title: Through the lens of culture: quality of life among Latina breast cancer survivors.
abstract: Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. Latina survivors were 1-5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M = 105; SD = 19.4 on the FACT-B). Culturally based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62 % of the explained model variance of overall quality of life (Adjusted R (2) = 0.53, P < 0.001). Similar relationships were seen for quality of life subdomains in which cultural, social, and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R (2) = 0.23, P < .001), social well-being (Adjusted R (2) = 0.51, P < 0.001), emotional well-being (Adjusted R (2) = 0.28, P < 0.001), functional well-being (Adjusted R (2) = 0.41, P < 0.001), and additional breast concerns (Adjusted R (2) = 0.40, P < 0.001). Efforts to improve Latinas' survivorship experiences should consider cultural, social, and medical contextual factors to close existing quality of life gaps between Latinas and other survivors.
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA. kdg9@georgetown.edu
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Graves
authors.forename: Roxanne E
authors.initials: RE
authors.lastname: Jensen
authors.forename: Janet
authors.initials: J
authors.lastname: Cañar
authors.forename: Monique
authors.initials: M
authors.lastname: Perret-Gentil
authors.forename: Kara-Grace
authors.initials: KG
authors.lastname: Leventhal
authors.forename: Florencia
authors.initials: F
authors.lastname: Gonzalez
authors.forename: Larisa
authors.initials: L
authors.lastname: Caicedo
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
authors.forename: Scott
authors.initials: S
authors.lastname: Kelly
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mandelblatt
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*