Impact of Socio-Demographic Factors, Financial Burden, and Social Support on Anxiety and Depression Symptoms in Puerto Rican Women with Breast Cancer

Abstract

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.

Keywords: Hispanic; Puerto Rico; anxiety; breast cancer; depression; financial burden; mental health; psycho-oncology; social determinants; social support.