Examining emotional outcomes among a multiethnic cohort of breast cancer survivors.

PURPOSE/OBJECTIVES To describe emotional concerns among a multiethnic sample of breast cancer survivors from a clinically sensitive approach and to examine differences in emotional items according to demographic characteristics. DESIGN Cross-sectional design. SETTING California Cancer Surveillance Program, Los Angeles-area hospitals, and community agencies in southern California. SAMPLE 703 multiethnic, population-based breast cancer survivors, including European, African, Latina, and Asian Americans. METHODS Two emotional outcome subscales were assessed, one each from the Functional Assessment of Cancer Therapy-General (FACT-G) and the SF-36®. MAIN RESEARCH VARIABLES Emotional outcomes and health-related quality of life (HRQOL), as measured by FACT-G, SF-36, and demographic characteristics. FINDINGS Emotional item responses measured by the FACT-G and SF-36 varied by ethnicity, income, education, employment status, language, and age. Overall, worry about the cancer getting worse or recurrence (FACT-G), as well as negative feelings about sadness or uncertainty (SF-36), were reported as the most bothersome concerns across all breast cancer survivors regardless of ethnic group. CONCLUSIONS Findings reveal unique patterns relevant to emotional outcomes on overall HRQOL scores. Clinically, this study suggests the need for greater attention and appreciation of the influence of demographic contexts on emotional well-being. IMPLICATIONS FOR NURSING The findings provide a unique observation of the use of individual item response to inform and enhance the assessment of emotional outcomes for clinical and scientific purposes.