Ethnic Differences in Psychosocial Factors for Cancer Survivorship Among Asian American Breast Cancer Survivors: Secondary Outcomes of a Randomized Controlled Trial.

Abstract

Background: Asian American breast cancer survivors face substantial disparities in recurrence rates; however, ethnic differences in breast cancer survivorship remain understudied.

Objective: To examine the associations between psychosocial factors and breast cancer survivorship, with a focus on ethnic differences among Chinese, Korean, and Japanese Americans.

Methods: This secondary analysis used data from 167 participants in a randomized clinical trial of Asian American breast cancer survivors. Cancer survivorship was measured with the Supportive Care Needs Survey, the Memorial Symptom Assessment Scale, and the Functional Assessment of Cancer Therapy-Breast Cancer. Psychosocial factors included attitudes, self-efficacy, perceived barriers, and social influences. All assessments were administered at baseline, 4-week posttest, and 12-week posttest. Baseline differences across ethnic groups were examined with analysis of variance (ANOVA), post hoc, and chi-square tests. Panel data were analyzed with mixed-effects linear regression models.

Results: ANOVA tests indicated that Chinese Americans reported more negative attitudes toward cancer survivorship, whereas Japanese Americans reported lower levels of social influence. Mixed-effects linear regression models showed significant ethnic differences in associations: Compared with Japanese Americans, Chinese Americans exhibited stronger negative associations of cancer survivorship outcomes with a lack of social support and perceived barriers. Among Korean Americans, higher loneliness and lower social influence were associated with greater unmet needs (Supportive Care Needs Survey).

Conclusion: To address survivorship experiences among Asian American breast cancer survivors, ethnic differences must be considered.

Implications for oncology nursing practice: Survivorship care for Asian American breast cancer survivors should incorporate ethnic differences and modifiable psychosocial factors to guide culturally tailored interventions.