Other Titles

The Association Between Symptoms, Social Support, SDOH, and HRQOL In Cardio-Oncology Patients Using Data From the All-of-Us Research Program [Poster Title]

Abstract

Cardio-oncology focuses on comprehensive cardiovascular care throughout their cancer journey1. When cancer and cardiovascular disease (CVD) coexist in the same individual, the overlapping symptoms intensify the challenges in managing cardio-oncology symptoms and impacting health outcomes2,3. Social determinants of health (SDOH) play a critical role in influencing cancer and CVD symptoms, symptom management, and outcomes4. Health outcomes across cancer and CVD are substantially impacted by disparities in environment and healthcare systems5. Notably, gaps in utilization and access to cardio-oncology care services are especially pressing in regions where essential healthcare systems are limited, contributing to heightened cancer mortality rates in these areas6,7. Addressing these disparities related to the environment and healthcare systems is essential from the SDOH perspective. This study aims to explore the influence of SDOH domains on symptoms, symptom management, and outcomes in cardio-oncology patients. We conducted a cross-sectional analysis by using the All-of-Us Research Program participant survey responses. The study sample was restricted to adults with cancer and CVD who had completed the surveys. Then, we created the concept set according to relevant variables by using survey responses in this cohort. After that, the calculated dataset, including each concept set within the built cohort, was analyzed using the R within the All-of-Us workbench. We performed multiple linear regression to predict how symptoms, symptom management, and outcomes influence on environment and healthcare systems. The environment model was significant, with depression (B = 0.40, p < 0.001) and relationship (B = 0.28, p < 0.05) as predictors, suggesting that higher levels of depression and strong relationship were associated with less favorable perceptions of the environment. The healthcare system model was also significant (F = 4.80, p < 0.001), with pain (B = 0.35, p < 0.001) and fatigue (B = -0.22, p < 0.05) as significant predictors, indicating that greater pain correlated with increased healthcare burden, while higher fatigue levels were associated with reduced healthcare engagement. This study provides insights into the complexity of symptom management and underscores the importance of addressing SDOH perspectives to enhance health outcomes in cardio-oncology patients.

Notes

References:

1. Parent, S., Pituskin, E., & Paterson, D. I. (2016). The cardio-oncology program: a multidisciplinary approach to the care of cancer patients with cardiovascular disease. Canadian Journal of Cardiology, 32(7), 847-851.

2. Fadol, A. P. (2018). Management of chemotherapy-induced left ventricular dysfunction and heart failure in patients with cancer while undergoing cancer treatment: The MD Anderson Practice. Frontiers in cardiovascular medicine, 5, 24.

3. Fadol, A. P., Patel, A., Shelton, V., Krause, K. J., Bruera, E., & Palaskas, N. L. (2021). Palliative care referral criteria and outcomes in cancer and heart failure: a systematic review of literature. Cardio-Oncology, 7, 1-21.

4. Jackson CS, Gracia JN. Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health. Public Health Rep. 2014;129(suppl 2):57–61. doi: 10.1177/00333549141291S211

5. Al-Kindi, S. G., & Oliveira, G. H. (2016, January). Prevalence of preexisting cardiovascular disease in patients with different types of cancer: the unmet need for onco-cardiology. In Mayo Clinic Proceedings (Vol. 91, No. 1, pp. 81-83). Elsevier.

6. Scheil-Adlung X. Global evidence on inequities in rural health protection. (2015). Available online at: http:// www. social- prote ction. org/ gimi/ gess/Resso urceP DF. action? id= 51297.

7. Blake KD, Moss JL, Gaysynsky A, Srinivasan S, Croyle RT. Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends. Cancer Epidemiol Biomarkers Prev. 2017;26:992–7. https:// doi. org/ 10. 1158/ 1055- 9965. EPI- 17- 0092

Description

Cardio-oncology integrates cardiovascular care within the cancer journey, where overlapping cancer and CVD symptoms complicate management and affect health outcomes. This study used All-of-Us program data to explore the influence of SDOH on symptoms, symptom management, and outcomes. Depression and relationships significantly influenced environmental perceptions, while pain and fatigue affected healthcare engagement. The findings emphasize addressing SDOH to improve outcomes in cardio-oncology.

Author Details

Cheongin Rachel Im, MSN, RN, PhD Candidate; Julie A. Zuniga, PhD, RN, FAAN; Kavita Radhakrishnan, PhD, MSEE, RN, FAAN

Sigma Membership

Epsilon Theta

Type

Poster

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Health Equity or Social Determinants of Health, Sub-acute Care, Public and Community Health, Cardio-oncology

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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The Influence of SDOH on Symptoms, Symptom Management, and Outcomes in Cardio-Oncology Patients

Seattle, Washington, USA

Cardio-oncology focuses on comprehensive cardiovascular care throughout their cancer journey1. When cancer and cardiovascular disease (CVD) coexist in the same individual, the overlapping symptoms intensify the challenges in managing cardio-oncology symptoms and impacting health outcomes2,3. Social determinants of health (SDOH) play a critical role in influencing cancer and CVD symptoms, symptom management, and outcomes4. Health outcomes across cancer and CVD are substantially impacted by disparities in environment and healthcare systems5. Notably, gaps in utilization and access to cardio-oncology care services are especially pressing in regions where essential healthcare systems are limited, contributing to heightened cancer mortality rates in these areas6,7. Addressing these disparities related to the environment and healthcare systems is essential from the SDOH perspective. This study aims to explore the influence of SDOH domains on symptoms, symptom management, and outcomes in cardio-oncology patients. We conducted a cross-sectional analysis by using the All-of-Us Research Program participant survey responses. The study sample was restricted to adults with cancer and CVD who had completed the surveys. Then, we created the concept set according to relevant variables by using survey responses in this cohort. After that, the calculated dataset, including each concept set within the built cohort, was analyzed using the R within the All-of-Us workbench. We performed multiple linear regression to predict how symptoms, symptom management, and outcomes influence on environment and healthcare systems. The environment model was significant, with depression (B = 0.40, p < 0.001) and relationship (B = 0.28, p < 0.05) as predictors, suggesting that higher levels of depression and strong relationship were associated with less favorable perceptions of the environment. The healthcare system model was also significant (F = 4.80, p < 0.001), with pain (B = 0.35, p < 0.001) and fatigue (B = -0.22, p < 0.05) as significant predictors, indicating that greater pain correlated with increased healthcare burden, while higher fatigue levels were associated with reduced healthcare engagement. This study provides insights into the complexity of symptom management and underscores the importance of addressing SDOH perspectives to enhance health outcomes in cardio-oncology patients.