Do coping strategies mediate the effects of emotional support on emotional well-being among Spanish-speaking Latina breast cancer survivors?

ObjectiveThis study aimed to assess the relationship between emotional social support and emotional well-being among Latina immigrants with breast cancer and test whether two culturally relevant coping strategies, fatalism and acceptance, mediate this relationship. MethodsOne hundred fifty Spanish-speaking Latinas within 1year of breast cancer diagnosis participating in a randomized trial of a stress management intervention were assessed in person at baseline and via telephone 6months later. Survey measures included baseline emotional support, fatalism, and acceptance and emotional well-being 6months later. Generalized linear models estimated direct effects of emotional support on emotional well-being and indirect effects through fatalism and acceptance. ResultsMean age was 50.1 (SD=10.9) years; most women had low education and acculturation levels. Emotional support was negatively associated with fatalism (r=-0.24, p<0.01) and positively associated with acceptance (r=0.30, p<0.001). Emotional support (r=0.23, p=0.005) and acceptance (r=0.28, p=0.001) were positively associated with emotional well-being, whereas fatalism (r=-0.36, p<0.0001) was negatively associated with emotional well-being. In multivariable models, emotional support was associated with emotional well-being (b=0.88, 95% CI: 0.24, 1.52). This direct effect remained significant when additionally controlling for fatalism (b=0.66, 95% CI: 0.03, 1.30) and acceptance (b=0.73, 95% CI: 0.09, 1.37) in separate models. There was a significant indirect effect of emotional support on emotional well-being through fatalism (b=0.21, 95% CI: 0.04, 0.51) as well as a marginally significant effect through acceptance (b=0.15, 95% CI: 0.001, 0.43). ConclusionsEmotional support may increase well-being among Spanish-speaking Latina cancer survivors by reducing cancer fatalism.Copyright (c) 2015 John Wiley & Sons, Ltd.