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

Oncol Nurs Forum. 2023 Feb 17;50(2):241-251. doi: 10.1188/23.ONF.241-251.

Abstract

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.

Keywords: gynecologic cancers; psychoneurologic symptoms; social determinants of health.

MeSH terms

  • Ambulatory Care Facilities
  • Female
  • Genital Neoplasms, Female* / radiotherapy
  • Humans
  • Longitudinal Studies
  • Social Determinants of Health*
  • Syndrome