Mercedes Ramirez-Ruiz

Background/Objectives: Chronic medical conditions may contribute to psychological burden among individuals with cancer. This study examined associations between chronic medical conditions and posttraumatic stress, depressive symptoms, anxiety, and perceived stress among Puerto Rican adults with a self-reported cancer diagnosis. Methods: This quantitative secondary analysis used baseline data from a longitudinal study (N = 402) conducted in Puerto Rico following Hurricane Maria. The analytic sample included 108 adults with a self-reported cancer diagnosis. Psychological outcomes were assessed using the PCL-5, PHQ-8, GAD-7, and PSS. Mann–Whitney U and chi-square tests were conducted, followed by multivariable logistic and linear regression models adjusting for co-occurring conditions, age, and gender. Results: Asthma was associated with higher posttraumatic stress, depressive symptoms, and perceived stress scores; arthritis with higher depressive symptoms, anxiety, and perceived stress; and thyroid disorders with higher anxiety symptoms. Unadjusted analyses showed associations between asthma and clinically significant posttraumatic stress symptoms (OR = 3.13) and thyroid disorders and anxiety symptoms (OR = 2.90). After adjustment, thyroid disorders remained associated with clinically significant anxiety (aOR = 2.70, p = 0.041), whereas asthma was no longer significantly associated with posttraumatic stress (aOR = 2.45, p = 0.116). Self-reported depression was associated with all psychological outcomes in adjusted models. Conclusions: Specific chronic medical conditions were associated with psychological burden among adults with cancer, supporting psychological screening and coordinated care.

Background/Objectives: Lay Community Health Workers (CHWs) play a critical role in reducing mental health disparities, particularly among underserved and vulnerable populations, by bridging gaps in care and promoting mental well-being. This narrative review aimed to identify and characterize training programs designed for CHWs, with a focus on those targeting cancer patients and individuals with chronic conditions. Methods: A comprehensive literature search was conducted across databases including PubMed, EBSCOhost, Scielo, Redalyc, and Google Scholar. From an initial pool of 10,372 references, 27 relevant articles were selected, encompassing research articles, training materials, curricula, and other resources. Results: The identified training methods included role-playing, instructional videos, and manuals designed to equip CHWs with skills in mental health intervention, prevention, management, education, and stigma reduction. Training programs also incorporated evidence-based interventions and psychological skill training. This review highlights a notable gap in research on CHW-led interventions in cancer palliative care and mental health. Conclusions: The findings support the development of a specialized mental health training program tailored for CHWs working with cancer survivors, to enhance their capacity to address mental health challenges, reduce stigma, and promote psychological well-being. Future efforts involve developing a training intervention for CHWs to support the needs of cancer survivors.

Breast cancer (BC) is the leading cancer diagnosis among women in Puerto Rico. Psychological distress is prevalent in this population, and social determinants may exacerbate this risk. This study examines whether sociodemographic characteristics, financial burden, and social support levels are associated with symptoms of anxiety and depression in Puerto Rican women with BC. A quantitative secondary analysis was conducted on a sample of 208 Hispanic women with BC, utilizing the Patient Health Questionnaire (PHQ-8) and the Generalized Anxiety Disorder (GAD-7) questionnaire. These scores were compared with sociodemographic values and Interpersonal Support Evaluation List (ISEL-12) scores, establishing statistical significance through association, parametric, and non-parametric tests, and regression models. 38.5% and 26.4% of participants showed clinically significant symptoms of depression and anxiety, respectively. Age and perceived income showed significant associations with psychological outcomes. However, regression analysis revealed perceived income as the only significant predictor for both depression and anxiety. Tangible and belonging support were significantly lower in participants with symptoms of depression, while appraisal support was significantly lower in participants with symptoms of anxiety. Findings highlight the influence of perceived financial stress on mental health and the need for psychosocial interventions tailored to the patients’ economic context.