Jung-won Lim

Breast Cancer Cause Beliefs Chinese, Korean, and Mexican American Breast Cancer Survivors

This study examined causal attribution beliefs about breast cancer and the influence that these beliefs exert on health behavior change among breast cancer survivors (BCS). Focus groups with Chinese (n = 21), Korean (n = 11), and Mexican American (n = 9) BCS recruited through community- and hospital-based support groups were conducted. Interviews were audio-recorded, transcribed verbatim, and translated into English for thematic content analysis. Three themes concerning beliefs about breast cancer cause common to all three groups included (a) stress, (b) diet, and (c) fatalism. Causal beliefs corresponded to behavioral changes with women describing efforts to improve their diet and manage their stress. Ethnic minority BCS adhere to beliefs about what caused their cancer that influence their health behaviors. Providing quality health care to ethnically diverse cancer survivors requires cultural sensitivity to patients’ beliefs about the causes of their cancer and awareness of how beliefs influence patients’ health behaviors post diagnosis.

Communication, coping, and quality of life of breast cancer survivors and family/friend dyads: a pilot study of Chinese‐Americans and Korean‐Americans

This study aimed to understand the dyadic relationships between family communication and quality of life (QOL) and between coping and QOL in Chinese‐American and Korean‐American breast cancer survivor (BCS)–family member dyads.

Understanding the Stress Process of Chinese- and Korean-American Breast Cancer Survivors

Guided by the stress process model (SPM), this study investigated the direct and indirect pathways of primary (negative self-image and life stress), secondary stressors (family communication strain) and family coping (external and internal) on mental health outcomes among Chinese- and Korean-American breast cancer survivors (BCS). A total of 156 Chinese- and Korean-American BCS were surveyed. Results showed primary and secondary stressors had a negative effect on better mental health outcomes. External coping was associated with better mental health. Family communication strain mediated the relationship between life stress and mental health outcomes. External coping mediated the relationship between family communication strain and mental health outcomes. Multi-group analysis revealed the stress process did not differ across ethnic groups. Findings suggest the SPM may be applicable to understand the stress process of Chinese- and Korean-American BCS and provide valuable insight into the role of family communication and external coping on mental health outcomes.

The impact of comorbidity on the relationship between life stress and health-related quality of life for Chinese- and Korean-American breast cancer survivors.

ABSTRACT Objective: The current study aimed to (1) identify the occurrence of comorbidities among Chinese- and Korean-American breast cancer survivors (BCS), (2) examine whether health-related quality of life (HRQOL) scores varied with the occurrence of specific comorbidities, and (3) investigate the mediating effect of comorbidities on the relationship between life stress and HRQOL. Design: Data were drawn from the parent study, a cross-sectional study investigating HRQOL in 86 Chinese- and 71 Korean-American BCS in Southern California. Two comorbidity-related variables, the occurrence of the specific comorbidity and the total number of comorbidities, were used to comprehensively reflect the characteristics of comorbidity. Results: Approximately 60% of participants had at least one comorbid disease, and osteoporosis was the most prevalent comorbidity. HRQOL differences based on the occurrence of a specific comorbidity were evident for arthritis, eye/vision problems, dental and gum problems, lymphedema, and psychological difficulties. Structural equation modeling demonstrated that the nature of the outcome variable, either physical or mental HRQOL, influenced the overall patterns of the findings. For example, life stress was significantly associated with the total number of comorbidities and in turn influenced physical HRQOL. In terms of mental HRQOL, arthritis, dental and gum problems, chronic pain, heart disease, lymphedema, and psychological difficulties mediated the relationship between life stress and mental HRQOL. Conclusion: The current study adds to the existing literature by examining the mediating effects of comorbidity on the relationship between life stress and HRQOL. The findings support the need for health care professionals to clearly assess physical and psychological comorbidities when providing survivorship care for cancer survivors.

Barriers to Cancer Care, Perceived Social Support, and Patient Navigation Services for Korean Breast Cancer Patients

The present study aimed to examine the relationships among barriers to cancer care, perceived social support, and patient navigation services (PNS) for Korean breast cancer patients. For Korean breast cancer patients, PNS are comprised of five services, including emotional, financial, information, transportation, and disease management. The study findings demonstrated that transportation and disease management barriers were directly associated with PNS, whereas emotional and financial barriers were indirectly associated with PNS through perceived social support. The current study provides a preliminary Korean patient navigation model to identify how barriers to cancer care can be reduced through social support and PNS.

The role of post-traumatic growth in promoting healthy behavior for couples coping with cancer

ObjectivePost-traumatic growth (PTG) could be beneficial to cancer survivors who translate growth cognitions or emotional processes into positive behavior changes. The current study aimed to determine how post-traumatic growth (PTG) is associated with health behaviors in couples coping with cancer. Specifically, five hypothetical models based on PTG domains were created to better understand the dyadic relationship between PTG domain and health behaviors.MethodsA total of 91 breast, colorectal, and prostate cancer survivor-spouse dyads were collected from the University Hospital Registry in Cleveland, Ohio. Standardized questions regarding PTG and health behaviors including eating and exercise were used. The actor-partner interdependence model with the use of structural equation modeling was utilized to analyze dyadic data.ResultsFindings indicated that survivor actor effects of PTG on health behaviors were observed for survivors only. In the spiritual change and appreciation of life PTG models, the survivor or the spouse partner effects were observed, respectively. The spiritual change model produced the best fit of all of the other models, indicating both a survivor actor effect and survivor partner effect of spiritual change PTG on health behaviors. Thus, the relationships between PTG and health behavior at the dyadic level differed by five domains of PTG.ConclusionsThe findings reveal valuable insight into the nature of relationships between PTG and health behaviors at the individual and dyadic levels. The changed philosophies of life for cancer survivor-spouse dyads can specifically encourage healthy behaviors of couples coping with cancer.