Perceived risk factors of depression among Latina breast cancer survivors

Women with breast cancer commonly, between 27%-33%, experience depression. However, this condition often goes under-recognized and under-treated, especially in ethnic minorities. If left untreated, co-occurring depression can complicate cancer treatment, lead to poor treatment adherence, lead to impaired functioning and increased physical symptoms, and has been shown to increase mortality rate by 25% to 27%. The need for public health efforts to prevent premature death is obvious. A theory-driven parallel mixed-methods (quantitative and qualitative) approach was used to identify potential risk factors of depression within an ecological framework. The purpose of the qualitative phase, focus of this presentation, was to contextualize the perceived psychosocial, cultural, and cancer prognostic/treatment-related risk factors of depression among Latinas diagnosed with breast cancer within the last 5 years. Women with a cancer reoccurrence or terminal cancer were excluded. Ninety participants completed a semi-structured phone interview. Participants were recruited through Latino cancer support groups and other community organizations in West Central Florida. Content and thematic analyses were performed. Salient themes related to risk factors for depression include (1) intrapersonal factors - acceptance of illness, lack of faith and access to health care among other structural barriers, and body-image, (2) interpersonal factors - disclosure of illness to family and others, lack of trust in doctors and family support to include relationship changes with partner (i.e., divorce), and (3) community factors - negative advertisement and informational resources, stigma, and lack of access to health care in Spanish. Participants provided recommendations for culturally-appropriate interventions to prevent or reduce depression.