Skip to main content

Advertisement

SpringerLink
Log in

Mediational roles of stress-coping factors in the relationship between patient-perceived communication quality and physical functioning: racial difference between Chinese and Non-Hispanic White American breast cancer survivors

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The assumption that patient–provider communication may mediate patients’ sense of control over cancer to affect health outcomes has limited evidence. This study examines whether patient-perceived cancer care communication quality (PPCQ) mediates stress appraisal and coping behavior, affecting physical functioning across different racial groups.

Methods

Two hundred and twenty Chinese American and 216 non-Hispanic White (NHW) women (ages 28–80) with stage 0–III breast cancer, 1–5 years post-diagnosis, and without recurrence, enrolled and completed a cross-sectional telephone survey. Physical functioning was measured by the NIH-PROMIS short form. Validated measures of PPCQ, patients’ evaluation of their socioeconomic well-being, stress appraisal (perceived severity and control), use of coping strategies, treatment-related symptoms, and comorbidities were also assessed. Path analyses were used to examine the mediation for each racial group.

Results

Regardless of race, treatment-related symptoms, comorbidities, and socioeconomic well-being were all directly related to physical functioning (p < 0.05). The impact of PPCQ on physical functioning was mediated by perceived control in the Chinese American group (p < 0.05), but not in the NHW group. Perceived severity and coping were not mediators of physical functioning in either group.

Conclusions

The mediational pathway from PPCQ to perceived control to physical functioning in Chinese American survivors may be partially explained by their lower socioeconomic well-being and culturally valued conformity to physicians as a medical authority. These sociocultural dynamics reinforce the importance of cancer care communication. For NHW survivors, the impact of treatment-related symptoms and socioeconomic well-being on physical functioning outweighed their PPCQ and perceived control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cooper, R., Kuh, D., Cooper, C., Gale, C. R., Lawlor, D. A., Matthews, F., & Hardy, R. (2011). Objective measures of physical capability and subsequent health: A systematic review. Age Aging, 40(1), 14–23. https://doi.org/10.1093/ageing/afq117

    Article  Google Scholar 

  2. Ganz, P. A., Desmond, K. A., Leedham, B., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2002). Quality of life in long-term, disease-free survivors of breast cancer: A follow-up study. Journal of the National Cancer Institute, 94, 39–49. https://doi.org/10.1093/jnci/94.1.39

    Article  PubMed  Google Scholar 

  3. Mallinson, T., Cella, D., Cashy, J., & Holzner, B. (2006). Giving meaning to measure: Linking self-reported fatigue and function to performance of everyday activities. Journal of Pain and Symptom Management, 31(3), 229–241. https://doi.org/10.1016/j.jpainsymman.2005.07.012

    Article  PubMed  Google Scholar 

  4. Winters-Stone, K. M., Medysky, M. E., & Savin, M. A. (2019). Patient-reported and objectively measured physical function in older breast cancer survivors and cancer-free controls. Journal of Geriatric Oncology, 10, 311–316. https://doi.org/10.1016/j.jgo.2018.10.006

    Article  PubMed  Google Scholar 

  5. Stone, D. S., Ganz, P. A., Pavlish, C., & Robbins, W. A. (2017). Young adult cancer survivors and work: A systematic review. Journal of Cancer Survivorship, 11(6), 765–781. https://doi.org/10.1007/s11764-017-0614-3

    Article  PubMed  PubMed Central  Google Scholar 

  6. Schmidt, M. E., Scherer, S., Wiskemann, J., & Steindorf, K. (2019). Return to work after breast cancer: The role of treatment-related side effects and potential impact on quality of life. Randomized Controlled Trial, 28(4), e13051. https://doi.org/10.1111/ecc.13051

    Article  Google Scholar 

  7. Joshy, G., Thandrayen, J., Koczwara, B., Butow, P., Laidsaar-Powell, R., Rankin, N., Canfell, K., Stubbs, J., Grogan, P., Bailey, L., Yazidjoglou, A., & Banks, E. (2020). Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC Medicine, 18(1), 372. https://doi.org/10.1186/s12916-020-01830-4

