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A preliminary prospective study of health-related quality of life among Chinese-American breast cancer survivors

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Abstract

Purpose

This study examined the predictors of health-related quality of life (HRQOL) and changes in HRQOL over a 1-year period among Chinese-American breast cancer survivors (BCS).

Methods

A two-wave longitudinal research design included participants from hospital-based cancer registries and community organizations in Los Angeles. Participants completed mailed questionnaires at baseline and 12-month follow-up. HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G v.4). Change in HRQOL was assessed using a 7-point meaningful change score.

Results

Participants were 73 Chinese-American BCS, a majority of whom were middle-aged (M = 54.6, SD = 9.2), lower income (63% < 45K), and diagnosed with stage I–II (83%) breast cancer. Regression analyses showed that multilevel contextual factors including general health perception, quality of care, life stress, and improvement in general health perception significantly predicted HRQOL at baseline and follow-up. The final model explained 72% of the variance of HRQOL. The examination of meaningful change indicated that improvement was reported by 32% (n = 22) and deterioration by 25% (n = 17); the majority indicated minimal change (43%, n = 30). Improvement was associated with increases in family communication, social support, and general health perception, while deterioration was associated with declines in social support, family communication, and general health perception.

Conclusion

Findings indicate that among Chinese-American BCS, HRQOL is influenced by socioecological factors such as family communication and life stress. Results suggest that cancer survivorship outcomes research may benefit from theoretical foundations that examine the broader contextual dimensions that seem to impact and predict HRQOL. Implications for research are discussed.

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Acknowledgements

The authors would like to acknowledge Chun Nok Lam for his assistance with the data analyses.

Funding

This study was funded by Susan G. Komen (grant number POP0601091).

Author information

Authors and Affiliations

  1. Department of Population Sciences, City of Hope Comprehensive Cancer Center, Beckman Research Institute, 1500 E Duarte Road, Duarte, CA, 91010-3000, USA

    Kimlin Tam Ashing

  2. Lung Cancer Screening and Prevention Program, City of Hope National Medical Center, Duarte, CA, USA

    Sophia Yeung & Lily Lai

  3. Herald Cancer Association, Chinese Christian Herald Crusades, San Gabriel, CA, USA

    Lucy Young

  4. Fuller Theological Seminary, School of Psychology & Marriage and Family Therapy, Pasadena, CA, USA

    Alison G. Wong

Authors
  1. Kimlin Tam Ashing
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  2. Sophia Yeung
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  3. Lily Lai
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  4. Lucy Young
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  5. Alison G. Wong
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Sophia Yeung, and data analyses were performed by Dr. Alison Wong. The first draft of the manuscript was written by Dr. Kimlin Ashing, and all authors including Dr Lai contributed to the writing and commented on all versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kimlin Tam Ashing.

Ethics declarations

Ethics approval

Approval was obtained from the City of Hope Institutional Review Board. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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The manuscript was submitted for consideration of publication in the Supportive Care in Cancer. The manuscript is not under consideration or previously published elsewhere.

Conflicts of interest

The authors declare no competing interests.

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Ashing, K.T., Yeung, S., Lai, L. et al. A preliminary prospective study of health-related quality of life among Chinese-American breast cancer survivors. Support Care Cancer 29, 6021–6030 (2021). https://doi.org/10.1007/s00520-021-06181-1

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  • DOI: https://doi.org/10.1007/s00520-021-06181-1

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