Self‐stigma and quality of life among Chinese American breast cancer survivors: A serial multiple mediation model
Open accessAbstract
Objective: Despite the increasing scholarly attention toward self‐stigma among Asian breast cancer survivors, research is limited about the underlying psychological mechanisms by which self‐stigma may influence quality of life for this population. The present study investigated how self‐stigma is associated with quality of life among Chinese American breast cancer survivors by examining the serial mediating effects of concerns about breast cancer, self‐efficacy for coping with cancer, and depressive symptoms. Methods: Chinese American breast cancer survivors ( n = 112) completed a questionnaire packet assessing self‐stigma related to breast cancer, concerns about breast cancer, self‐efficacy for coping with cancer, depressive symptoms, and quality of life. Path analysis was conducted to test the hypothesized serial multiple mediation model. Results: The hypothesized model was supported: self‐stigma was negatively associated with quality of life through concerns about breast cancer, self‐efficacy, and depressive symptoms. After the mediators were controlled for, the direct effect of self‐stigma on quality of life was no longer significant. Conclusions: Our findings suggest that concerns about breast cancer, self‐efficacy for coping, and depressive symptoms are important pathways through which self‐stigma may influence quality of life among Chinese American breast cancer survivors. Healthcare practitioners should be aware of survivors' self‐stigma and make efforts to alleviate survivors' excessive cancer concerns, facilitate their self‐efficacy, and offer emotional support to improve quality of life for this population.
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In Chinese society and culture, internalization of patient stereotypes, direct rejection by others, and discrimination in the social system have contributed to the creation of societal self-isolation.
“In the development of Chinese society and culture, the internalization of patient stereotypes, direct rejection by others, and discrimination in the social system have contributed to the creation of societal self-isolation [51,52].”
From Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study. (2023) · cites this paper as [51]
The Background says Chinese American breast cancer survivors internalize negative beliefs about cancer, and the Discussion describes sensitivity to others’ avoidance. The Measures section includes self-estrangement as an item on the self-stigma scale. But the paper does not establish direct rejection or systemic discrimination as causes of societal self-isolation; its findings concern self-stigma and quality of life in Chinese American breast cancer survivors. Page numbers were not supplied. (LLM, conf=0.86)
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- Authors
- Chu, Q., Wong, C. C. Y., Chen, L., Shin, L. J., Chen, L., & Lu, Q.
- Affiliations
- Shanghai Jiao Tong University (CN)
- The College at Brockport, State University of New York Brockport New York USA
- The University of Texas MD Anderson Cancer Center (US)
- Department of Health Disparities Research The University of Texas MD Anderson Cancer Center Houston Texas USA
- Corresponding author
- Chu, Qiao
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2020-11-27
- Volume
- 30
- Issue
- 3
- Pages
- 392-399
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC10044476
- OpenAlex
- W3100028465
- Cited by
- 33
- References
- 41
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 2
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (K99CA267678, CA180896, R01CA180896, P30CA016672)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- self-stigma, breast cancer survivors, quality of life, Chinese Americans, self-efficacy, depressive symptoms, serial mediation
- MeSH terms
- Cancer Survivors, Adaptation, Psychological, Adult, Asian, Breast Neoplasms, Depression, Female, Humans, Middle Aged, Quality of Life, Surveys and Questionnaires, Self Efficacy, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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