Social determinants of health among family caregiver centered outcomes in lung cancer: a systematic review

Dede K Teteh; Madeleine Love; Marissa Ericson; Marissa Chan; Tanyanika Phillips; Aroona Toor; Betty Ferrell; Loretta Erhunmwunsee; Susanne B Montgomery; Virginia Sun; Jae Y Kim

doi:10.21037/jtd-22-1613

Social determinants of health among family caregiver centered outcomes in lung cancer: a systematic review

J Thorac Dis. 2023 May 30;15(5):2824-2835. doi: 10.21037/jtd-22-1613. Epub 2023 May 9.

Authors

Affiliations

¹ Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA.
² Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
³ Department of Psychology, University of Southern California, Los Angeles, CA, USA.
⁴ Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
⁵ Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
⁶ Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
⁷ Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
⁸ School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA.

Abstract

Background: Lung cancer is the leading cause of cancer death globally. Both lung cancer patients and family caregivers (FCGs) have unmet quality of life (QOL) needs. An understudied topic in lung cancer research is the role of social determinants of health (SDOH) on QOL outcomes for this population. The purpose of this review was to explore the state of research on SDOH FCGs centered outcomes in lung cancer.

Methods: The databases PubMed/MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association (APA) PsycInfo were searched for peer-reviewed manuscripts evaluating defined SDOH domains on FCGs published within the last ten years. The information extracted using Covidence included patients, FCGs and study characteristics. Level of evidence and quality of articles were assessed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale.

Results: Of the 344 full-text articles assessed, 19 were included in this review. The social and community context domain focused on caregiving stressors and interventions to reduce its effects. The health care access and quality domain showed barriers and underuse of psychosocial resources. The economic stability domain indicated marked economic burdens for FCGs. Four interconnected themes emerged among articles on the influence of SDOH on FCG-centered outcomes in lung cancer: (I) psychological well-being, (II) overall quality of life, (III) relationship quality, and (IV) economic hardship. Notably, most participants in the studies were White females. The tools used to measure SDOH factors included primarily demographic variables.

Conclusions: Current studies provide evidence on the role of SDOH factors on lung cancer FCGs' QOL. Expanded utilization of validated SDOH measures in future studies would provide greater consistency in data, that could in turn inform interventions to improve QOL. Further research focusing on the domains of education quality and access and neighborhood and built environment should be carried out to bridge gaps in knowledge.

Keywords: Social determinants of health (SDOH); family caregivers (FCGs); lung cancer; quality of life (QOL).

Publication types

Review

Grants and funding

L60 CA253971/CA/NCI NIH HHS/United States