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

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.

Psycho-oncology. 2015 Nov 09 [Epub ahead of print]

Natalie Escobio Bustillo, Heather L McGinty, Jason R Dahn, Betina Yanez, Michael H Antoni, Bruce R Kava, Frank J Penedo

Miami VA Healthcare System, Miami, FL, USA. , Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA. , Miami VA Healthcare System, Miami, FL, USA. , Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA. , Department of Psychology, University of Miami and Sylvester Cancer Center, Miami, FL, USA. , Miami VA Healthcare System, Miami, FL, USA. , Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.

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