Fatalism and educational disparities in beliefs about the curability of advanced cancer

Paul R. Duberstein, Michael Chen, Benjamin P. Chapman, Michael Hoerger, Fahad Saeed, Elizabeth Guancial, Jennifer W. Mack

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism. Methods We studied 977 patients with advanced, incurable cancer. Two logistic regression analyses were conducted. Model One examined the effect of education on beliefs about curability. Model Two added fatalism. Results The significant association between having less than a high school education and the belief that advanced cancer can be cured (OR = 2.55; 95% CI: 1.09–5.96) in Model One was attenuated by 39% and rendered nonsignificant in Model Two. Fatalism was associated with the belief that advanced cancer can be cured. Whites were less likely to believe they could be cured than Blacks and Asians/Pacific Islanders. Beliefs about curability were not associated with income or insurance status. Conclusions People who do not complete high school are more likely to believe that their advanced cancer is curable, in part because they are more likely to hold fatalistic worldviews. Practice implications Interventions to help oncologists care for patients with fatalistic beliefs could mitigate socioeconomic disparities in end-of-life care.

Original languageEnglish (US)
Pages (from-to)113-118
Number of pages6
JournalPatient Education and Counseling
Volume101
Issue number1
DOIs
StatePublished - Jan 2018

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Neoplasms
Education
Patient Care
Insurance Coverage
Terminal Care
Logistic Models
Regression Analysis
Oncologists

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Keywords

  • Cancer
  • Education
  • End-of-life
  • Fatalism
  • Health disparities
  • Oncology
  • Patient-clinician communication

Cite this

Duberstein, Paul R. ; Chen, Michael ; Chapman, Benjamin P. ; Hoerger, Michael ; Saeed, Fahad ; Guancial, Elizabeth ; Mack, Jennifer W. / Fatalism and educational disparities in beliefs about the curability of advanced cancer. In: Patient Education and Counseling. 2018 ; Vol. 101, No. 1. pp. 113-118.
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Fatalism and educational disparities in beliefs about the curability of advanced cancer. / Duberstein, Paul R.; Chen, Michael; Chapman, Benjamin P.; Hoerger, Michael; Saeed, Fahad; Guancial, Elizabeth; Mack, Jennifer W.

In: Patient Education and Counseling, Vol. 101, No. 1, 01.2018, p. 113-118.

Research output: Contribution to journalArticle

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AU - Saeed, Fahad

AU - Guancial, Elizabeth

AU - Mack, Jennifer W.

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AB - Objective Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism. Methods We studied 977 patients with advanced, incurable cancer. Two logistic regression analyses were conducted. Model One examined the effect of education on beliefs about curability. Model Two added fatalism. Results The significant association between having less than a high school education and the belief that advanced cancer can be cured (OR = 2.55; 95% CI: 1.09–5.96) in Model One was attenuated by 39% and rendered nonsignificant in Model Two. Fatalism was associated with the belief that advanced cancer can be cured. Whites were less likely to believe they could be cured than Blacks and Asians/Pacific Islanders. Beliefs about curability were not associated with income or insurance status. Conclusions People who do not complete high school are more likely to believe that their advanced cancer is curable, in part because they are more likely to hold fatalistic worldviews. Practice implications Interventions to help oncologists care for patients with fatalistic beliefs could mitigate socioeconomic disparities in end-of-life care.

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