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

Abstract Background To explore and characterize the inter-relationship between psychological well-being, spirituality, social support, comorbidity, demographic and lifestyle factors and quality of life (QoL). Methods This cross-sectional study was conducted with 305 breast cancer survivors in northern Iran in 2017. The demographic and socio-economic data and physical activity were measured with a standard questionnaire. The standard European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 QoL scale, a system-of-belief inventory questionnaire, the social support scale, the short form of the Hospital Anxiety and Depression Scale and the fatigue severity scale (FSS) were used in data collection. In structural equation modelling analysis, we used the maximum likelihood procedure to estimate the direct and indirect effects of relevant factors on QoL. Results The median age (quartile 1 [Q1], quartile 3 [Q3]) of patients was 50 y (43, 55). The psychological factors designated by anxiety, depression and FSS had a negative significant direct effect on QoL (β=−0.62). Spirituality has a positive direct effect (β=0.089) but a negligible indirect effect (β=0.020) on QoL, while the direct association of social support was almost negligible. Conclusions The findings emphasized the unifying structure of the determinants of QoL and the mediating negative association of psychological factors with QoL. Thus the supportive education efforts should focus on improving psychological well-being along with standard treatment in breast cancer survivors.

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Associations between morning–evening chronotype, fatigue, and QOL in breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.246 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 246-246 ◽

Cited By ~ 1

Author(s):

Oxana Palesh ◽

M. Melissa Packer ◽

Holly George ◽

Cheryl Koopman ◽

Pasquale F. Innominato

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Bright Light ◽

Well Being ◽

Cancer Treatments ◽

Significant Difference ◽

Morning Type ◽

The Relationship ◽

Range Of Values

246 Background: Emerging evidence suggests that circadian disruption is associated with cancer and cancer treatments. Chronotype is defined as a behaviorally manifested preference for a certain timing of sleep and activity. Previous studies have revealed that living out of sync from one’s innate chronotype can have detrimental effects on one’s health. Although there has been research examining the associations between chronotype and health, not much is known about the relationship between chronotype, fatigue, and QOL in cancer survivors. Methods: 68 Breast cancer survivors completed questionnaires to assess their chronotype (Horne-Ostberg), to rate their fatigue (MDASI), and to evaluate their QOL (FACIT). The Horne-Ostberg questionnaire yields a range of values indicating survivors’ preference for early or late activity. The study sample was divided by terciles according to survivors’ “morningness” or “eveningness” preferences (i.e., chronotypes). Results: Morning chronotype was associated with significantly less severe tiredness and drowsiness as well as significantly better physical well-being and fatigue subscale scores as compared to evening chronotype. Tiredness median (M) scores were highest for evening chronotype (M=5.5), moderate for mid-range chronotype (M=4.5), and lowest for morning chronotype (M=3.0), a significant difference (p=0.046). Drowsiness scores were highest for evening chronotype (median=6.0), moderate for mid-range chronotype (M=4.0), and lowest for morning chronotype (M=3.0), p=0.046. The median score for physical well-being was significantly lower for evening compared to morning chronotypes (22.5 vs. 25.0, p=0.038) and morning types reported significantly better health in respect to fatigue compared to evening types (40.5 vs. 35.5, p=0.045). Conclusions: Survivors with early chronotype (early to bed, early to rise) reported less fatigue, drowsiness, and better overall physical well-being. While chronotype is believed to be genetically driven, certain behavioral, pharmacological, and bright light modifications can be used to help patients shift their circadian rhythm towards earlier morning type and may experience improvements in physical well-being.

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