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sehl, M., Lu, X., Silliman, R., & Ganz, P. A. (2013). Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women. Journal of Cancer Survivorship, 7(1), 20–31. https://doi.org/10.1007/s11764-012-0239-5

    Article  PubMed  Google Scholar 

  9. Ezzatvar, Y., Ramírez-Vélez, R., Sáez de Asteasu, M. L., Martínez-Velilla, N., Zambom-Ferraresi, F., Izquierdo, M., & García-Hermoso, A. (2021). Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis. Journals of Gerontology: Medical Science, 76(8), 1447–1453. https://doi.org/10.1093/gerona/glaa305

    Article  Google Scholar 

  10. Wang, J. H., Gomez, S. L., Brown, R. L., Davis, K., Allen, L., Huang, E., Chentsova Dutton, Y., & Schwartz, M. D. (2019). Factors associated with Chinese-American and White cancer survivors’ physical and psychological functioning. Health Psychology, 38(5), 455–465. https://doi.org/10.1037/hea0000666

    Article  PubMed  PubMed Central  Google Scholar 

  11. Check, D. K., Chawla, N., Kwan, M. L., Pinheiro, L., Roh, J. M., Ergas, I. J., Stewart, A. L., Kolevska, T., Ambrosone, C., & Kushi, L. H. (2018). Understanding racial/ethnic differences in breast cancer-related physical well-being: The role of patient-provider interactions. Breast Cancer Research and Treatment, 170(3), 593–603. https://doi.org/10.1007/s10549-018-4776-0

    Article  PubMed  PubMed Central  Google Scholar 

  12. Huang, I. C., Hudson, M. M., Robison, L. L., & Krull, K. R. (2017). Differential impact of symptom prevalence and chronic conditions on quality of life in cancer survivors and non-cancer individuals: A population study. Cancer Epidemiology, Biomarkers, and Prevention, 26(7), 1124–1132. https://doi.org/10.1158/1055-9965.EPI-16-1007

    Article  Google Scholar 

  13. Rincon, M. A., Smith, A. W., Yu, M., & Kent, E. E. (2020). Trends in racial/ethnic disparity of health-related quality of life in older adults with and without cancer (1998–2012). Cancer Epidemiology, Biomarkers, and Prevention, 29(6), 1188–1195.

    Article  Google Scholar 

  14. Crouch, A., Champion, V. L., & Ah, D. V. (2021). Comorbidity, cognitive dysfunction, physical functioning, and quality of life in older breast cancer survivors. Supportive Care in Cancer, 30(1), 359–366. https://doi.org/10.1007/s00520-021-06427-y

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lazarus, R. S. (1966). Psychological stress and the coping process. McGraw-Hill.

    Google Scholar 

  16. Lazarus, R. S., & Cohen, J. B. (1977). Environmental stress. In I. Altman, & J. F. Wohlwill (Eds.), Human behavior and environment (Vol. 2, pp. 89–127). Plenum.

  17. Lazarus, R. S. & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

  18. Epstein, R., & Street, R. L. (2007). Patient-centered communication in cancer care: Promoting healing and reducing suffering. (No. no. 07-6225). National Cancer Institute, U.S. Department of Health and Human Services, National Institutes of Health.

  19. Donovan, H. S., Hartenbach, E. M., & Method, M. W. (2005). Patient-provider communication and perceived control for women experiencing multiple symptoms associated with ovarian cancer. Gynecologic Oncology, 99(2), 404–411. https://doi.org/10.1016/j.ygyno.2005.06.062

    Article  PubMed  Google Scholar 

  20. Ruben, M. A., Meterko, M., & Bokhour, B. G. (2018). Do patient perceptions of provider communication relate to experiences of physical pain? Patient Education and Counseling, 101(2), 209–213. https://doi.org/10.1016/j.pec.2017.08.002

    Article  PubMed  Google Scholar 

  21. Maly, R. C., Liu, Y., Leake, B., Thind, A., & Diamant, A. L. (2010). Treatment-related symptoms among underserved women with breast cancer: The impact of physician-patient communication. Breast Cancer Research and Treatment, 119(3), 707–716. https://doi.org/10.1007/s10549-009-0418-x

