Racial and ethnic differences in beliefs about lung cancer care

Sirisha Jonnalagadda, Jenny J. Lin, Judith E. Nelson, Charles A. Powell, John Salazar-Schicchi, Andrew R. Berman, Steven M. Keller, Cardinale B. Smith, Linda Lurslurchachai, Ethan A. Halm, Howard Leventhal, Juan P. Wisnivesky

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Disparities in lung cancer treatment and palliative care are well documented. However, the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. Methods: Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. Results: Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups (P > .05), whereas black patients were more likely to believe that surgery might cause lung cancer to spread (P = .008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups (P ≤ .02). No significant differences were found in attitudes toward clinician communication about cancer prognosis (P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care (P ≤ .02). Conclusions: Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.

Original languageEnglish (US)
Pages (from-to)1251-1258
Number of pages8
JournalChest
Volume142
Issue number5
DOIs
StatePublished - Nov 2012

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Lung Neoplasms
Palliative Care
Hispanic Americans
Hospice Care
Advance Care Planning
Advance Directives
Minority Groups
Terminal Care
Therapeutics
Neoplasms
Patient Care
Radiotherapy
Communication
Regression Analysis
Drug Therapy
Research

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Jonnalagadda, S., Lin, J. J., Nelson, J. E., Powell, C. A., Salazar-Schicchi, J., Berman, A. R., ... Wisnivesky, J. P. (2012). Racial and ethnic differences in beliefs about lung cancer care. Chest, 142(5), 1251-1258. https://doi.org/10.1378/chest.12-0330

Racial and ethnic differences in beliefs about lung cancer care. / Jonnalagadda, Sirisha; Lin, Jenny J.; Nelson, Judith E.; Powell, Charles A.; Salazar-Schicchi, John; Berman, Andrew R.; Keller, Steven M.; Smith, Cardinale B.; Lurslurchachai, Linda; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

In: Chest, Vol. 142, No. 5, 11.2012, p. 1251-1258.

Research output: Contribution to journalArticle

Jonnalagadda, S, Lin, JJ, Nelson, JE, Powell, CA, Salazar-Schicchi, J, Berman, AR, Keller, SM, Smith, CB, Lurslurchachai, L, Halm, EA, Leventhal, H & Wisnivesky, JP 2012, 'Racial and ethnic differences in beliefs about lung cancer care', Chest, vol. 142, no. 5, pp. 1251-1258. https://doi.org/10.1378/chest.12-0330
Jonnalagadda S, Lin JJ, Nelson JE, Powell CA, Salazar-Schicchi J, Berman AR et al. Racial and ethnic differences in beliefs about lung cancer care. Chest. 2012 Nov;142(5):1251-1258. https://doi.org/10.1378/chest.12-0330
Jonnalagadda, Sirisha ; Lin, Jenny J. ; Nelson, Judith E. ; Powell, Charles A. ; Salazar-Schicchi, John ; Berman, Andrew R. ; Keller, Steven M. ; Smith, Cardinale B. ; Lurslurchachai, Linda ; Halm, Ethan A. ; Leventhal, Howard ; Wisnivesky, Juan P. / Racial and ethnic differences in beliefs about lung cancer care. In: Chest. 2012 ; Vol. 142, No. 5. pp. 1251-1258.
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abstract = "Background: Disparities in lung cancer treatment and palliative care are well documented. However, the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. Methods: Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. Results: Of the 335 patients, 21{\%} were black, 20{\%} were Hispanic, and 59{\%} were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups (P > .05), whereas black patients were more likely to believe that surgery might cause lung cancer to spread (P = .008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups (P ≤ .02). No significant differences were found in attitudes toward clinician communication about cancer prognosis (P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care (P ≤ .02). Conclusions: Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.",
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AU - Nelson, Judith E.

AU - Powell, Charles A.

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AU - Berman, Andrew R.

AU - Keller, Steven M.

AU - Smith, Cardinale B.

AU - Lurslurchachai, Linda

AU - Halm, Ethan A.

AU - Leventhal, Howard

AU - Wisnivesky, Juan P.

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N2 - Background: Disparities in lung cancer treatment and palliative care are well documented. However, the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. Methods: Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. Results: Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups (P > .05), whereas black patients were more likely to believe that surgery might cause lung cancer to spread (P = .008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups (P ≤ .02). No significant differences were found in attitudes toward clinician communication about cancer prognosis (P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care (P ≤ .02). Conclusions: Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.

AB - Background: Disparities in lung cancer treatment and palliative care are well documented. However, the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. Methods: Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. Results: Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups (P > .05), whereas black patients were more likely to believe that surgery might cause lung cancer to spread (P = .008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups (P ≤ .02). No significant differences were found in attitudes toward clinician communication about cancer prognosis (P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care (P ≤ .02). Conclusions: Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.

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