title: The relationship between communication and health-related quality of life in survivorship care for Chinese-American and Korean-American breast cancer survivors.
abstract: OBJECTIVE
  The purpose of this study was (1) to compare family communication, decision support (i.e., supporting the patient in making decisions), self-efficacy in patient-physician communication (i.e., patients' confidence level in communicating with physicians), and health-related quality of life (HRQOL) between Chinese-American and Korean-American breast cancer survivors (BCS) and (2) to investigate how family communication, decision support, and self-efficacy in patient-physician communication influence HRQOL for Chinese-American and Korean-American BCS.
  
  
  METHODS
  A cross-sectional design was used. A total of 157 Chinese-American (n = 86) and Korean-American (n = 71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The chronic care model was utilized.
  
  
  RESULTS
  Chinese-Americans and Korean-Americans showed a significant difference in the decision support only. Self-efficacy in patient-physician communication was directly associated with HRQOL for Chinese-Americans, whereas for Korean-Americans, family communication was related to HRQOL. The mediating effects of decision support and self-efficacy in physician-patient communication in the relationship between family communication and HRQOL were observed for Chinese-Americans only. Multiple group analysis demonstrated that the structural paths varied between Chinese-American and Korean-American BCS.
  
  
  CONCLUSIONS
  Our results provide insight into the survivorship care of Chinese-American and Korean-American BCS, allowing a better understanding of communication among survivors, family, and healthcare providers. Communication skills to manage conflict and attain consensus among them under the cultural contexts are essential to improve HRQOL for BCS.
authors.affiliation: Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA. jung-won.lim@case.edu
authors.forename: Jung-won
authors.initials: JW
authors.lastname: Lim
authors.forename: Min-so
authors.initials: MS
authors.lastname: Paek
mesh_terms: D000368:Aged; D001213:Asian; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality / Q000523:psychology; D002140:California; D002681:China / Q000208:ethnology; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D011788:Quality of Life; D056910:Republic of Korea / Q000208:ethnology; D011795:Surveys and Questionnaires; D015996:Survival Rate