    Article  PubMed  Google Scholar 

  22. Palmer, N. R. A., Kent, E. E., Forsythe, L. P., Akora, N. K., Rowland, J. H., Blanch-Hartigan, N. M. D., Oakley-Girvan, I., Hamilton, A. S., & Weaver, K. E. (2014). Racial and ethnic disparities in patient-provider communication, quality-of-care ratings, and patient activation among long-term cancer survivors. Journal of Clinical Oncology, 32(36), 4087–4094. https://doi.org/10.1200/JCO.2014.55.5060

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wang, J. H., Adams, I. F., Tucker-Seeley, R., Gomez, S. L., Wang, Y., & Pasick, R. J. (2013). A mixed method exploration of survivorship among Chinese American and non-Hispanic White breast cancer survivors: The role of socioeconomic well-being. Quality of Life Research, 22(10), 2709–2720. https://doi.org/10.1007/s11136-013-0374-0

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ayanian, J. Z., Zaslavsky, A. M., Arora, N. K., Kahn, K. L., Malin, J. L., van Ryn, P. A. G., Hornbrook, M. C., Kiefe, C. I., He, Y., Urmie, K. M., Weeks, J. C., & Harrington, D. P. (2010). Patients’ experiences with care for lung cancer and colorectal cancer: Findings from the Cancer Care Outcomes Research and Surveillance Consortium. Journal of Clinical Oncology, 28(27), 4154–4161. https://doi.org/10.1200/JCO.2009.27.3268

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kirby, J. B., Berdahl, T. A., & Stone, R. A. T. (2021). Perceptions of patient-provider communication across the six largest Asian subgroups in the USA. Journal of General Internal Medicine, 36(4), 888–893. https://doi.org/10.1007/s11606-020-06391-z

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ashing-Giwa, K. T., Padill, G., Tejero, J., Kraemer, J., Wright, K., Coscarelli, A., Clayton, S., Williams, I., & Hills, D. (2004). Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psycho-Oncology, 13(6), 408–428. https://doi.org/10.1002/pon.750

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kagawa-Singer, M., Dadia, A. V., Yu, M. C., & Surbone, A. (2010). Cancer, culture, and health disparities. CA: A Cancer Journal for Clinicians, 60(1):12–39. https://doi.org/10.3322/caac.20051

  28. Budiman, A., Cilluffo, A., & Ruiz, N. G. (2019, May 22). Key facts about Asian origin groups in the U.S. Pew Research Center. https://www.pewresearch.org/fact-tank/2019/05/22/key-facts-about-asian-origin-groups-in-the-u-s/.

  29. Wang, J. H., Adams, I. F., Pasick, R. J., Gomez, S. L., Allen, L., Ma, G. X., Lee, M. X., & Huang, E. (2013). Perceptions, expectations, and attitudes about communication with physicians among Chinese American and non-Hispanic white women with early stage breast cancer. Supportive Care in Cancer, 21(12), 3315–3325. https://doi.org/10.1007/s00520-013-1902-8

    Article  PubMed  PubMed Central  Google Scholar 

  30. Black, L. J., Murphy, S. T., Frank, G., Michel, V., & Azen, S. (1995). Ethnicity and attitudes toward patient autonomy. Journal of the American Medical Association, 274(10), 820–825. https://doi.org/10.1001/jama.1995.03530100060035

    Article  Google Scholar 

  31. Kornblith, A. (1998). Psychological adaptation to cancer. In J. Holland, W. Breitbart, & P. Jacobsen (Eds.), Psycho-Oncology (pp. 223–241).

  32. Kolonel, L. N., Henderson, B. E., Hankin, J. H., Nomura, A. M. Y., Wilkens, I. R., Pike, M. C., Stram, D. O., Monroe, K. R., Earle, M. E., & Nagamine, F. S. (2000). A multiethnic cohort in Hawaii and Los Angeles: Baseline characteristics. American Journal of Epidemiology, 151(4), 346–357.

