Psychological Distress, Symptoms, Social Support and Health Care Utilization in Rural and Urban Latinas with Breast Cancer

Abstract

The specific aims of this study were to 1) determine the differences between rural and urban Latinas with breast cancer for psychosocial distress (depression and anxiety), symptoms and symptom management, social support, and health care use, and, 2) determine the relationships among depression, anxiety, symptom distress, symptom management, social support (emotional and informational) and health care use. Method: This descriptive study was a secondary data analysis of data from a randomized controlled trial (RCT) testing the effectiveness of telephone interpersonal counseling intervention compared to supportive health education for Latinas with breast cancer and their informal caregivers. Latinas were recruited throughout the Southwest and Florida. Sample: A total of 120 Latinas with breast cancer participated in this study and the data used was from the baseline assessment. Latinas with breast cancer were matched on stage of breast cancer, and divided based on rurality. Sixty participants were in the rural group and 60 were in the urban group. Results: Essentially, there were no significant differences between rural and urban Latina women for depression, anxiety, symptoms and symptom management, social support, and health care use. Although there were no significant differences between rural and urban Latinas for depression, the rates for depression were similar for both groups. Both groups experienced clinically significant depressive symptoms. Increased depression also increased anxiety and symptom distress, and decreased the ability to manage symptoms and perceptions of emotional and informational support. Conclusion: The findings were not consistent with previous research that rural Latinas suffer from higher rates of depression, anxiety, distress, and lack access to social support versus their urban counterparts. However, the rural and urban groups had similar rates of depression, anxiety, and global symptom distress. Therefore, affecting their ability to manage symptoms, and decreasing perceptions of emotional and informational support. Women demonstrated the need for supportive interventions that are culturally appropriate, accessible, and cost effective.