Through the lens of culture: quality of life among Latina breast cancer survivors

Abstract

BACKGROUND Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. METHODS Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. RESULTS Latina survivors were 1-5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M=105; SD=19.4 on the FACT-B). Culturally-based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62% of the explained model variance of overall quality of life (Adjusted R2=0.53, P<.001). Similar relationships were seen for quality of life subdomains in which cultural, social and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R2=0.23, P <.001), social well-being (Adjusted R2=0.51, P<.001), emotional well-being (Adjusted R2=0.28, P<.001), functional well-being (Adjusted R2=0.41, P<.001) and additional breast concerns (Adjusted R2=0.40, P<.001). CONCLUSIONS Efforts to improve Latinas’ survivorship experiences should consider cultural, social and medical contextual factors to close existing quality of life gaps between Latinas and other survivors.

Reducing Racial Disparities in Breast Cancer Survivors' Ratings of Quality Cancer Care

“…Journal for Healthcare Quality cohort was 4.05, which is also comparable to a study with Latina breast cancer survivors: 3.9 (SD: 0.6) (Graves et al, 2012). Relatively high satisfaction with care has been noted in samples of primarily White patients (Brown et al, 2009;Brown et al, 2001;Chino et al, 2014).…”

Breast Cancer Among Special Populations: Disparities in Care Across the Cancer Control Continuum

“…Hispanic women have been found to suffer more from pain, fatigue, depression, and fi nancial hardship related to treatment compared to non-Hispanic women (Fu et al 2009 ;Graves et al 2012 ). American Indian/Alaskan Native women also report problems related to pain, fatigue, depression and hair loss (Burhansstipanov et al 2010 ).…”

“…Native American languages have no word for cancer, but it translates to "the disease for which there is no cure. "(Native American Cancer Research Corporation Native Americans and Cancer) Language barriers compound acculturation issues and produce long-lasting problems with access and adherence (Graves et al 2012 ;Ashing-Giwa et al 2013b ).…”

Obesity, Ethnicity, and Quality of Life Among Breast Cancer Survivors and Women Without Breast Cancer: The Long-Term Quality of Life Follow-Up Study

“…Although there are well-known disparities in breast cancer outcomes between Hispanic and nonHispanic white (NHW) women in the USA [3,4], more Hispanic women are surviving cancer because of these improvements in screening and access to recommended treatment [5,6]. Hispanic survivors are projected to account for an increasing proportion of the vastly growing breast cancer survivor population [7][8][9].…”

“…Additionally, research gaps exist in the understanding of QOL among Hispanic breast cancer survivors [8]. Specific factors reported to influence QOL in NHW survivors include age at diagnosis, cancer stage, relationship status and social support, symptom distress and coping strategies [9,[11][12][13][14]. However, other data suggest that cultural and contextual factors, such as Hispanic role expectations, greater fear of recurrence, and barriers in patientphysician interaction may play larger roles in QOL among Hispanics, contributing to QOL disparities [7-9, 15, 16].…”