Acculturation and quality of life among Chinese American breast cancer survivors: The mediating role of self-stigma, ambivalence over emotion expression, and intrusive thoughts

William Tsai, Ivan H C Wu, Qian Lu

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

OBJECTIVES: Highly acculturated Chinese American breast cancer survivors have greater access to health care providers, are English language proficient, and have more knowledge about the health care system. However, less is known about the potential psychosocial factors that may account for the health benefits of acculturation. As such, the current study seeks to understand how mainstream acculturation is associated with higher quality of life by investigating self-stigma, ambivalence over emotion expression (AEE), and intrusive thoughts, as serial mediators among Chinese breast cancer survivors.

METHODS: One hundred twelve Chinese American breast cancer survivors completed a self-reported questionnaire with these trait variables.

RESULTS: We found support for a serial multiple mediation hypothesis in which mainstream acculturation was indirectly associated with quality of life through self-stigma, AEE, and intrusive thoughts. Specifically, mainstream acculturation was associated with lower self-stigma, which, in turn, was associated with lower AEE and intrusive thoughts and subsequently resulted in lower quality of life among Chinese American breast cancer survivors.

CONCLUSIONS: The findings suggest that psychosocial factors are important mechanisms through which acculturation is associated with quality of life among Chinese American breast cancer survivors. As Chinese immigrants acculturate to mainstream American culture, they may benefit from the reduced public stigma toward breast cancer and incorporate new post-immigration knowledge about cancer that protects them from high levels of self-stigma. This, in turn, may lead Chinese American breast cancer survivors to experience lower AEE and intrusive thoughts and subsequently experience higher quality of life.

Original languageEnglish (US)
Pages (from-to)1063-1070
Number of pages8
JournalPsycho-Oncology
Volume28
Issue number5
DOIs
StatePublished - May 2019
Externally publishedYes

Bibliographical note

© 2019 John Wiley & Sons, Ltd.

Keywords

  • Acculturation
  • Adult
  • Aged
  • Aged, 80 and over
  • Asian Americans/psychology
  • Breast Neoplasms/psychology
  • Cancer Survivors/psychology
  • Cognition
  • Communication
  • Emotions
  • Female
  • Humans
  • Middle Aged
  • Quality of Life/psychology
  • Self Concept
  • Social Stigma
  • Surveys and Questionnaires
  • Thinking

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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