    Article  CAS  PubMed  Google Scholar 

  33. PROMIS. Physical Function-Short Form 20a. PROMIS Item Bank v.1.0. Retrieved from https://www.nihpromis.org.

  34. Jensen, R. E., Potosky, A. L., Reeve, B. B., Hahn, E., Cella, D., Fries, J., Smith, A. W., Keegan, T. H. M., Wu, X., Paddock, L., & Moinpour, C. M. (2015). Validation of the PROMIS physical function measures in a diverse U.S. population-based cohort of cancer patients. Quality of Life Research, 24(10):2333–2344. https://doi.org/10.1007/s11136-015-0992-9

  35. McGinty, H. L., Goldenberg, J. L., & Jacobsen, P. B. (2012). Relationship of threat appraisal with coping appraisal to fear of cancer recurrence in breast cancer survivors. Psycho-Oncology, 21(2), 203–210. https://doi.org/10.1002/pon.1883

    Article  PubMed  Google Scholar 

  36. Arora, N. K., Weaver, K. E., Clayman, M. L., Oakley-Girvan, I., & Potosky, A. L. (2009). Physicians’ decision-making style and psychosocial outcomes among cancer survivors. Patient Education and Counseling, 77(3), 404–412. https://doi.org/10.1016/j.pec.2009.10.004

    Article  PubMed  PubMed Central  Google Scholar 

  37. Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6

    Article  CAS  PubMed  Google Scholar 

  38. Yang, H. C., Brothers, B. M., & Andersen, B. L. (2008). Stress and quality of life in breast cancer recurrence: Moderation or mediation of coping? Annals of Behavioral Medicine, 35(2), 188–197. https://doi.org/10.1007/s12160-008-9016-

    Article  PubMed  Google Scholar 

  39. Arora, N. K., Reeve, B. B., Hays, R. D., Clauser, S. B., & Oakley-Girvan, I. (2011). Assessment of quality of cancer-related follow-up care from the cancer survivor’s perspective. Journal of Clinical Oncology, 29(10), 1280–1289. https://doi.org/10.1200/JCO.2010.32.1554

    Article  PubMed  PubMed Central  Google Scholar 

  40. Head, B. A., & Faul, A. C. (2008). Development and validation of a scale to measure socioeconomic well-being in persons with cancer. Journal of Supportive Oncology, 6(4), 183–192.

    PubMed  Google Scholar 

  41. Bellury, L., Pett, M. A., Ellington, L., Beck, S. L., Clark, J. C., & Stein, K. D. (2012). The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer, 118(24), 6171–6178. https://doi.org/10.1002/cncr.27656

    Article  PubMed  Google Scholar 

  42. Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8

    Article  CAS  PubMed  Google Scholar 

  43. Lam, W. W. T., Law, C. C., Fu, Y. T., Wong, K. H., Chang, V. T., & Fielding, R. (2008). New insights in symptom assessment: The Chinese versions of the memorial symptom assessment scale short form (MSAS-SF) and the condensed MSAS (CMSAS). Journal of Pain and Symptom Management, 36(6), 584–595. https://doi.org/10.1016/j.jpainsymman.2007.12.008

    Article  PubMed  Google Scholar 

  44. Cella, D., Land, S. R., Chang, C., Day, R., Costantino, J. P., Wolmark, N., & Ganz, P. A. (2008). Symptom measurement in the breast cancer prevention trial (BCPT) (P-1): Psychometric properties of a new measure of symptoms for midlife women. Breast Cancer Research and Treatment, 109(3), 515–526. https://doi.org/10.1007/s10549-007-9682-9

    Article  PubMed  Google Scholar 

  45. Alfano, C. M., McGregor, B. A., Kuniyuki, A., Reeve, B. B., Bowen, D. J., Baumgartner, K. B., Bernstein, L., Ballard-Barbash, R., Malone, K. E., Ganz, P. A., & McTiernan, A. (2006). Psychometric properties of a tool for measuring hormone-related symptoms in breast cancer survivors. Psycho-Oncology, 15, 985–1000. https://doi.org/10.1002/pon.1033

    Article  PubMed  PubMed Central  Google Scholar 

  46. Bentler, P. M., & Chou, C. H. (1987). Practical issues in structural modeling. Sociological Methods and Research, 16(1), 78–117.

