Do coping strategies mediate the effects of emotional support on emotional well-being among Spanish-speaking Latina breast cancer survivors?
This study aimed to assess the relationship between emotional social support and emotional well-being among Latina immigrants with breast cancer and test whether two culturally relevant coping strategies, fatalism and acceptance, mediate this relationship.



One hundred fifty Spanish-speaking Latinas within 1 year of breast cancer diagnosis participating in a randomized trial of a stress management intervention were assessed in person at baseline and via telephone 6 months later. Survey measures included baseline emotional support, fatalism, and acceptance and emotional well-being 6 months later. Generalized linear models estimated direct effects of emotional support on emotional well-being and indirect effects through fatalism and acceptance.



Mean age was 50.1 (SD = 10.9) years; most women had low education and acculturation levels. Emotional support was negatively associated with fatalism (r = -0.24, p < 0.01) and positively associated with acceptance (r = 0.30, p < 0.001). Emotional support (r = 0.23, p = 0.005) and acceptance (r = 0.28, p = 0.001) were positively associated with emotional well-being, whereas fatalism (r = -0.36, p < 0.0001) was negatively associated with emotional well-being. In multivariable models, emotional support was associated with emotional well-being (b = 0.88, 95% CI: 0.24, 1.52). This direct effect remained significant when additionally controlling for fatalism (b = 0.66, 95% CI: 0.03, 1.30) and acceptance (b = 0.73, 95% CI: 0.09, 1.37) in separate models. There was a significant indirect effect of emotional support on emotional well-being through fatalism (b = 0.21, 95% CI: 0.04, 0.51) as well as a marginally significant effect through acceptance (b = 0.15, 95% CI: 0.001, 0.43).



Emotional support may increase well-being among Spanish-speaking Latina cancer survivors by reducing cancer fatalism.Copyright © 2015 John Wiley & Sons, Ltd.
Cancer Prevention Fellowship Program, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA. anapoles@ucsf.edu.
Felisa A
FA
Gonzales
Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Alejandra
A
Hurtado-de-Mendoza
Division of General Internal Medicine and the Center for Aging in Diverse Communities, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Jasmine
J
Santoyo-Olsson
Division of General Internal Medicine and the Center for Aging in Diverse Communities, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Anna María
AM
Nápoles
D000069:Acculturation; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000523:psychology*; D000073116:Cancer Survivors / Q000523:psychology*; D003376:Counseling / Q000379:methods*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D012944:Social Support; D011795:Surveys and Questionnaires
Latino/Hispanic; breast cancer; coping; emotional support; emotional well-being; oncology