The sampling frame consisted of 1,133 eligible women according to tumor registry data. We were unable to contact 29% (n=333), 22% (n=249) were ineligible mostly due to misclassification of ethnicity, 14% (n=161) declined, and 6% (n=60) were deceased or too ill. We obtained a 67% response rate of those who were eligible, not too ill, and accessible (330/491), or 29% of the sampling frame. The survey took 32 minutes on average. Compared to non-participants (ineligibles, refusals, and those who were unable to be contacted, deceased or too ill), participants tended to be younger at the time of the interview (mean age 58.3 vs. 61.4 years, p<.001) and at diagnosis (55.8 versus 58.2 years, p<.001), and less likely to have well differentiated tumors (14.1% vs. 18.5%, p<.05). There were no significant differences between participants and non-participants by county of residence or stage at diagnosis.
The mean age of the sample was 58 years (range=30–90 years; SD=11.9 years); 25% were less than age 50 (). About 60% were foreign-born and only 30% were English dominant. Approximately 70% were of Mexican origin, 14% were Central American, and 7% were South American. Almost 70% had a high school education or less. Sixty percent were married or living with someone. The majority was not employed outside the home. Less than 3% was uninsured, with two-thirds privately insured and almost one-third publicly insured.
Demographic and Clinical Characteristics, and Coping Resources of Latinas with Breast Cancer, Northern California, 2004 (N=308–330).
Coping resources were fairly high among this group of Latina cancer survivors. The mean cancer self-efficacy score was 3.41 (SD 0.60) on a 1–4 scale. The mean spiritual well-being score was 40.8 (SD 7.02) on a 0–48 scale. Mean scale scores for perceived support from family/friends and oncologists were both above 3.5 on a 1–4 scale.
About 60% of the women had a mastectomy, half had well or moderately differentiated histological grading of their tumors, and almost 70% had in situ or localized breast cancer. Almost all were within two or three years of diagnosis when interviewed (283; 85.8%). Slightly less than 20% reported a comorbid chronic condition, consisting mostly of hypertension, diabetes, and arthritis. Over 20% reported experiencing some functional limitations, and over one-fourth reported being in poor or fair health.
In bivariate analyses, being older, less acculturated, less educated, unemployed, or having public health insurance, a mastectomy, or comorbidity were associated with a greater likelihood of reporting functional limitations (). In bivariate models, cancer self-efficacy, spiritual well-being, and perceived social support from family and friends, were inversely associated with functional limitations.
Odds of Reporting Functional Limitations among Latina Breast Cancer Survivors (N=265–330).
In multivariate models examining the independent effects of sociodemographic, clinical, and coping factors on functional limitations, controlling for other variables in the model, employment status, type of surgery, comorbidity, and cancer self-efficacy were significantly associated with functional status. Unemployed women were seven times more likely to report functional limitations than women who were working (Adjusted Odds Ratio or AOR 7.06, 95% CI 2.04, 24.46). Women with a mastectomy were almost three times as likely to report functional limitations as women with a lumpectomy (AOR 2.67; 95% CI 1.06, 6.77). Comorbidity was associated with a four-fold increased risk of functional limitations (AOR 4.09, 95 CI 1.69, 9.89). Cancer self-efficacy was protective against functional limitations (AOR 0.40, 95% CI 0.18, 0.90).
In bivariate analyses, being less acculturated, less educated, unemployed, and having a comorbid chronic condition were associated with poorer self-rated health (). In bivariate models, all of the coping resources (cancer self-efficacy, spiritual well-being, social support from family and friends, and social support from oncologists) were protective against reporting poorer health.
Odds of Reporting Poor or Fair Self-Rated Health among Latina Breast Cancer Survivors (N=265–330).
In the multivariate model, women with a comorbid condition were almost five times more likely to report being in poor/fair health than those with no other chronic health problem (AOR 4.95, 95% CI 2.13, 11.47). Of the coping resources, only cancer self-efficacy remained independently associated with self-rated health, such that women with higher levels of self-efficacy were less likely to report being in poor/fair health (AOR 0.30, 95% CI 0.13, 0.66).