Quality of Life, Social Support, and Uncertainty Among Latina and Caucasian Breast Cancer Survivors: A Comparative Study

Angela Sammarco

Lynda M. Konecny

breast cancer, breast neoplasms, uncertainty, Latina, social support, breast cancer survivors
ONF 2009, 37(1), 93-99. DOI: 10.1188/10.ONF.93-99

Purpose/Objectives: To examine the differences between Latina and Caucasian breast cancer survivors in perceived social support, uncertainty, and quality of life (QOL), and the differences between the cohorts in selected demographic variables.

Design: Descriptive, comparative study.

Setting: Selected private hospitals and American Cancer Society units in a metropolitan area of the northeastern United States.

Sample: 182 Caucasian and 98 Latina breast cancer survivors.

Methods: Participants completed a personal data sheet, the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale-Community Form, and the Ferrans and Powers QOL Index-Cancer Version III at home and returned the questionnaires to the investigators via postage-paid envelope.

Main Research Variables: Perceived social support, uncertainty, and QOL.

Findings: Caucasians reported significantly higher levels of total perceived social support and QOL than Latinas.

Conclusions: Psychiatric illness comorbidity and lower level of education in Latinas were factors in the disparity of QOL.

Implications for Nursing: Nurses should be mindful of the essential association of perceived social support, uncertainty, and QOL in Latina breast cancer survivors and how Latinas differ from Caucasian breast cancer survivors. Factors such as cultural values, comorbidities, and education level likely influence perceived social support, uncertainty, and QOL.