    Article  Google Scholar 

  47. Bollen, K. A. (1989). Structural equations with latent variables. John Wiley.

    Book  Google Scholar 

  48. Hooper, D., Coughlan, J., & Mullen, M. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6(1), 53–60.

    Google Scholar 

  49. Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin Journal, 88(3), 588–606.

    Article  Google Scholar 

  50. Kenny, D. (2020, June 5). Measuring model of fit. http://davidakenny.net/cm/fit.htm.

  51. Xia, Y. & Yang, Y. (2019). RMSEA, CFI, and TLI in structural equation modeling with ordered categorical data: The story they tell depends on the estimation methods. Behavioral Research Methods, 51, 409–428. https://doi.org/10.3758/s13428-018-1055-2

  52. Sorbom, D. (1989). Model modification. Psychometrika, 54(3), 371–384. https://doi.org/10.1007/BF02294623

    Article  Google Scholar 

  53. Whittaker, T. A. (2012). Using the modification index and standardized expected parameter change for model modification. Journal of Experimental Education, 80(1), 26–44. https://doi.org/10.1080/00220973.2010.531299

    Article  Google Scholar 

  54. Goldstein, E., Topitzes, J., Miller-Cribbs, J., & Brown, R. L. (2020). Influence of race/ethnicity and income on the link between adverse childhood experiences and child flourishing. Pediatric Research, 89, 1861–1869. https://doi.org/10.1038/s41390-020-01188-6

    Article  PubMed  PubMed Central  Google Scholar 

  55. Sorbom, D. (1974). A general method for studying differences in factor means and factor structures between groups. British Journal of Mathematical and Statistical Psychology, 27, 229–239.

    Article  Google Scholar 

  56. Ryu, E., & Cheong, J. (2017). Comparing indirect effects in different groups in single-group and multi-group structural equation models. Frontiers in Psychology, 11(8), 747. https://doi.org/10.3389/fpsyg.2017.00747

    Article  Google Scholar 

  57. MacKinnon, D. P., Lockwood, C. M., & Williams, J. M. (2004). Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99–128. https://doi.org/10.1207/s15327906mbr3901_4

    Article  PubMed  PubMed Central  Google Scholar 

  58. Puts, M. T. E., Tapscott, B., Fitch, M., Howell, D., Monette, J., Wan-Chow-Wah, D., Krzyzanowska, M., Leighl, N. B., Springall, E., & Alibhai, S. M. (2015). A systematic review of factors influencing older adults’ decision to accept or decline cancer treatment. Cancer Treatment Reviews, 41(2), 197–215. https://doi.org/10.1016/j.ctrv.2014.12.010

    Article  PubMed  Google Scholar 

  59. DiMartino, L. D., Birken, S. A., & Mayer, D. K. (2017). The relationship between cancer survivors’ socioeconomic status and reports of follow-up care discussions with providers. Journal of Cancer Education, 32(4), 749–755. https://doi.org/10.1007/s13187-016-1024-3

    Article  PubMed  PubMed Central  Google Scholar 

  60. Ejaz, A., Kim, Y., Winner, M., Page, A., Tisnado, D., Dy, S. E. M., & Pawlik, T. M. (2016). Associations between patient perceptions of communication, cure, and other patient-related factors regarding patient-reported quality of care following surgical resection of lung and colorectal cancer. Journal of Gastrointestinal Surgery, 20, 812–826. https://doi.org/10.1007/s11605-015-3035-5

    Article  PubMed  Google Scholar 

  61. Strayhorn, S. M., Lewis-Thames, M. W., Carnahan, L. R., Henderson, V. A., Watson, K. S., Ferrans, C. E., & Molina, Y. (2021). Assessing the relationship between patient-provider communication quality and quality of life among rural cancer survivors. Supportive Care in Cancer, 29(4), 1913–1921. https://doi.org/10.1007/s00520-020-05674-9

    Article  PubMed  Google Scholar 

  62. Feldman, P. J., & Steptoe, A. (2004). How neighborhoods and physical functioning are related: The roles of neighborhood socioeconomic status, perceived neighborhood strain, and individual health risk factors. Annals of Behavioral Medicine, 27(2), 91–99. https://doi.org/10.1207/s15324796abm2702_3

    Article  PubMed  Google Scholar 

  63. Bailis, D. S., Segall, A., Mahon, M. J., Chipperfield, J. G., & Dunn, E. M. (2001). Perceived control in relation to socioeconomic and behavioral resources for health. Social Science & Medicine, 52(11), 1661–1676.

