UCLA

Asian American is predicted to be the largest immigrant group by the year 2055. Breast cancer is the primary cancer diagnosis and the second-leading cause of death among Asian-American women. Despite the lengthy presence of Asian immigrants in the US and the recent predictions of increasing breast cancer incidence in this population, the unique cultural needs and psychological responses to cancer survivorship remain relatively unknown. In order to expand the understanding in Asian American breast cancer survivorship, this dissertation applied the Transactional Model of Stress and Coping to examine how stressors experienced by the Asian American breast cancer survivors and their coping use influenced their psychological well-being. Secondary data analysis was conducted on 233 participants (Chinese = 44%, Japanese = 37%, and Vietnamese = 19%) who completed qualitative questionnaires that assessed their physical, emotional, social, and financial stress. Participants also completed standardized measures on their coping strategies used and psychological well-being. The analysis on the relationship between stress and psychological well-being indicated that higher levels of stress (in all four types of stressors) were associated with poor psychological well-being. Moderation of ethnicity on the relationship between stress and psychological well-being was unable to be tested due to low sample size. The analysis of the relationship between coping and psychological well-being revealed ethnic differences in the following coping strategies: expressive suppression, active coping, denial, use of emotional support, use of instrumental support, positive reframing, acceptance, and self-blame. The increased use of all emotion-focused coping strategies of positive valence and problem-focused coping strategies was associated with good psychological well-being (except the relationship between cognitive reappraisal and self-stigma). Furthermore, the increased use of all emotion-focused coping strategies of negative valence was associated with poor psychological well-being. Moderation of ethnicity on the relationship between coping and psychological well-being could not be tested due to low sample size. Mediation of coping on the relationship between stress and psychological well-being could not be tested either, due to low sample size. The findings from this dissertation could advance public health theories and improve doctor-patient communication with Asian American breast cancer survivors.