title: Perceived Stress as a Mediator Between Social Support and Posttraumatic Growth Among Chinese American Breast Cancer Survivors.
abstract: BACKGROUND
  Studies have shown that social support is positively associated with posttraumatic growth (PTG) among white cancer survivors. Whether the same relationship holds among Asian American cancer survivors and through what mechanism social support may influence PTG is unclear.
  
  
  OBJECTIVE
  This study examined the association between social support and PTG among Chinese American breast cancer survivors and proposed perceived stress as a mediator.
  
  
  METHODS
  Chinese American breast cancer survivors (n = 118) were recruited from Southern California. Participants' social support, perceived stress, and PTG were measured in a questionnaire package.
  
  
  RESULTS
  Social support was associated with lower perceived stress (r= -0.34, P<.001) and higher PTG (r=0.44, P<.001). Perceived stress was negatively associated with PTG (r=-0.36, P< .001). Results from structural equation modeling supported the mediation model, with satisfactory model fit indices (χ37= 65.55, comparative fit index= 0.98, Tucker-Lewis Index = 0.97, root-mean-square error of approximation = 0.08). Both the indirect effect from social support to PTG via perceived stress (β = .07, P< .05) and the direct effect from social support and PTG (β= .40, P< .001) were statistically significant, suggesting a partial mediation effect of perceived stress between social support and PTG.
  
  
  CONCLUSIONS
  The positive association between social support and Chinese American breast cancer survivors' PTG was supported. Our findings also suggested that social support may facilitate PTG through reduction of perceived stress.
  
  
  CONCLUSIONS
  Interventions that help to enhance Chinese American breast cancer survivors' social support may also facilitate their PTG.
authors.affiliation: Author affiliations: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong (Dr Yeung); Department of Psychology, University of Houston, Texas (Dr Lu).
authors.forename: Nelson C Y
authors.initials: NCY
authors.lastname: Yeung
authors.forename: Qian
authors.initials: Q
authors.lastname: Lu
mesh_terms: D000223:Adaptation, Psychological; D001213:Asian / Q000523:psychology* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology*; D002140:California; D000073116:Cancer Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires