Psychosocial concerns and needs of cancer survivors treated at a comprehensive cancer center and a community safety net hospital

The number of cancer survivors in the United States is expected to grow to 18 million by 2020 because of improved cancer treatment outcomes and the aging of the population.[1] Many cancer survivors are at increased risk for cancer recurrence and other adverse long-term physical and psychosocial conditions.[2-5] Disparities in survival are associated with inadequate or no health insurance coverage because individuals are more likely to be diagnosed with cancer at later stages,[6] and higher incidence for some cancers among African Americans.[7] Few studies have examined psychosocial health disparities during cancer survivorship,[8-13] and little is known about how psychosocial factors subsequent to diagnosis affect survival and long-term outcomes. [4,14] While clinical care relevant to survivorship outcomes is advancing, [15, 16] optimal practices for preparing survivors for treatment and transitioning off treatment have yet to be defined. [11, 15, 17] Furthermore, guidance is needed for serving minority and underserved survivor populations where health disparities exist.[7] More data are needed about incidence of adverse outcomes and their determinants, overall and in disparity populations to inform development of best practices for preventive interventions. The purpose of this study was to identify similarities and differences among two groups of survivors in (1) sources of information at time of cancer diagnosis, (2) sources of support used during and after treatment, (3) stressors and challenges during and after treatment, and (4) coping strategies[18] used during and following cancer treatment. These factors might be associated with health services use,[19] and with survivorship disparities.[20] One group was treated at Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center, and the other at Meharry Medical College (MMC), its partner medical setting that serves patients who are mostly publicly-insured and uninsured. Secondary analysis of data from focus group participants was undertaken to address the four study topics and to guide future development of interventions tailored to preferences and needs of diverse survivors

PhD

Breast cancer (BC) remains the most common cancer in women. Although screening mammography (SM) is an effective approach for early detection of BC, uninsured, underinsured, and minority women often do not have access to SM. The National Breast and Cervical Early Detection Program provide free access to SM. Of women who screen, 10-15% requires further testing, and half of those delay or do not return. Delay may contribute to later stage BC at diagnosis and increased rates of recurrence and death. This study was conducted to identify predictors of delay after an abnormal mammogram and predictors of rescreening behavior in women enrolled in the Tennessee Breast and Cervical Screening Program. Bivariate and multivariate logistic regression analyses were used to explore association between age, race, ethnicity, and marital status, BC history, and presence of breast symptoms and the outcomes of delay and rescreening behavior. Of 11,610 women, 37% required further testing. In a subset of women with time to completion > 1 day, 30% experienced delay > two months. Seventeen percent had another SM during the study period (2002-2006). The high percentage of women needing further testing is likely attributed to the program receiving referrals for diagnosis of symptomatic women as well as asymptomatic screening. Controlling for marital status, age, and BC history, there was more delay in test completion if the women African American versus Caucasian (OR 1.45, 95% CI 1.13, 1.85), Hispanic (OR .72, 95% CI 0.55, 0.93) and reported no breast symptoms (OR 1.50, 95% CI 1.27, 1.77). A delay in receipts of test results > 1 week contributed to the overall delay. Controlling for race and BC history, there was greater likelihood of rescreening if the women were married (OR 1.27, 95% CI 1.12, 1.43) and over 50 years of age (OR 1.92, 95% CI 1.67, 2.21) and less likelihood if the women were non-Hispanic (OR 0.71, 95% CI 0.60, 0.83) and had no breast symptoms (OR 0.85, 95% CI 0.76.,0.96). Findings can be used to identify women at risk for delay, assess understanding of the indication for further test, identify potential barriers to completion of testing or rescreening, and tailor interventions to overcome the barriers

Cancer Nursing: Principles and Practice 7th Edition

Meredith [Wallace] Kazer (with A. Harmon) is a contributing author, Prostate Cancer . Book description: For more than eighteen years, best-selling Cancer Nursing: Principles and Practice has provided oncology nurses with the latest information on new trends in the rapidly changing science of oncology. Now, in its Seventh Edition, Cancer Nursing has been completely revised and updated to reflect key new developments. New topics covered include targeted therapy, hypersensitivity reactions, mucositis, and family and caregiver issues. With 27 new chapters featuring insights from key authors, the Seventh Edition is a must-have resource for every oncology nurse. --Publisher description.https://digitalcommons.fairfield.edu/nursing-books/1057/thumbnail.jp