title: Exploring the association between functional strain and emotional well-being among a population-based sample of breast cancer survivors.
abstract: OBJECTIVE
  Breast cancer survival and survivorship outcomes have improved dramatically; yet, there are still considerable morbidities associated with this illness. Functional strain is conceptualized as the unfavorable outcome of the functional well-being domain of health-related quality of life. This study intends to (1) examine the adequacy of the functional strain concept; (2) describe the level of functional strain and emotional well-being by ethnicity and job types; and (3) investigate the salient functional strain components influencing emotional well-being for breast cancer survivors (BCS) after controlling for ethnicity and job types.
  
  
  METHODS
  A cross-sectional design with mixed sampling methods was used. BCS were recruited from the California Cancer Surveillance Program, hospital registries and community agencies in Southern California. Functional strain was measured by assessing family and work burdens.
  
  
  RESULTS
  Confirmatory factor analysis established the adequacy of the two factors (family and work burdens) defining the functional strain. Findings demonstrated significant differences in functional strain by ethnicity and job types. Latina-Americans and homemakers/housewives showed the worst scores in functional strain variables. The final model examining the impact of functional strain components on emotional well-being explained 34% of the variance of emotional well-being.
  
  
  CONCLUSIONS
  Findings suggest the impact of cancer on family and work life varies by ethnic and demographic characteristics, such that Latino ethnicity and homemaker/housewife status may be risk factors for functional strain. Our findings imply that functional strain provides a reasonable concept that can be used to deepen our understanding and examination of the impact of functional status on emotional well-being.
authors.affiliation: Center of Community Alliance for Research and Education (CCARE), Division of Population Sciences, City of Hope National Medical Center, Duarte, CA 91010-3000, USA. Kashing@coh.org
authors.forename: Kimlin T
authors.initials: KT
authors.lastname: Ashing-Giwa
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult