Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona: DAMA cohort.

PURPOSE: This study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona. METHODS: Data from 2235 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical, and breast cancer treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated. RESULTS: Although when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance, as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy. CONCLUSIONS: Social and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impact on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women.

Mental Well-Being during the COVID-19 Confinement among Adolescents in Catalonia: The Role of Demographic and Other COVID-Related Variables.

This study aimed to describe the impact of the COVID-19 pandemic on the social situation, self-perceived health status, and mental well-being of adolescents in Catalonia during home confinement, and to evaluate factors that are associated with poor overall mental well-being. An online cross-sectional study among a cohort of students (14-18 years old) of central Catalonia (DESKcohort) was performed during June-July 2020. Poisson regression models with robust variance were used to identify variables associated with "poor overall well-being," measured by the short version of the Warwick-Edinburgh Mental Wellbeing Scale. Out of 303 participants, 42.1% reported a decrease in family income, and 32.8% a loss of parental employment due to the COVID-19 pandemic, and these percentages were higher among people living in low socioeconomic neighborhoods (53.3% and 43.2%, respectively). Overall, 56.8% presented a poor overall well-being. Participants reporting a decrease in their family's income (aPR = 1.33) and those knowing a close person or family who died of COVID-19 (aPR = 1.42) were more likely to report a poor overall well-being. This study highlights the patterns of inequality and social vulnerability for COVID-19 pandemic outcomes. Considering social inequalities, interventions are needed to mitigate the impact of COVID-19 pandemic on the physical and the psychological wellbeing of children and their families.