TY - JOUR
T1 - The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors
AU - Wu, Ivan H.C.
AU - Tsai, William
AU - McNeill, Lorna H.
AU - Lu, Qian
N1 - Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - Ambivalence over emotional expression
KW - Breast cancer survivorship
KW - Oncology
KW - Self-stigma
KW - Sleep
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U2 - 10.1007/s00520-019-05233-x
DO - 10.1007/s00520-019-05233-x
M3 - Article
C2 - 31858250
AN - SCOPUS:85077064213
SN - 0941-4355
VL - 28
SP - 3935
EP - 3944
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 8
ER -