Quality of Life Research

, Volume 26, Issue 1, pp 73–84 | Cite as

Match between culture and social support: Acculturation moderates the relationship between social support and well-being of Chinese American breast cancer survivors




Social support does not always lead to health benefits; the outcomes depend on the match between the need and the provision of social support. Culture shapes individuals’ preference of social support types (e.g., supportive communication, social companionship, and tangible support). The present study examined how the association between social support and well-being may vary as a function of acculturation among minority cancer survivors.


One hundred and twenty-three Chinese American breast cancer survivors were invited to complete a questionnaire package.


Findings showed that acculturation moderated the association of social support subtypes with psychological and physical well-being. Higher emotional/information support was associated with better quality of life and less physical symptoms among highly acculturated cancer survivors but more physical symptoms among those who were less acculturated. Tangible support was associated with more physical symptoms among highly acculturated cancer survivors but less physical symptoms among those who are less acculturated. Positive social interaction was associated with better quality of life and less physical symptoms among less acculturated cancer survivors but not associated with quality of life or physical symptoms among their highly acculturated counterparts.


The findings pointed to the significance of acculturation in breast cancer experience among minority women, especially its interplay with social support transactions.


Acculturation Social support Cancer survivorship Quality of life Breast cancer Chinese American 


  1. 1.
    Montazeri, A. (2008). Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007. Journal of Experimental and Clinical Cancer Research, 27(1), 27–32. doi:10.1186/1756-9966-27-32.CrossRefGoogle Scholar
  2. 2.
    Cousson-Gelie, F., Bruchon-Schweitzer, M., Dilhuydy, J. M., & Jutand, M. A. (2007). Do anxiety, body image, social support and coping strategies predict survival in breast cancer? A ten-year follow-up study. Psychosomatics, 48, 211–216.CrossRefPubMedGoogle Scholar
  3. 3.
    Reynolds, P., Boyd, P. T., Blacklow, R. S., Jackson, J. S., Greenberg, R. S., Austin, D. F., et al. (1994). The relationship between social ties and survival among black and white breast cancer patients. National Cancer Institute Black/White Cancer Survival Study Group. Cancer Epidemiology, Biomarkers and Prevention, 3, 253–259.PubMedGoogle Scholar
  4. 4.
    Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.CrossRefPubMedGoogle Scholar
  5. 5.
    Stein, R. R., & Smith, B. W. (2015). Social support attenuates the harmful effects of stress in healthy adult women. Social Science and Medicine, 146, 129–136.CrossRefPubMedGoogle Scholar
  6. 6.
    Hobfoll, S. E., & London, P. (1986). The relationship of self-concept and social support to emotional distress among women during war. Journal of Social and Clinical Psychology, 4(2), 189–203. doi:10.1521/jscp.1986.4.2.189.CrossRefGoogle Scholar
  7. 7.
    Cutrona, C. E. (1990). Stress and social support: In search of optimal matching. Journal of Social and Clinical Psychology, 9(1), 3–14.CrossRefGoogle Scholar
  8. 8.
    Cutrona, C., & Russell, D. (1990). Type of social support and specific stress: Toward a theory of optimal matching. In B. R. Sarason, I. G. Sarason, & G. R. Pierce (Eds.), Social support: An interactional view (pp. 319–366). Oxford, England: Wiley.Google Scholar
  9. 9.
    Reynolds, J. S., & Perrin, N. A. (2004). Mismatches in social support and psychosocial adjustment to breast cancer. Health Psychology, 23(4), 425–430. doi:10.1037/0278-6133.23.4.425.CrossRefPubMedGoogle Scholar
  10. 10.
