A contextual approach to understanding breast cancer survivorship among Latinas

Abstract

Objectives The purpose of this review is to describe the empirical literature on the health-related quality of life (HRQOL) in Latina breast cancer survivors by exploring the social determinants of health. In framing the key domains of survivors’ quality of life within a ecological-contextual model that evaluates individual and societal contributions to health outcomes, we provide a comprehensive landscape of the diverse factors constituting Latina survivors’ lived experiences and their resultant quality of life outcomes. Methods We retrieved 244 studies via search engines and reference lists, of which 37 studies met the inclusion criteria. Results Findings document the importance of the social determinants of HRQOL, with studies documenting ecological and contextual factors accounting for significant variance in HRQOL outcomes. Our review identifies a dearth of research examining community-, institutional-, and policy-level factors, such as health care access, legal and immigration factors, physical and built environments, and health care affordability and policies affecting Latina breast cancer survivors’ HRQOL. Conclusions Overall research on Latina breast cancer survivorship is sparse, with even greater underrepresentation within longitudinal and intervention studies. Results highlight a need for clear documentation of the comprehensive care needs of underserved cancer survivors and interventions considering integrated systems of care to address the medical and ecological factors known to impact the HRQOL of breast cancer survivors.

Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors

“…Research to delineate the factors associated with HRQOL in ethnic minority cancer survivors is limited [8]. The purpose of this study was to explore relationships among these factors in a sample of African American and Latina BCS, using the Contextual Model of HRQOL [9] (hereafter referred to as “‘Contextual Model” or “model”) as a framework to guide the research.…”

“…Factors associated with HRQOL in BCS include life burden (e.g., role limitations, neighborhood characteristics, daily stressors) [15], social support [18], ethnicity [8], ethnic identity [19], spirituality [4], socioeconomic status [20], employment status [21], chronological age and marital/relationship status [18], health insurance status [22], quality of the patient-physician relationship [23], side effects of cancer treatment and comorbidities [24], diet and exercise habits [20, 25], stage at diagnosis and treatment characteristics [4, 18], personal control beliefs [26], and depressive symptomology [27]. …”

Obesity, Ethnicity, and Quality of Life Among Breast Cancer Survivors and Women Without Breast Cancer: The Long-Term Quality of Life Follow-Up Study

“…Although there are well-known disparities in breast cancer outcomes between Hispanic and nonHispanic white (NHW) women in the USA [3,4], more Hispanic women are surviving cancer because of these improvements in screening and access to recommended treatment [5,6]. Hispanic survivors are projected to account for an increasing proportion of the vastly growing breast cancer survivor population [7][8][9].…”

Psychological Distress, Social Withdrawal, and Coping Following Receipt of an Abnormal Mammogram Among Different Ethnicities: A Mediation Model

“…Ethnic differences in coping along the cancer continuum have largely focused on coping during treatment and survivorship. Latinas are more likely to employ religious coping (e.g., prayer) (Ashing-Giwa et al, 2004; Culver, Arena, Antoni, & Carver, 2002; Culver, Arena, Wimberly, Antoni, & Carver, 2004; Lopez-Class, Gomez-Duarte, Graves, & Ashing-Giwa, 2012) and avoidant coping strategies (e.g., denial, self-distraction) (Culver et al, 2002; Umezawa et al, 2012) than their NLC counterparts. With regard to early detection, a few studies have assessed coping in relation to ethnic screening.…”