The intersectionality of gender and poverty on symptom suffering among adolescents with cancer

Lyon, Maureen E.; Cheng, Yao I.; Needle, Jennifer; Friebert, Sarah; Baker, Justin N.; Jiang, Jiji; Wang, Jichuan

doi:10.1002/pbc.29144

Cited by 11 publications

(11 citation statements)

References 55 publications

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“…As reported by Shariff‐Marco et al, for breast cancer specific mortality these disparate outcomes were amplified when combined with low SES 38 . Female gender was also a predictor of information avoidance and high distress among cancer patients, and disparities widened among females who also had low SES 36,39 …”

Section: Resultsmentioning

confidence: 69%

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Intersectionality in cancer care: A systematic review of current research and future directions

et al. 2022

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Objectives The objective of the current review was to synthesize the literature on intersectionality relative to disparities across the cancer care continuum. A model to support future intersectional cancer research was proposed. Methods Web‐based discovery services and discipline‐specific databases were queried for both peer‐reviewed and gray literature. Study screening and data extraction were facilitated through the Covidence software platform. Results Among 497 screened studies, 28 met study inclusion criteria. Most articles were peer‐reviewed empirical studies (n = 22) that focused on pre‐diagnosis/screening (n = 19) and included marginalized racial/ethnic (n = 22) identities. Pre‐cancer diagnosis, sexual orientation and race influenced women's screening and vaccine behaviors. Sexual minority women, particularly individuals of color, were less likely to engage in cancer prevention behaviors prior to diagnosis. Race and socioeconomic status (SES) were important factors in patient care/survivorship with worse outcomes among non‐white women of low SES. Emergent themes in qualitative results emphasized the importance of patient intersectional identities, as well as feelings of marginalization, fears of discrimination, and general discomfort with providers as barriers to seeking cancer care. Conclusions Patients with intersectional identities often experience barriers to cancer care that adversely impact screening, diagnosis, treatment, as well as survivorship. The use of an “intersectional lens” as a future clinical and research framework will facilitate a more multidimensional and holistic approach to the care of cancer patients.

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Section: Resultsmentioning

confidence: 69%

“…38 Female gender was also a predictor of information avoidance and high distress among cancer patients, and disparities widened among females who also had low SES. 36,39…”

Section: Kamen Et Al Identified a Variety Of Different Experiences Amongmentioning

confidence: 99%

Intersectionality in cancer care: A systematic review of current research and future directions

et al. 2022

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“…Differences in symptom occurrence by gender were most apparent within certain groups such as sarcoma, HL, and NHL. This information adds to the limited evidence suggesting that overall, females experience increased symptoms with subsequent decreases in quality of life 22,23 …”

Section: Discussionmentioning

confidence: 79%

“…This information adds to the limited evidence suggesting that overall, females experience increased symptoms with subsequent decreases in quality of life. 22,23 In the time since diagnosis subset, several symptoms occurred more frequently within the first 6 months of diagnosis in both the total sample and within several diagnostic groups. It is likely the symptoms of nausea, hair loss, appetite loss, and difficulty sleeping occurred more frequently early in the disease trajectory because these symptoms are acute side effects of initial chemotherapy regimens.…”

Section: Nausea N Discussionmentioning

confidence: 99%

Symptom Profiles of Adolescents and Young Adults in Active Cancer Treatment by Diagnostic Groups

et al. 2021

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Background: The symptom experience of adolescents and young adults (AYAs) with cancer can differ based on the cancer and its treatments. A dearth of information exists on how symptoms differ by individual factors such as age and gender. Objectives: The objectives were to describe symptoms in AYAs across 5 cancer diagnostic groups by the individual factors of age group, sex, race/ethnicity, and time since diagnosis; and then to describe symptoms based on these individual factors within diagnostic groups. Methods: This was a secondary analysis of baseline data pooled from 2 multisite studies on symptoms in AYAs with acute lymphoblastic leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, and sarcoma. Symptoms were assessed using the Computerized Symptom Capture Tool. Results: Data from 118 AYAs with cancer, aged 13 to 29 years, were analyzed. Eight of the most commonly reported symptoms were reported in at least 4 diagnostic groups. Across diagnostic groups, symptoms varied little based on individual factors. Within groups, certain symptoms differed in frequency by individual factors. Conclusions: The lack of major differences in symptom prevalence based on individual factors across diagnostic groups supports a heterogeneous approach to symptom research with AYAs. The study identified individual factors within diagnostic groups worthy of further exploration. Implications for Practice: Providers can facilitate discussions with AYAs about symptoms by being aware of common symptoms that may occur in certain cancer diagnostic groups and based on individual factors. The significance of the individual symptom experience should not be underestimated, emphasizing the importance of person-centered symptom assessment.

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“…Second, utilization of inpatient hospital services for procedures and therapies as well as laboratories and x-rays were 6 to 8 times higher for children with cancer than for children with nonspecified chronic conditions. These findings suggest that children with cancer may need more healthcare services than the general pediatric concurrent hospice care patient, which may reflect the unique complexities of cancer symptom burden and suffering 17,19,20 …”

Section: Discussionmentioning

confidence: 99%

Patterns of Healthcare Services Among Children With Advanced Cancer in Concurrent Hospice Care

et al. 2022

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Concurrent hospice care Latent class analysis Pediatric hospice care Pediatric oncology Background: Children with advanced cancer have access to comprehensive cancer care and hospice care if they enroll in concurrent hospice care. However, little is known about the patterns of nonhospice healthcare services used by these children. Objective: The aim of this study was to examine the patterns of nonhospice healthcare services among children with cancer in concurrent hospice care. Methods: This study was a retrospective cohort analysis of 2011-2013 Medicaid claims data from 862 pediatric cancer patients. Data were analyzed using descriptive statistics and latent class analysis (LCA). Results: Children used 120 388 healthcare services, including inpatient and outpatient hospital services, laboratories and x-rays, durable medical equipment, medications, and others. These services clustered into 2 classes with moderate-intensity (57.49%) and high-intensity (42.50%) healthcare service use. Children in the highintensity cluster were more likely to reside in the South with comorbidities, mental/ behavioral health conditions, and technology dependence and were less likely to have solid tumors, compared with the moderate-intensity group. Conclusions: Nonhospice healthcare services clustered together in 2 distinct classes, providing critical insight into the complexity of the healthcare use among children with cancer in concurrent hospice care. Implications for Practice: Understanding that pediatric patients in concurrent care may have different healthcare service patterns may assist oncology nurses caring for children with advanced cancer. These findings also have policy implications.

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The intersectionality of gender and poverty on symptom suffering among adolescents with cancer

Cited by 11 publications

References 55 publications

Intersectionality in cancer care: A systematic review of current research and future directions

Intersectionality in cancer care: A systematic review of current research and future directions

Symptom Profiles of Adolescents and Young Adults in Active Cancer Treatment by Diagnostic Groups

Patterns of Healthcare Services Among Children With Advanced Cancer in Concurrent Hospice Care

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