    Yoo, W., Namkoong, K., Choi, M., Shah, D. V., Tsang, S., Hong, Y., et al. (2014). Giving and receiving emotional support online: Communication competence as a moderator of psychosocial benefits for women with breast cancer. Computers in Human Behavior, 30, 13–22. doi:10.1016/j/chb.2013.07.024.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Kim, H. S., & Chiu, T. Q. (2010). Cultural variation in the motivation of self-expression. In D. Dunning (Ed.), Social motivation (pp. 57–78). New York: Taylor & Francis.Google Scholar
  12. 12.
    Kim, H. S., Sherman, D. K., & Taylor, S. E. (2008). Culture and social support. American Psychologist, 63(6), 518–526. doi:10.1037/0003-066X.CrossRefPubMedGoogle Scholar
  13. 13.
    Taylor, S. E., Sherman, D. K., Kim, H. S., Jarcho, J., Takagi, K., & Dunagan, M. S. (2004). Culture and social support: Who seeks it and why? Journal of Personality and Social Psychology, 87(3), 354–362. doi:10.1037/0022-3514.87.3.354.CrossRefPubMedGoogle Scholar
  14. 14.
    Kagawa-Singer, M., & Wellisch, D. K. (2003). Breast cancer patients’ perceptions of their husbands’ support in a cross-cultural context. Psycho-Oncology, 12(1), 24–37. doi:10.1002/pon.619.CrossRefPubMedGoogle Scholar
  15. 15.
    Wen, K. Y., Fang, C. Y., & Ma, G. X. (2014). Breast cancer experience and survivorship among Asian Americans: A systematic review. Journal of Cancer Survivorship, 8(1), 94–107. doi:10.1007/s11764-013-0320-8.CrossRefPubMedGoogle Scholar
  16. 16.
    You, J., & Lu, Q. (2014). Sources of social support and adjustment among Chinese cancer survivors: Gender and age differences. Supportive Care in Cancer, 22(3), 697–704. doi:10.1007/s00520-013-2024-z.CrossRefPubMedGoogle Scholar
  17. 17.
    Kim, H. S., Sherman, D. K., Ko, D., & Taylor, S. E. (2006). Pursuit of comfort and pursuit of harmony: Culture, relationships, and social support seeking. Personality and Social Psychology Bulletin, 32(12), 1595–1607. doi:10.1177/0146167206291991.CrossRefPubMedGoogle Scholar
  18. 18.
    Taylor, S. E., Welch, W. T., Kim, H. S., & Sherman, D. K. (2007). Cultural differences in the impact of social support on psychological and biological stress responses. Psychological Sciences, 18(9), 831–837. doi:10.1111/j.1467-9280.2007.01987.x.CrossRefGoogle Scholar
  19. 19.
    Kang, S., Shaver, P. R., Sue, S., Min, K., & Jing, H. (2003). Culture-specific patterns in the prediction of life satisfaction: Roles of emotion, relationship quality, and self-esteem. Personality and Social Psychology Bulletin, 29(12), 1596–1608.CrossRefPubMedGoogle Scholar
  20. 20.
    Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224–253.CrossRefGoogle Scholar
  21. 21.
    Chen, J. M., Kim, H. S., Mojaverian, T., & Morling, B. (2012). Culture and social support provision: Who gives what and why. Personality and Social Psychology Bulletin, 38(1), 3–13. doi:10.1177/0146167211427309.CrossRefPubMedGoogle Scholar
  22. 22.
    Choi, S., Rankin, S., Stewart, A., & Oka, R. (2008). Effects of acculturation on smoking behavior in Asian Americans. Journal of Cardiovascular Nursing, 23(1), 67–73.CrossRefPubMedGoogle Scholar
  23. 23.
    Yoon, E., Chang, C., Kim, S., Clawson, A., Cleary, S. E., Meghan, H., et al. (2013). A meta-analysis of acculturation/enculturation and mental health. Journal of Counseling Psychology, 60(1), 15–30.CrossRefPubMedGoogle Scholar
  24. 24.
    Miller, M. J. (2007). A bilinear multidimensional measurement model of Asian American acculturation and enculturation: Implications for counseling interventions. Journal of Counseling Psychology, 54(2), 118–131. doi:10.1037/0022-0167.54.2.118.CrossRefGoogle Scholar
  25. 25.
    Chen, S. J., Zhou, Q., Main, A., & Lee, E. H. (2015). Chinese American immigrant parents’ emotional expression in the family: Relations with parents’ cultural orientations and children’s emotion-related regulation. Cultural Diversity and Ethnic Minority Psychology, 21(4), 619–629. doi:10.1037/cdp0000013.CrossRefPubMedGoogle Scholar
  26. 26.
    Brislin, R. W. (1970). Back translation for cross-cultural research. Journal of Cross Cultural psychology, 1(3), 185–216. doi:10.1177/135910457000100301.CrossRefGoogle Scholar
