title: Breast cancer among Asian Americans: is acculturation related to health-related quality of life?
abstract: OBJECTIVE
  To examine the association of acculturation with health-related quality of life (HRQOL) among Asian American breast cancer survivors.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Analysis of an Asian American subsample of breast cancer survivors from a larger multiethnic study.
  
  
  METHODS
  206 Asian Americans, including Chinese, Filipinos, Koreans, and Japanese. Most were diagnosed with early-stage breast cancer (stage 0-II) and were an average of 54 years old.
  
  
  METHODS
  Participants completed a mailed questionnaire or answered a telephone survey in English, Mandarin, or Korean. HRQOL was measured using the Functional Assessment of Cancer Therapy Breast Version 4. Acculturation was measured using an eight-item scale adapted from Marin's Short Acculturation Scale.
  
  
  METHODS
  HRQOL, acculturation, health insurance, life stress, and social support.
  
  
  RESULTS
  Acculturation was significantly associated with HRQOL when demographic, medical, socioecologic, and healthcare access factors were controlled. However, the significant association between acculturation and HRQOL disappeared when Asian subgroup membership was considered. Subgroup differences in HRQOL remained after controlling for covariates, with Korean Americans reporting lower HRQOL than the other Asian American subgroups.
  
  
  CONCLUSIONS
  The absence of a significant association between acculturation and HRQOL in the final model is likely a result of the strong association between acculturation and Asian American subgroup membership. The results suggest that the correlation between acculturation and HRQOL is not an effect of having health insurance, life stress, and social support.
  
  
  CONCLUSIONS
  Closer attention is needed regarding acculturation level; Asian American subgroup differences, including language capacity; and socioecologic characteristics in nursing practice and research.
authors.affiliation: College of Health and Human Sciences, Northern Illinois University, DeKalb, USA.
authors.forename: Jinsook
authors.initials: J
authors.lastname: Kim
authors.forename: Kimlin T
authors.initials: KT
authors.lastname: Ashing-Giwa
authors.forename: Marjorie
authors.initials: M
authors.lastname: Kagawa Singer
authors.forename: Judith S
authors.initials: JS
authors.lastname: Tejero
mesh_terms: D000069:Acculturation; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000451:nursing / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008875:Middle Aged; D009859:Oncology Nursing; D011788:Quality of Life; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires