high support needs in newly diagnosed breast cancer patients. Eur J Cancer Care 20(4):466–474CrossRefGoogle Scholar
  45. 45.
    Lam WW, Au AH, Wong JH, Lehmann C, Koch U, Fielding R, Mehnert A (2011) Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat 130(2):531–541CrossRefPubMedGoogle Scholar
  46. 46.
    Schmid-Büchi S, Halfens RJ, Müller M, Dassen T, van den Borne B (2013 Feb 28) Factors associated with supportive care needs of patients under treatment for breast cancer. Eur J Oncol Nurs 17(1):22–29CrossRefPubMedGoogle Scholar
  47. 47.
    Li WW, Lam WW, Au AH, Ye M, Law WL, Poon J, Kwong A, Suen D, Tsang J, Girgis A, Fielding R (2013) Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer. Psycho-Oncology 22(4):792–798CrossRefPubMedGoogle Scholar
  48. 48.
    Brédart A, Kop JL, Griesser AC, Fiszer C, Zaman K, Panes-Ruedin B, Jeanneret W, Delaloye JF, Zimmers S, Berthet V, Dolbeault S (2013) Assessment of needs, health-related quality of life, and satisfaction with care in breast cancer patients to better target supportive care. Ann Oncol 24(8):2151–2158CrossRefPubMedGoogle Scholar
  49. 49.
    Silver JK, Baima J, Mayer RS (2013 Sep 1) Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA Cancer J Clin 63(5):295–317CrossRefPubMedGoogle Scholar
  50. 50.
    Silver JK (2015) Cancer prehabilitation and its role in improving health outcomes and reducing health care costs. Sem Oncol Nurs 31(1):13–30CrossRefGoogle Scholar
  51. 51.
    Santa Mina D, Brahmbhatt P, Lopez C, Baima J, Gillis C, Trachtenberg L, Silver JK (2017) The case for prehabilitation prior to breast cancer treatment. PM&R 9(9):S305–S316CrossRefGoogle Scholar
  52. 52.
    Hayes SC, Johansson K, Stout NL, Prosnitz R, Armer JM, Gabram S, Schmitz KH (2012) Upper-body morbidity after breast cancer. Cancer 118(S8):2237–2249CrossRefPubMedGoogle Scholar
  53. 53.
    Prvu Bettger JA, Stineman MG (2007) Effectiveness of multidisciplinary rehabilitation services in postacute care: state-of-the-science. A review. Arch Phys Med Rehabil 88:1526–1534CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Egan MY, McEwen S, Sikora L, Chasen M, Fitch M, Eldred S (2013) Rehabilitation following cancer treatment. Disab Rehab 35(26):2245–2258CrossRefGoogle Scholar
  55. 55.
    Silver JK, Gilchrist LS (2011) Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions. Am J Phys Med Rehab 90(5):S5–S15Google Scholar
  56. 56.
    Stubblefield MD, Hubbard G, Cheville A, Koch U, Schmitz KH, Dalton SO (2013) Current perspectives and emerging issues on cancer rehabilitation. Cancer 119(S11):2170–2178CrossRefPubMedGoogle Scholar
  57. 57.
    Lyons KD, Radomski MV, Alfano CM, Finkelstein M, Sleight AG, Marshall TF, McKenna R, Fu JB (2017) Delphi study to determine rehabilitation research priorities for older adults with Cancer. Arch Phys Med Rehabil 98(5):904–914CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Alix G. Sleight
    • 1
  • Kathleen Doyle Lyons
    • 2
    • 3
  • Cheryl Vigen
    • 1
  • Heather Macdonald
    • 4
  • Florence Clark
    • 1
  1. 1.Mrs. T.H. Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Norris Cotton Cancer CenterDartmouth-Hitchcock Medical CenterLebanonUSA
  3. 3.Geisel School of Medicine at DartmouthHanoverUSA
  4. 4.Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations