Correlates of Life Satisfaction among Northern Plains American Indian Women Cancer Survivors

Overview: This study examines the influence of depressive symptoms, spiritual well-being, and social support on the life satisfaction of American Indian women cancer survivors in the Northern Plains.Proposal text:

Background:

Rates of cancer are dramatically increasing among American Indian (AI) women nationwide and represents one of the leading causes of death (American Indian Cancer Foundation, 2022) and disproportionately presents at advanced stages for AI women diagnosed with the disease (Guadagnolo, Petereit, & Coleman, 2017; Petereit et al., 2004). Research has shown that experiencing cancer and related treatment often have long-term effects on the quality of life of survivors (Porter, 2013; Deimling, Brown, Albitz, & Burant, 2015). Life satisfaction—defined as an individual's cognitive assessment of the fit between desired goals in life and actual life outcomes (Diener & Suh, 2000)—is one of the most widely examined global indicators of quality of life among cancer survivors.
Extensive research has demonstrated the relationships between mental health outcomes, spirituality, depressive symptoms, and social support among cancer survivors. Yet, research has been scarce on positive mental health outcomes, especially life satisfaction, in AI women cancer survivors. Also, research specific to AI populations is lacking, and the diversity across more than 9.7 million people (Indian Country Today, 2022) belonging to 574 federally recognized tribes and approximately 66 state recognized tribes (National Conference of State Legislatures, 2022) make examining distinct tribal contexts important. Moreover, cancer mortality, spirituality, social support, and depressive symptoms rates can vary by gender (Espey et al., 2014), which warrants the separate investigation of women’s experiences. Thus, understanding life satisfaction and its psychosocial correlates among AI women cancer survivors remains an important but understudied area with high public health significance. Such research would be of value in developing interventions to increase life satisfaction among AI women cancer survivors.

Methods:
Data were obtained from a cross-sectional survey of 73 AI women cancer survivors aged 32 to 77 (a mean age of 56.5 years) in the Midwest of the United States. Standardized measures were used to assess for depression (Center for Epidemiologic Studies Depressive Symptoms Scale Short Form), spiritual well-being (Functional Assessment of Chronic Illness Therapy, Spiritual Well-being Scale), social support (Medical Outcomes Study of Social Support Questionnaire), and life satisfaction (Satisfaction with Life Scale).

Results:
The mean score for life satisfaction was 25.12, indicating participants reported moderate life satisfaction. A hierarchical regression analysis was employed to explore the independent effects of depressive symptoms, spiritual well-being, and social support related to life satisfaction. The results indicated that higher levels of spiritual well-being significantly predicted higher levels of life satisfaction, whereas higher levels of depressive symptoms significantly predicted lower levels of life satisfaction.

Conclusion:
Based on our results, bolstering spiritual health activities is a promising opportunity for improving cancer care and treatment. Also, regular depression screening and psychotherapy among AI women cancer survivors seem imperative. A community-based culturally appropriate and holistic approach to a wellness program should be developed to increase AI women cancer survivor’s life satisfaction. In closing, AI women cancer survivors are likely to benefit from an improved quality of life and result in enhanced life satisfaction when social workers and health professional team members provide spiritual-based interventions along with regular depression checkups.