Through the lens of culture: quality of life among Latina breast cancer survivors.

Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. Latina survivors were 1-5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M = 105; SD = 19.4 on the FACT-B). Culturally based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62 % of the explained model variance of overall quality of life (Adjusted R (2) = 0.53, P < 0.001). Similar relationships were seen for quality of life subdomains in which cultural, social, and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R (2) = 0.23, P < .001), social well-being (Adjusted R (2) = 0.51, P < 0.001), emotional well-being (Adjusted R (2) = 0.28, P < 0.001), functional well-being (Adjusted R (2) = 0.41, P < 0.001), and additional breast concerns (Adjusted R (2) = 0.40, P < 0.001). Efforts to improve Latinas' survivorship experiences should consider cultural, social, and medical contextual factors to close existing quality of life gaps between Latinas and other survivors.