The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors

Ivan H C Wu, William Tsai, Lorna H McNeill, Qian Lu

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

PURPOSE: The aim of the current study was to examine the incidence of poor sleep quality, medication use, and dysfunction and the association of self-stigma and perceived social constraints (i.e., ambivalence over emotional expression; AEE) on sleep among a sample of Chinese American breast cancer survivors.

METHODS: The data were based on self-report baseline data (n = 136) from an expressive writing intervention study for Chinese American breast cancer survivors (MTime since diagnosis = 27.17 months; SD = 19.31). Participants completed self-report questionnaires related to psychological and physical health and health behaviors. Using linear regression and path modeling, our hypotheses were tested using models where (1) self-stigma predicted sleep characteristics (i.e., quality, medication use, and dysfunction) with (2) AEE mediating the relationship between self-stigma and sleep.

RESULTS: Participants frequently reported poor sleep quality (44.9%), use of sleep aids (37.5%), and difficulty staying awake during the day (37.5%). Greater self-stigma was related to greater AEE (b = .48, SE = .09, p < .05), which was related to worse sleep quality (b = - .19, SE = .08, p < .05), greater use of sleep aids (b = .25, SE = .11, p < .05), and greater difficulty staying awake during the day (b = .30, SE = .09, p < .05). Further, the indirect effect of self-stigma on sleep quality (ab = - .09, 95% CI - .19, - .03), use of sleep aids (ab = .12, 95% CI .03, .25), and difficulty staying awake during the day (ab = .15, 95% CI .06, .18) through AEE was significant.

CONCLUSION: The results of this study highlight significant sleep-related problems among Chinese American breast cancer survivors and the importance of considering cultural beliefs of cancer in counseling.

IMPLICATION FOR CANCER SURVIVORS: Chinese American breast cancer survivors are at risk for sleep-related difficulties due, in part, to perceived self-stigma and emotional constraints. Greater education and community outreach to Chinese communities may help destigmatize breast cancer and encourage emotional expression around cancer-related topics.

Original languageEnglish (US)
Pages (from-to)3935-3944
Number of pages10
JournalSupportive Care in Cancer
Volume28
Issue number8
DOIs
StatePublished - Aug 2020
Externally publishedYes

Keywords

  • Affect
  • Asian Americans/psychology
  • Breast Neoplasms/ethnology
  • Cancer Survivors/psychology
  • Dyssomnias/ethnology
  • Emotions
  • Female
  • Humans
  • Middle Aged
  • Quality of Life/psychology
  • Self Concept
  • Sleep/physiology
  • Social Behavior
  • Social Stigma
  • Surveys and Questionnaires

PubMed: MeSH publication types

  • Journal Article

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