儿童癌症成年幸存者的邻里脆弱性及与健康相关的生活质量低下的关联。

IF 3.4 Q2 ONCOLOGY JNCI Cancer Spectrum Pub Date : 2024-11-01 DOI:10.1093/jncics/pkae088
Jaesung Choi, Madeline R Horan, Tara M Brinkman, D Kumar Srivastava, Kirsten K Ness, Gregory T Armstrong, Melissa M Hudson, I-Chan Huang
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引用次数: 0

摘要

背景:很少有研究调查儿童癌症人群中邻里脆弱性与健康相关生活质量(HRQOL)之间的关系。本研究评估了邻里脆弱性对儿童癌症成年幸存者 HRQOL 的影响:这项横断面研究纳入了圣裘德终身队列研究(St Jude Lifetime Cohort Study)中的 4393 名儿童癌症成年幸存者。在基线期(2007-2020 年),HRQOL 采用 SF36v2 的身体/精神成分汇总表(PCS/MCS)进行评估。邻里脆弱性采用社会脆弱性指数(SVI)和少数民族健康 SVI(MHSVI)的总分、领域分和特定指标分进行评估。多变量逻辑回归用于评估邻里脆弱性(四分位数:Q1-Q4)与受损的 HRQOL(低于标准值 1SD)之间的关系,并对诊断、人口统计学、个人社会经济地位 (SES)、生活方式和慢性疾病负担进行调整。分析了SVI/MHSVI与个人社会经济地位对受损的HRQOL的交互作用:在幸存者中,51.9%为男性,评估时平均年龄为30.3岁,确诊后平均年龄为21.5岁。比较易感性较高与较低的社区(Q4 与 Q1),总体易感性(OR = 1.60,95%CI = 1.19-2.16)和特定领域的易感性(社会经济,OR = 1.59,95%CI = 1.19-2.16)均有所下降:OR = 1.59,95%CI = 1.18-2.15;家庭组成:OR=1.54,95%CI=1.16-2.06;住房/交通:OR=1.33,95%CI=1.00-1.76;医疗脆弱性:OR=1.60,95%CI=1.22-2.09)与 PCS 下降显著相关,但与 MCS 无关。居住在缺乏紧急护理诊所的社区与 PCS 受损有显著相关性(OR = 1.39,95%CI = 1.08-1.78)。个人教育程度较低与较高以及居住在较脆弱的社区都与PCS受损有关(P交互作用=0.021):结论:邻里脆弱性的某些方面会增加身体健康与生活质量受损的风险。解决这些邻里因素对于提高幸存者的 HRQOL 至关重要。
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Neighborhood vulnerability and associations with poor health-related quality of life among adult survivors of childhood cancer.

Background: Few studies have investigated the relationship between neighborhood vulnerability and health-related quality of life (HRQOL) in the childhood cancer population. This study evaluated the impact of neighborhood vulnerability on HRQOL among adult survivors of childhood cancer.

Methods: This cross-sectional study included 4393 adult survivors of childhood cancer from the St Jude Lifetime Cohort Study. At the baseline (2007-2020), HRQOL was assessed using the SF36v2's physical and mental components summaries (PCS and MCS). Neighborhood vulnerability was assessed using the overall, domain, and indicator-specific scores of the Social Vulnerability Index (SVI) and Minority Health SVI (MHSVI). Multivariable logistic regression was used to evaluate associations of neighborhood vulnerability (quartiles: Q1-Q4) with impaired HRQOL (1SD below the norm), adjusting for diagnosis, demographics, personal socioeconomic status (SES), lifestyle, and chronic health condition burden. Interactions of SVI and MHSVI with personal SES on impaired HRQOL were analyzed.

Results: Among survivors, 51.9% were male, averaging 30.3 years of age at evaluation and 21.5 years since diagnosis. Comparing neighborhoods with higher vs lower vulnerability (Q4 vs Q1), overall (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.19 to 2.16) and domain-specific vulnerability (socioeconomic: OR = 1.59, 95% CI = 1.18 to 2.15; household composition: OR = 1.54, 95% CI = 1.16 to 2.06; housing and transportation: OR = 1.33, 95% CI = 1.00 to 1.76; medical vulnerability: OR = 1.60, 95% CI = 1.22 to 2.09) were significantly associated with impaired PCS, but not MCS. Residing in neighborhoods lacking urgent care clinics was significantly associated with impaired PCS (OR = 1.39, 95% CI = 1.08 to 1.78). Having lower vs higher personal education and living in higher vulnerability neighborhoods were associated with more impaired PCS (Pinteraction = .021).

Conclusions: Specific aspects of neighborhood vulnerability increase the risk for impaired physical HRQOL. Addressing these neighborhood factors is essential to enhance the HRQOL of survivors.

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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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