Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors

Abstract Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of t...

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Autores principales:	Mary Rodriguez-Rabassa, Ruthmarie Hernandez, Zindie Rodriguez, Claudia B. Colon-Echevarria, Lizette Maldonado, Nelmit Tollinchi, Estefania Torres-Marrero, Adnil Mulero, Daniela Albors, Jaileene Perez-Morales, Idhaliz Flores, Julie Dutil, Heather Jim, Eida M. Castro, Guillermo N. Armaiz-Pena
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bbf4c822783147b7a21f5f94cf0f2d3e
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spelling	oai:doaj.org-article:bbf4c822783147b7a21f5f94cf0f2d3e2021-12-02T17:45:12ZImpact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors10.1038/s41598-020-66628-z2045-2322https://doaj.org/article/bbf4c822783147b7a21f5f94cf0f2d3e2020-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-66628-zhttps://doaj.org/toc/2045-2322Abstract Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n = 50) and non-cancer participants (n = 50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Among this cohort, we identified 41 matched cancer survivors/non-cancer participants pairs. Data were analyzed through descriptive, frequencies, correlational, and regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, predicted more barriers to receiving health care, especially in the first six weeks after the event, after which the effect was attenuated. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, VCAM-1, Vitamin D BP, and PDGF-AA, were significantly upregulated in cancer survivors while MMP9 and Osteopontin both had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial well-being. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines but did not show differences in anxiety, stress, and post-traumatic symptoms compared to non-cancer participants.Mary Rodriguez-RabassaRuthmarie HernandezZindie RodriguezClaudia B. Colon-EchevarriaLizette MaldonadoNelmit TollinchiEstefania Torres-MarreroAdnil MuleroDaniela AlborsJaileene Perez-MoralesIdhaliz FloresJulie DutilHeather JimEida M. CastroGuillermo N. Armaiz-PenaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-12 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mary Rodriguez-Rabassa Ruthmarie Hernandez Zindie Rodriguez Claudia B. Colon-Echevarria Lizette Maldonado Nelmit Tollinchi Estefania Torres-Marrero Adnil Mulero Daniela Albors Jaileene Perez-Morales Idhaliz Flores Julie Dutil Heather Jim Eida M. Castro Guillermo N. Armaiz-Pena Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
description	Abstract Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n = 50) and non-cancer participants (n = 50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Among this cohort, we identified 41 matched cancer survivors/non-cancer participants pairs. Data were analyzed through descriptive, frequencies, correlational, and regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, predicted more barriers to receiving health care, especially in the first six weeks after the event, after which the effect was attenuated. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, VCAM-1, Vitamin D BP, and PDGF-AA, were significantly upregulated in cancer survivors while MMP9 and Osteopontin both had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial well-being. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines but did not show differences in anxiety, stress, and post-traumatic symptoms compared to non-cancer participants.
format	article
author	Mary Rodriguez-Rabassa Ruthmarie Hernandez Zindie Rodriguez Claudia B. Colon-Echevarria Lizette Maldonado Nelmit Tollinchi Estefania Torres-Marrero Adnil Mulero Daniela Albors Jaileene Perez-Morales Idhaliz Flores Julie Dutil Heather Jim Eida M. Castro Guillermo N. Armaiz-Pena
author_facet	Mary Rodriguez-Rabassa Ruthmarie Hernandez Zindie Rodriguez Claudia B. Colon-Echevarria Lizette Maldonado Nelmit Tollinchi Estefania Torres-Marrero Adnil Mulero Daniela Albors Jaileene Perez-Morales Idhaliz Flores Julie Dutil Heather Jim Eida M. Castro Guillermo N. Armaiz-Pena
author_sort	Mary Rodriguez-Rabassa
title	Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
title_short	Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
title_full	Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
title_fullStr	Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
title_full_unstemmed	Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors
title_sort	impact of a natural disaster on access to care and biopsychosocial outcomes among hispanic/latino cancer survivors
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/bbf4c822783147b7a21f5f94cf0f2d3e
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Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors

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