Associations Between Social Determinants of Health and Psychoneurologic Symptom Clusters in Women With Gynecologic Cancers: A Longitudinal Study

Zahra A. Barandouzi

Jinbing Bai

Tony Y. Eng

Pretesh Patel

Joseph Shelton

Namita Khanna

Isabelle Scott

Jill Remick

Rebecca Meador

Deborah Watkins Bruner

social determinants of health, psychoneurologic symptoms, gynecologic cancers
ONF 2023, 50(2), 241-251. DOI: 10.1188/23.ONF.241-251

Objectives: To evaluate the associations between social determinants of health (SDOH) and psychoneurologic symptom (PNS) clusters in women with gynecologic cancers during cancer treatment.

Sample & Setting: 67 women with gynecologic cancers who received radiation therapy were assessed at baseline, six to eight weeks after treatment, and six months after treatment at oncology clinics in Georgia.

Methods & Variables: Fatigue, pain, sleep disturbances, cognitive impairment, and depressive symptoms were measured to determine a PNS cluster score. Associations between SDOH and PNS cluster scores were assessed using mixed-effect models.

Results: Larger mean PNS cluster scores were reported in individuals with less education, lower income, and unemployment, as well as in those living in more disadvantaged neighborhoods.

Implications for Nursing: Individual- and community-level SDOH and their interactions were associated with more PNS clusters. Studying SDOH at multiple levels depicts how various social disadvantages can exacerbate poor health outcomes.

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