title: Is family functioning and communication associated with health-related quality of life for Chinese- and Korean-American breast cancer survivors?
abstract: OBJECTIVE
  This study aims to investigate direct and indirect pathways of family flexibility, social support, and family communication on health-related quality of life (HRQOL) for Chinese- and Korean-American breast cancer survivors (BCS).
  
  
  METHODS
  A total of 157 Chinese (n = 86)- and Korean-American (n = 71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The present study was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation.
  
  
  RESULTS
  Structural equation modeling demonstrated that (1) family communication was directly associated with HRQOL for both groups; (2) family flexibility was indirectly associated with HRQOL through family communication for Korean-Americans only; (3) social support mediated the relationship between family flexibility and family communication for Chinese-Americans only; and (4) acculturation was directly related to social support for both groups. Multigroup analysis demonstrated that the structural paths were equivalent between Chinese- and Korean-American BCS, although statistical differences in baseline parameters were noted.
  
  
  CONCLUSIONS
  Our findings suggest that family communication impacts HRQOL among Asian-American BCS. Our results show that while there are commonalities in family characteristics among Asian-Americans, specific ethnic variations also exist. Therefore, specific cultural and familial contexts should be assessed to better inform interventions to enhance family communication strategies and improve HRQOL.
authors.affiliation: Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA. jung-won.lim@case.edu
authors.forename: Jung-won
authors.initials: JW
authors.lastname: Lim
authors.forename: Kimlin T
authors.initials: KT
authors.lastname: Ashing-Giwa
mesh_terms: D000069:Acculturation; D000368:Aged; D001213:Asian / Q000208:ethnology / Q000523:psychology*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D002140:California / Q000453:epidemiology; D002681:China / Q000208:ethnology; D003142:Communication; D005190:Family / Q000523:psychology; D005195:Family Relations / Q000208:ethnology; D005260:Female; D006304:Health Status; D006801:Humans; D007723:Korea / Q000208:ethnology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014481:United States