Treatment experiences of Latinas after diagnosis of breast cancer

Abstract

Objectives We examined race/ethnic differences in patient perspectives about their breast cancer treatment experiences. Methods A weighted random sample of women newly diagnosed with breast cancer in 2013–15 in Los Angeles County and Georgia were sent surveys 2 months after surgery (N=5,080, 70% response rate). The analytic sample was limited to patients in Los Angeles County (N=2,397). Results The pattern of visits with different specialists before surgery was similar across race/ethnic groups. Low acculturated Latinas (Latinas-LA) were less likely to report high clinician communication quality for both surgeons and medical oncologists (under 69% vs over 72% for all other groups, p<.05). The proportion of patients who reported high satisfaction about how doctors worked together was similar across race/ethnic groups. Latinas-LA were more likely to have a low autonomy decision style (48% vs 24%–50% for all other groups, p<.001) and were more likely to report getting too much information vs other ethnic groups (20% vs <16% for other groups, p<.001). Patients who reported a low autonomy decision style were more likely to rate amount of information received for the surgery decision as “too much” (16% vs 9%, p<.001). Conclusions There is moderate disparity in breast cancer treatment communication and decision making experiences reported by Latinas with low acculturation vs other groups. The approach to treatment decision making by Latinas with low acculturation represents an important challenge to health care providers. Initiatives are needed to improve patient engagement in decision-making and increase clinician awareness of these challenges in this patient population.

Randomized controlled trial of supportive care interventions to manage psychological distress and symptoms in Latinas with breast cancer and their informal caregivers

“…Further, one-third of our sample lived in rural areas where access to services was lower than in urban areas. Rurality and poverty are likely to influence psychological distress and access to care (Ashing-Giwa & Lim, 2009;Katz et al, 2017). The advantages of using the telephone and delivering the interventions in Spanish was to increase accessibility for those who typically are underserved with psychosocial interventions.…”

“…Latinas also report more difficulty understanding written materials and finding culturally appropriate psychosocial treatment options. These difficulties may be due to some Latinas experiencing language and cultural barriers along with low health literacy (Katz et al, 2017).…”

Information and participation preferences and needs of non-Western ethnic minority cancer patients and survivors: A systematic review of the literature

“…In most studies, Asian patients and survivors prefer passive participation [29,[72][73][74] or shared participation [29,38,70].…”

“…-Demographic and socio-cultural factors [46,54,72] Asian-Australian [46] and Asian-American [72] patients with a lower level of acculturation [72] or education [46] preferred passive participation. Asian-Australian [46] patients with a higher level of education preferred active or shared participation in the decision-making process [46].…”

How Well Informed Do Patients Feel about Their Breast Cancer Surgery Options? Findings from a Nationwide Survey of Women after Lumpectomy and/or Mastectomy

“…3) Some participants' responses to certain questions might have suffered from recall bias. 4) Due to the design and sampling, the results might not be applicable to many breast cancer patients, including women living outside the US; women who do not read English 53 ; men 2,54 ; and women who do not use the internet due to lack of access, lack of interest, or other reasons. 5) Women whose health has deteriorated substantially since their operation (eg due to cancer recurrence, surgical complications, or other unrelated comorbidities) would be less likely to participate in public surveys than women in reasonably good health.…”