    Article  CAS  Google Scholar 

  64. Kagawa-Singer, M., & Blackhall, L. J. (2001). Negotiating cross-cultural issues at the end of life: “You got to go where he lives.” Journal of the American Medical Association, 286(23), 2993–3001. https://doi.org/10.1001/jama.286.23.2993

    Article  CAS  PubMed  Google Scholar 

  65. Yu, Y., & Sherman, K. A. (2015). Communication avoidance, coping and psychological distress of women with breast cancer. Journal of Behavioral Medicine., 38(3), 565–577. https://doi.org/10.1007/s10865-015-9636-3

    Article  PubMed  Google Scholar 

  66. Maxwell, S. E., & Cole, D. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. Psychological Methods, 12(1), 23–44. https://doi.org/10.1037/1082-989X.12.1.23

    Article  PubMed  Google Scholar 

  67. MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614. https://doi.org/10.1146/annurev.psych.58.110405.085542

    Article  PubMed  PubMed Central  Google Scholar 

  68. Shrout, P. E. (2011). Commentary: Mediation analysis, causal process, and cross-sectional data. Multivariate Behavioral Research, 46(5), 852–860. https://doi.org/10.1080/00273171.2011.606718

    Article  PubMed  Google Scholar 

  69. Breznau, N., Rinke, E. M., Wuttke, A., & Żółtak, T. (2022). Observing many researchers using the same data and hypothesis reveals a hidden universe of uncertainty. PNAS, 119(44), e2203150119. https://doi.org/10.1073/pnas.2203150119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The project described was supported by Award Number R21CA139408 from the National Cancer Institute (NCI) and Lance Armstrong Foundation Young Investigator Award. The translation and validation of the PROMIS Chinese short forms was supported by National Institutes of Health (NIH) Grants No. U01AR057971. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement # U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s). Endorsement by the State of California Department of Public Health, the NCI and NIH, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.

Funding

Funding was provided by National Cancer Institute (US) (Grant No. R21CA139408) and Lance Armstrong Foundation, Young Investigator Award.

Author information

Authors and Affiliations

  1. Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 2115 Wisconsin Avenue, N.W., Suite 300, Washington, DC, 20007, USA

    Judy Huei-yu Wang, Ellen Huang & Marc D. Schwartz

  2. School of Medicine, Nursing and Public Health, University of Wisconsin-Madison, Madison, WI, USA

    Roger L. Brown

Authors
  1. Judy Huei-yu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roger L. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ellen Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marc D. Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: Judy Wang, Marc Schwartz; Methodology: Judy Wang, Roger Brown, Marc Schwartz; Formal analysis and investigation: Judy Wang, Roger Brown, Ellen Huang; Writing—original draft preparation: Judy Wang; Writing—review and editing: All authors; Funding acquisition: Judy Wang, Marc Schwartz; Supervision: Judy Wang; Project administration: Judy Wang, Ellen Huang; Validation: Roger Brown; Data curation: Judy Wang.

Corresponding author

Correspondence to Judy Huei-yu Wang.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose. We thank Dr. Scarlett L. Gomez for her partnership and contribution to the data collection of this study and Dr. Rena J. Pasick for her scientific advice on study methods and previous manuscripts.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file 1 (PDF 1431 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, J.Hy., Brown, R.L., Huang, E. et al. Mediational roles of stress-coping factors in the relationship between patient-perceived communication quality and physical functioning: racial difference between Chinese and Non-Hispanic White American breast cancer survivors. Qual Life Res 33, 253–265 (2024). https://doi.org/10.1007/s11136-023-03501-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-023-03501-2

Keywords

Search

Navigation