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Psychooncology. 2017 Mar;26(3):323-329. doi: 10.1002/pon.4030. Epub 2015 Nov 9.

Fatalism, medical mistrust, and pretreatment health-related quality of life in ethnically diverse prostate cancer patients.

Author information

1
Miami VA Healthcare System, Miami, FL, USA.
2
Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
3
Department of Psychology, University of Miami and Sylvester Cancer Center, Miami, FL, USA.
4
Miller School of Medicine, University of Miami, Miami, FL, USA.

Abstract

OBJECTIVE:

Few studies have examined the impact of cultural processes prevalent in minority ethnic groups such as cancer fatalism and medical mistrust on health-related quality of life (HRQoL) following a cancer diagnosis. The present study examined relationships among ethnicity, HRQoL, and two possible cultural vulnerability factors-fatalistic attitudes and medical mistrust-among an ethnically diverse sample of men with prostate cancer (PC) prior to undergoing active treatment.

METHODS:

A total of 268 men with localized PC (30% African American, 29% Hispanic, and 41% non-Hispanic White) were assessed cross-sectionally prior to active treatment. Path analyses examined relationships among ethnicity, vulnerability factors, and HRQoL.

RESULTS:

Ethnicity was not related to HRQoL after controlling for relevant covariates. Hispanic men reported greater cancer fatalism compared with non-Hispanic White men (β = 0.15, p = 0.03), and both Hispanics (β = 0.19, p < 0.01) and African Americans (β = 0.20, p < 0.01) reported greater medical mistrust than non-Hispanic Whites. Fatalism demonstrated a trend toward negatively impacting physical well-being (β = -0.12, p = 0.06), but was not significantly related to emotional well-being (β = -0.10, p = 0.11). Greater medical mistrust was associated with poorer physical (β = -0.14, p = 0.03) and emotional well-being (β = -0.13, p = 0.04).

CONCLUSIONS:

Results indicate that fatalistic attitudes and medical system mistrust were more prevalent among minority men. Less trust in the medical system was associated with poorer physical and emotional well-being. Attention to perceptions of the healthcare system and its relation to HRQoL may have implications for targeting culturally driven attitudes that may compromise adjustment to a PC diagnosis.Copyright © 2015 John Wiley & Sons, Ltd.

PMID:
26553139
PMCID:
PMC4945476
DOI:
10.1002/pon.4030
[Indexed for MEDLINE]
Free PMC Article

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