Patient Navigation in Mothers at Risk for and Surviving with Breast/Ovarian Cancer: The Role of Children's Ages in Program Utilization and Health Outcomes

乳腺癌/卵巢癌高危及幸存母亲的患者导航:儿童年龄在项目利用和健康结果中的作用

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Abstract

BACKGROUND/OBJECTIVES: Many women at risk for and surviving with breast/ovarian cancer are simultaneously raising children. These women often experience unique challenges due to concurrent demands as both parents and patients with cancer. Community-based cancer control organizations offer vital patient navigation (PN), including psychoeducational services. Yet, little is known about how PN addresses these mothers' comprehensive care needs. METHODS: We examined PN program data from N = 1758 women served by a national cancer organization. RESULTS: Out of the 69% of navigated women who were mothers, most were raising adult children only (age ≥ 18; 56%); however, 31% were mothers with young children only (age < 18), and 13% were mothers with both adult and young children (χ(2) = 341.46, p < 0.001). While mothers with adult children reported poorer quality of life (QoL) than mothers with young children (physically unhealthy days, t = -2.2, df = 526, p < 0.05; total unhealthy days, t = -1.2, df = 533, p < 0.05), there were no significant differences in their PN experiences. For mothers with young children, a better QoL was associated with a lower genetic risk for cancer (r = -0.12) and a stronger sense of psychosocial empowerment (r = 0.10) (all p's < 0.05). In an adjusted multivariate regression model of QoL, as empowerment increased, the influence of PN quality decreased (ß = -0.007, SE of ß = 0.00, p = 0.02), suggesting that strengthening mothers of young children's sense of agency over their breast/ovarian cancer is critical to achieving overall well-being. CONCLUSIONS: CBO-led cancer control programming that supportively cares for mothers across their cancer journey can be essential to their QoL, especially for those who are raising minors.

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