Quality of Life Research

, Volume 16, Issue 3, pp 413–428

Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma

Authors

    • Center of Community Alliance for Research and Education (CCARE), Division of Population SciencesCity of Hope National Medical Center
    • Center for Culture and HealthUCLA School of Medicine
  • Judith S. Tejero
    • Center of Community Alliance for Research and Education (CCARE), Division of Population SciencesCity of Hope National Medical Center
    • Center for Culture and HealthUCLA School of Medicine
  • Jinsook Kim
    • Department of Community Health SciencesUCLA School of Public Health
  • Geraldine V. Padilla
    • Department of NursingUniversity of California
  • Gerhard Hellemann
    • Semel Institute of Neuropsychiatry — Biostatistics CoreUCLA
Article

DOI: 10.1007/s11136-006-9138-4

Cite this article as:
Ashing-Giwa, K.T., Tejero, J.S., Kim, J. et al. Qual Life Res (2007) 16: 413. doi:10.1007/s11136-006-9138-4

Abstract

Background

This study examined health related quality of life (HRQOL) and its predictors among African-, Asian-, Latina-, and European American breast cancer survivors (BCS) using a socio-ecologically and culturally contextual theoretical model of HRQOL.

Methods

We employed a case–control, cross sectional design with a population-based sample from the California Cancer Registry. Descriptive, bivariate, and multivariate regression analyses were conducted.

Results

The sample included 703 BCS: 135 (19%) African-, 206 (29%) Asian-, 183 (26%) Latina-, and 179 (26%) European Americans. Latinas reported the lowest HRQOL (p < 0.0001). The final regression model explained 70% of variance in HRQOL. Years since diagnosis, number of comorbidities, role limitation, emotional wellbeing, quality of doctor–patient relationship, social support, and life stress are significant HRQOL determinants. Exploratory regression analyses indicate ethnic differences in significant predictors for HRQOL.

Conclusions

HRQOL among this multiethnic sample ranged from fair to good. Bivariate analysis suggests that ethnic differences in HRQOL exist. However, regression analyses demonstrated that socio-ecological factors in conjunction with medical characteristics are more salient to HRQOL outcomes, and that ethnic group membership may be a proxy for socio-ecological context. Furthermore, the influence of ethnicity, culture, and social-ecology are complex; research with large, population-based samples are necessary to disentangle the impact of contextual factors on HRQOL.

Keywords

Breast cancerCultureEthnic minorityHealth disparitiesHRQOLMultiethnicSocial-ecology

Abbreviations

ADQ

Adherence Determinants Questionnaire

ANOVA

Analysis of variance

BCS

Breast cancer survivors

BCSS

Breast cancer specific subscale (from the FACT)

CCR

California Cancer Registry

FACT

Functional Assessment of Cancer Therapy

HRQOL

Health related quality of life

SES

Socio-economic status

Copyright information

© Springer Science+Business Media B.V. 2007