  27. 27.
    Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714. doi:10.1016/0277-9536(91)90150-B.CrossRefPubMedGoogle Scholar
  28. 28.
    Yu, D. S. F., Lee, D. T. F., & Woo, J. (2004). Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C). Research in Nursing and Health, 27(2), 135–143. doi:10.1002/nur.20008.CrossRefPubMedGoogle Scholar
  29. 29.
    Stephenson, M. (2000). Development and validation of the Stephenson Multigroup Acculturation Scale (SMAS). Psychological Assessment, 12(1), 77–88. doi:10.1037/1040-3590.12.1.77.CrossRefPubMedGoogle Scholar
  30. 30.
    Wan, C., Zhang, D., Yang, Z., Tu, X., Tang, W., Feng, C., et al. (2007). Validation of the simplified Chinese version of the FACT-B for measuring quality of life for patients with breast cancer. Breast Cancer Research and Treatment, 106(3), 413–418. doi:10.1007/s10549-007-9511-1.CrossRefPubMedGoogle Scholar
  31. 31.
    Pennebaker, J. W. (1982). The psychology of physical symptoms. New York: Springer.CrossRefGoogle Scholar
  32. 32.
    King, L. A., & Emmons, R. A. (1990). Conflict over emotional expression: Psychological and physical correlates. Journal of Personality and Social Psychology, 58(5), 864–877.CrossRefPubMedGoogle Scholar
  33. 33.
    Stanton, A. L., Danoff-Burg, S., Sworowski, L. A., Collins, C. A., Branstetter, A. D., Rodriguez-Hanley, A., et al. (2002). Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology, 20(20), 4160–4168.CrossRefPubMedGoogle Scholar
  34. 34.
    Lu, Q., & Stanton, A. L. (2010). How benefits of expressive writing vary as a function of writing instructions, ethnicity and ambivalence over emotional expression. Psychology and Health, 25(6), 669–684. doi:10.1080/08870440902883196.CrossRefPubMedGoogle Scholar
  35. 35.
    Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
  36. 36.
    Kim, H. S. (2010). Culture and self-expression. http://www.apa.org/science/about/psa/2010/06/sci-brief.aspx.
  37. 37.
    Wei, M. F., Su, J. C., Carrera, S., Lin, S. P., & Yi, F. (2013). Suppression and interpersonal harmony: A cross-cultural comparison between Chinese and European Americans. Journal of Counseling Psychology, 60(4), 625–633.CrossRefPubMedGoogle Scholar
  38. 38.
    Kim, H. S., & Markus, H. R. (2002). Freedom of speech and freedom of silence: An analysis of talking as a cultural practice. In R. Shweder, M. Minow, & H. R. Markus (Eds.), Engaging cultural differences: The multicultural challenge in liberal democracies (pp. 432–452). New York: Russell Sage Foundation.Google Scholar
  39. 39.
    Soto, J. A., Perez, C. R., Kim, Y. H., Lee, E. A., & Minnick, M. R. (2011). Is expressive suppression always associated with poorer psychological functioning? A cross-cultural comparison between European Americans and Hong Kong Chinese. Emotion, 11(6), 1450–1455. doi:10.1037/a0023340.CrossRefPubMedGoogle Scholar
  40. 40.
    Wilkins, R., & Gareis, E. (2006). Emotion expression and the locution “I love you”: A cross-cultural study. International Journal of Intercultural Relations, 30(1), 51–75. doi:10.1016/j.ijintrel.2005.07.003.CrossRefGoogle Scholar
  41. 41.
    Helgeson, V. S., Cohen, S., Schulz, R., & Yasko, J. (2000). Group support interventions for women with breast cancer: Who benefits from what? Health Psychology, 19(2), 107–114. doi:10.1037/0278-6133.19.2.107.CrossRefPubMedGoogle Scholar
  42. 42.
    Berry, J. W. (1994). Acculturation and psychological adaptation: An over-view. In A. Bouvy, F. J. R. Van de Vijver, P. Boski, & P. Schmitz (Eds.), Journeys into cross-cultural psychology (pp. 129–141). Berwyn, PA: Swets & Zeitlinge.Google Scholar
  43. 43.
    Kim, B. S. K., Atkinson, D. R., & Umemoto, D. (2001). Asian cultural values and the counseling process: Current knowledge and directions for future research. The Counseling Psychologist, 29(4), 570–603.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of HoustonHoustonUSA

Personalised recommendations