Jump to a section


    Alferi, S., Carver, C., Antoni, M., Weiss, S., & Durán, R. (2001). An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer. Health Psychology, 20, 41-46. doi: 10.1037/0278-6133.20.1.41
    American Cancer Society. (2009). Cancer facts and figures for Hispanics/Latinos 2009-2011. Retrieved from
    Arora, N., Finney Rutten, L., Gustafson, D., Moser, R., & Hawkins, R. (2007). Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer. Psycho-Oncology, 16, 474-486. doi: 10.1002/pon.1084
    Ashing-Giwa, K., Padilla, G., Tejero, J., Kraemer, J., Wright, K., Coscarelli, A., … Hills, D. (2004). Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina, and Caucasian cancer survivors. Psycho-Oncology, 13, 408-428. doi: 10.1002/pon.750
    Aziz, N., & Rowland, J. (2002). Cancer survivorship research among ethnic minority and medically underserved groups. Oncology Nursing Forum, 29, 789-801. doi: 10.1188/02.ONF.789-801
    Budin, W. (1998). Psychosocial adjustment to breast cancer in unmarried women. Research in Nursing and Health, 21, 155-166. doi: 10.1002/(SICI)1098-240X(199804)21:2<155::AID-NUR6>3.0.CO;2-I
    Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300-314.
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY: Lawrence Erlbaum Associates.
    Culver, J., Arena, P., Antoni, M., & Carver, C. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, Hispanics, and non-Hispanic whites. Psycho-Oncology, 11, 495-504. doi: 10.1002/pon.615
    Diaz, V. (2002). Cultural factors in preventative care: Latinos. Primary Care, 29, 503-517. doi: 10.1016/S0095-4543(02)00010-6
    Dirksen, S., & Erickson, J. (2002). Well-being in Hispanic and non-Hispanic Caucasian survivors of breast cancer. Oncology Nursing Forum, 29, 820-826. doi: 10.1188/02.ONF.820-826
    Ferrans, C. (1990a). Development of a quality of life index for patients with cancer. Oncology Nursing Forum, 17(3, Suppl.), 15-19.
    Ferrans, C. (1990b). Quality of life: Conceptual issues. Seminars in Oncology Nursing, 6, 248-254. doi: 10.1016/0749-2081(90)90026-2
    Ferrans, C. (1994). Quality of life through the eyes of survivors of breast cancer. Oncology Nursing Forum, 21, 1645-1651.
    Ferrans, C. (1996). Development of a conceptual model of quality of life. Scholarly Inquiry for Nursing Practice, 10, 293-304.
    Gil, K., Mishel, M., Belyea, M., Germino, B., Porter, L., & Clayton, M. (2006). Benefits of the uncertainty management intervention for African American and Caucasian older breast cancer survivors: 20-month outcomes. International Journal of Behavioral Medicine, 13, 286-294. doi: 10.1207/s15327558ijbm1304_3
    Gil, K., Mishel, M., Belyea, M., Germino, B., Porter, L., LaNey, I., & Stewart, J. (2004). Triggers of uncertainty about recurrence and long-term treatment side-effects in older African American and Caucasian breast cancer survivors. Oncology Nursing Forum, 31, 633-639. doi: 10.1188/04.ONF.633-639
    Hoskins, C., Baker, S., Sherman, D., Bohlander, J., Bookbinder, M., Budin, W., … Maislin, G. (1996). Social support and patterns of adjustment to breast cancer. Scholarly Inquiry for Nursing Practice, 10, 99-103.
    Huerta, E. (2003). Cancer statistics for Hispanics: Good news, bad news, and the need for a health system paradigm change. CA: A Cancer Journal for Clinicians, 53, 205-207. doi: 10.3322/canjclin.53.4.205
    Hulme, P., Walker, S., Effle, K., Jorgensen, L., McGorwan, M., Nelson, J., & Pratt, E.N. (2003). Health-promoting lifestyle behaviors of Spanish-speaking Hispanic adults. Journal of Transcultural Nursing, 14, 244-254. doi: 10.1177/1043659603014003011
    Hunter, C. (2000). Epidemiology, stage at diagnosis, and tumor biology of breast carcinoma in multiracial and multiethnic populations. Cancer, 88(5, Suppl.), 1193-1202. doi: 10.1002/(SICI)1097-0142(20000301)88:5+<1193::AID-CNCR3>3.0.CO;2-D
    Knobf, M. (2007). Psychosocial responses in breast cancer survivors. Seminars in Oncology Nursing, 23, 71-83. doi: 10.1016/j.soncn.2006.11.009
    Lee, C. (1997). Quality of life and breast cancer survivors. Cancer Practice, 5, 309-316.
    Leedham, B., & Ganz, P. (1999). Psychosocial concerns and quality of life in breast cancer survivors. Cancer Investigation, 17, 342-348. doi: 10.3109/07357909909032876
    Mast, M. (1995). Adult uncertainty in illness: A critical review of research. Scholarly Inquiry for Nursing Practice, 9, 3-24.
    Mast, M. (1998). Survivors of breast cancer: Illness, uncertainty, positive appraisal, and emotional distress. Oncology Nursing Forum, 25, 555-562.
    Mishel, M. (1988). Uncertainty in illness. Image: The Journal of Nursing Scholarship, 20, 225-232. doi:10.1111/j.1547-5069.1988.tb00082.x
    Mishel, M. (1990). Reconceptualization of the uncertainty in illness theory. Image: The Journal of Nursing Scholarship, 22, 256-262. doi: 10.1111/j.1547-5069.1990.tb00225.x
    Mishel, M. (1997). Uncertainty in Illness Scales manual. Chapel Hill, NC: University of North Carolina at Chapel Hill.
    Naranjo, L., & Dirksen, S. (1998). The recruitment and participation of Hispanic women in nursing research: A learning process. Public Health Nursing, 15, 25-29. doi: 10.1111/j.1525-1446.1998.tb00317.x
    Neuling, S., & Winefield, H. (1988). Social support and recovery after surgery for breast cancer: Frequency and correlates of supportive behaviors by family, friends and surgeon. Social Science and Medicine, 27, 385-392. doi: 10.1016/0277-9536(88)90273-0
    Northouse, L. (1988). Social support in patients' and husbands' adjustment to breast cancer. Nursing Research, 37, 91-95. doi: 10.1097/00006199-198803000-00008
    Northouse, L., Laten, D., & Reddy, P. (1995). Adjustment of women and their husbands to recurrent breast cancer. Research in Nursing and Health, 18, 515-524. doi: 10.1002/nur.4770180607
    Pistrang, N., & Barker, C. (1995). The partner relationship in psychological response to breast cancer. Social Science and Medicine, 40, 789-797. doi: 10.1016/0277-9536(94)00136-H
    Sammarco, A. (2001). Perceived social support, uncertainty, and quality of life among younger women with breast cancer. Cancer Nursing, 24, 212-219. doi: 10.1097/00002820-200106000-00010
    Sammarco, A. (2003). Quality of life among older survivors of breast cancer. Cancer Nursing, 26, 431-438. doi: 10.1097/00002820-200312000-00002
    Sammarco, A., & Konecny, L. (2008). Quality of life, social support and uncertainty among Latina breast cancer survivors. Oncology Nursing Forum, 35, 844-849. doi: 10.1188/08.ONF.844-849