Predicting physical quality of life among a multiethnic sample of breast cancer survivors

Ashing-Giwa, Kimlin T.; Lim, Jung‐won

doi:10.1007/s11136-010-9642-4

Cited by 34 publications

(55 citation statements)

References 94 publications

(100 reference statements)

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“…Although there are previous findings on differences in HRQoL determinants between European, Latino, African American and Asian American patients [46], [47], this is the first study to document an even more ‘fine’ ethnic variation among three Asian ethnic groups: Chinese, Indian and Malay. Using comprehensive multivariate modeling to test both main and interaction effects, we were able to show that the effect of specific factors within each cluster of variables varied as function of ethnicity.…”

Section: Discussionmentioning

confidence: 62%

Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population – A National Cohort Study

et al. 2013

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BackgroundHRQoL is an important outcome to guide and promote healthcare. Clinical and socioeconomic factors may influence HRQoL according to ethnicity.MethodologyA multiethnic cross-sectional national cohort (N = 7198) of the Singapore general population consisting of Chinese (N = 4873), Malay (N = 1167) and Indian (N = 1158) adults were evaluated using measures of HRQoL (SF-36 version 2), family functioning, health behaviours and clinical/laboratory assessments. Multiple regression analyses were performed to identify determinants of physical and mental HRQoL in the overall population and their potential differential effects by ethnicity. No a priori hypotheses were formulated so all interaction effects were explored.Principal FindingsHRQoL levels differed between ethnic groups. Chinese respondents had higher physical HRQoL (PCS) than Indian and Malay participants (p<0.001) whereas mental HRQoL (MCS) was higher in Malay relative to Chinese participants (p<0.001). Regressions models explained 17.1% and 14.6% of variance in PCS and MCS respectively with comorbid burden, income and employment being associated with lower HRQoL. Age and family were associated only with MCS. The effects of gender, stroke and musculoskeletal conditions on PCS varied by ethnicity, suggesting non-uniform patterns of association for Chinese, Malay and Indian individuals.ConclusionsDifferences in HRQoL levels and determinants of HRQoL among ethnic groups underscore the need to better or differentially target population segments to promote well-being. More work is needed to explore HRQoL and wellness in relation to ethnicity.

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Section: Discussionmentioning

confidence: 62%

Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population – A National Cohort Study

et al. 2013

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“…Having difficulties in medical encounters may increase unmet needs pertaining to physical problems (e.g., treatment side effects) and subsequently increase physical and emotional distress[20,22-28]. Despite an increase in research on ethnic variability in QoL among BCS[29-34], studies that include Asian Americans are scarce[35,36]. …”

Section: Goalsmentioning

confidence: 99%

Physical distress and cancer care experiences among Chinese-American and non-Hispanic White breast cancer survivors

Wang

Adams

Huang

et al. 2012

Gynecologic Oncology

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Objective The number of Chinese-American breast cancer survivors (BCS) is increasing as a result of increasing incidence rates. There has been little research on Chinese BCS’ follow-up cancer care. This qualitative study aims to understand how Chinese-American BCS experience and cope with physical distress relative to non-Hispanic White (NHW) survivors. Methods Seventy-one BCS (37 Chinese immigrant, 7 US-born Chinese, 27 NHW) were recruited from the Greater Bay Area Cancer Registry to participate in focus group discussions or one-on-one interviews about their survivorship experiences. All BCS were diagnosed with breast cancer at stage 0-IIA between 2006-2009, and had survived for 1-4 years without recurrence. Interviews were conducted in Cantonese, Mandarin, or English. Data analyses followed established qualitative methods of content analysis. Results BCS experienced pain and side effects from radiation, surgery, and hormonal therapy. Physical distress subsequently caused emotional concerns about recurrence or metastasis. Most BCS consulted physicians about their physical distress. Chinese immigrant BCS were less likely to have their issues resolved compared to NHW and US-born Chinese who were more likely to question physicians, ask for referrals, and make repeat attempts if their problems were not resolved. Some Chinese immigrant BCS turned to Traditional Chinese Medicine for relief or accepted the idea that physical distress was part of survivorship. Conclusion Chinese immigrant BCS may be at risk for greater distress compared with US-born Chinese and NHW BCS because of cultural norms that make them less inclined to express their needs to physicians or challenge physicians when their needs are not met. Furthermore, they may express symptoms in culturally unique ways (e.g., hot-cold imbalances). Further research is needed to determine how to best improve survivorship care experiences in this understudied population, with the goal of decreasing BCS’ physical distress and improving quality of life.

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“…For example, Asian American breast cancer survivors have reported lower QOL than their European counterparts [9, 10]; Chinese American survivors are more likely to experience poorer socioeconomic well-being than non-Hispanic White survivors [11]. Qualitative evidence has also shown that Chinese survivors describe more distress than Americans [12].…”

Section: Introductionmentioning

confidence: 99%

Differences in quality of life between American and Chinese breast cancer survivors

Lü

You

Kavanagh

et al. 2016

Support Care Cancer

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Objective It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their western counterparts. However, no studies made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors’ QOL with United States (US) counterparts and examine if demographic and medical factors were associated with QOL across groups. Method The sample consisted of 159 breast cancer patients (97 Chinese and 62 US) who completed the Functional Assessment for Cancer Therapy Breast Cancer Scale (FACT-B) before the start of radiotherapy in Shanghai, China and Houston, US. Results Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL including FACT-G total scores and all four sub-dimensions including Functional Well-being (FWB), Physical Well-being (PWB), Emotional Well-being (EWB) and Social Well-being (SWB); they also reported more breast cancer specific concerns (BCS). Differences were also clinically significant for FACT-G total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors. Discussion Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

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Predicting physical quality of life among a multiethnic sample of breast cancer survivors

Cited by 34 publications

References 94 publications

Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population – A National Cohort Study

Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population – A National Cohort Study

Physical distress and cancer care experiences among Chinese-American and non-Hispanic White breast cancer survivors

Differences in quality of life between American and Chinese breast cancer survivors

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