Dataset Information

Sexual minority-specific experiences of colorectal cancer survivors.

ABSTRACT:

Objective

To examine how sexual minority-specific factors relate to colorectal cancer survivors' health-related quality of life, psychological adjustment, and quality of care.

Method

One hundred twenty-seven sexual minority survivors diagnosed with stage I, II, or III colorectal cancer were recruited from four cancer registries. An average of 3 years after diagnosis, eligible survivors participated in a telephone survey, which measured survivors' outcomes, consisting of physical and mental quality of life, anxiety, depression, self-rated fair or poor health, and quality of care. We considered sexual minority-specific factors (e.g., outness, discrimination) as correlates for each survivorship outcome using forward selection with generalized linear or logistic regression models.

Results

After adjusting for confounders, accumulation of lifetime discrimination experiences had negative associations with survivors' physical and mental quality of life, anxiety, and depression. Sexual minority-specific discrimination experiences were negatively associated with perceived quality of care after adjusting for confounders. Sexual minority survivors' self-rated fair or poor health and their rating of care as excellent were independent of sexual minority-specific factors.

Conclusion

Addressing and counteracting sexual minority-specific and other lifetime discrimination experiences may be a pathway to improving sexual minority cancer survivors' quality of care, quality of life, and psychological adjustment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

SUBMITTER: Boehmer U

PROVIDER: S-EPMC10367941 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Sexual minority-specific experiences of colorectal cancer survivors.

Boehmer Ulrike U Clark Melissa A MA Winter Michael M Berklein Flora F Ozonoff Al A

Health psychology : official journal of the Division of Health Psychology, American Psychological Association 20220908 11

<h4>Objective</h4>To examine how sexual minority-specific factors relate to colorectal cancer survivors' health-related quality of life, psychological adjustment, and quality of care.<h4>Method</h4>One hundred twenty-seven sexual minority survivors diagnosed with stage I, II, or III colorectal cancer were recruited from four cancer registries. An average of 3 years after diagnosis, eligible survivors participated in a telephone survey, which measured survivors' outcomes, consisting of physical a ...[more]

PMID: 36074595

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Project description:ImportanceAdvance care planning (ACP) can promote patient-centered end-of-life (EOL) care and is intended to ensure that medical treatments are aligned with patient's values. Sexual and gender minority (SGM) people face greater discrimination in health care settings compared with heterosexual, cisgender people, but it is unknown whether such discrimination occurs in ACP and how it might affect the ACP experiences of SGM people.ObjectivesTo increase understanding of barriers and facilitators of ACP facing SGM individuals.Design, setting, and participantsThis mixed-methods national study of ACP included a telephone survey of self-identified SGM and non-SGM participants in a nationally representative sample drawn from a larger omnibus national panel by SSRS. Qualitative interviews were conducted with a subset of survey participants who identified as SGM. Data were collected from October 2020 to March 2021.ExposuresSelf-identified SGM.Main outcomes and measuresThe survey included 4 items from the validated ACP Engagement Survey, adapted to capture experiences of discrimination. Interviews asked about participants' experiences with ACP, including the appointment of medical decision-makers, sharing preferences, and experiences within the health care system more broadly.ResultsA total of 603 adults participated in the survey, with 201 SGM individuals (mean [SD] age, 45.7 [18.7] years; 101 [50.2%] female; 22 [10.9%] Black, 37 [18.4%] Hispanic, and 140 [69.7%] White individuals) and 402 non-SGM individuals (mean [SD] age, 53.7 [19.2] years; 199 [49.5%] female; 35 [8.7%] Black, 41 [10.2%] Hispanic, and 324 [80.6%] White individuals). Regarding reasons for not completing ACP, SGM respondents, compared with non-SGM respondents, were more likely to say "I don't see the need" (72 [73.5%] vs 131 [57.2%], P = .006) and "I feel discriminated against by others" (12 [12.2%] vs 6 [2.6%], P < .001). Of 25 completed interviews among SGM participants, 3 main themes were identified: how fear and experiences of discrimination affect selection of clinicians and whether to disclose SGM identity; concerns about whether EOL preferences and medical decision-makers would be supported; and a preference to discuss EOL decisions and values outside of clinical settings.Conclusions and relevanceThis study found that fear of disclosing sexual orientation or gender identity information and discrimination are important barriers to ACP for SGM in clinical settings, but discussions of preferences and values still occur between many SGM people and medical decision-makers. More SGM-specific patient-centered care might better support these discussions within the health care system. Furthermore, health systems can facilitate improved engagement by supporting clinician sensitivity training, including guidance on documentation and requirements.

Dataset Information

Sexual minority-specific experiences of colorectal cancer survivors.

Objective

Method

Results

Conclusion

Publications

Sexual minority-specific experiences of colorectal cancer survivors.

Similar Datasets

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