A Cross-Sectional Analysis of Psychosocial Mediators Between Discrimination and Health-Related Quality of Life Among Sexual and Gender Minority Cancer Survivors.

IF 3.3 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2025-04-01 DOI:10.1002/pon.70154

Oscar Y Franco-Rocha, Christopher W Wheldon, Carolyn S Phillips, Mansi Patel, Tiffany A Whittaker, Shelli R Kesler, Ashley M Henneghan

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引用次数: 0

Abstract

Background: Acts of discrimination detrimentally impact the quality of life of sexual and gender minority (SGM) cancer survivors. However, it is unclear how demographic and psychosocial factors shape the impact of discrimination on health.

Aims: To evaluate the intermediating role of everyday discrimination on physical and mental health-related quality of life (HRQOL), and how such relationships vary based on the demographic and psychosocial factors of SGM survivors.

Methods: Secondary analysis with 381 SGM cancer survivors participating in the All of Us (AoU) research program. Valid and reliable measures to assess depression, anxiety, stress, social support, and loneliness were used to test whether these psychosocial variables mediated the relationship between discrimination and HRQOL. The hypothesized model was tested using structural equation modeling in the AoU workbench's RStudio platform.

Results: Discrimination affected physical (β = -0.141, p < 0.001) and mental (β = -0.115, p < 0.001) HRQOL through loneliness and psychological distress. The relationship between racial/ethnic minority status and physical (β = -0.045, p = 0.007) and mental (β = -0.036, p = 0.008) HRQOL was directly mediated by discrimination via psychological distress, and indirectly through loneliness and psychological distress (β physical HRQOL = -0.025, p = 0.010; β mental HRQOL = -0.020, p = 0.010).

Conclusions: Loneliness and psychological distress mediate the relationship between discrimination and HRQOL. The impact of discrimination on HRQOL was particularly higher for SGM survivors that were also part of a racial or ethnic minority group. Addressing psychosocial mediators through tailored support programs could mitigate the harmful effects of discrimination, thereby improving HRQOL for SGM cancer survivors.

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性别和性别少数癌症幸存者中歧视与健康相关生活质量的社会心理调节因素横断面分析

背景：歧视行为严重影响了性少数和性别少数（SGM）癌症幸存者的生活质量。然而，尚不清楚人口和社会心理因素如何影响歧视对健康的影响。目的：评估日常歧视对身心健康相关生活质量（HRQOL）的中介作用，以及这种关系如何根据SGM幸存者的人口统计学和社会心理因素而变化。方法：对参与All of Us （AoU）研究计划的381例SGM癌症幸存者进行二次分析。采用有效可靠的测量方法来评估抑郁、焦虑、压力、社会支持和孤独，以检验这些社会心理变量是否介导歧视与HRQOL之间的关系。在AoU工作台的RStudio平台上使用结构方程建模对假设模型进行了检验。结果：歧视影响生理（β = -0.141, p）。结论：孤独和心理困扰在歧视与HRQOL之间起中介作用。对于同样属于种族或少数民族群体的SGM幸存者来说，歧视对HRQOL的影响尤其大。通过量身定制的支持计划解决社会心理中介问题可以减轻歧视的有害影响，从而改善SGM癌症幸存者的HRQOL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.