Supportive Care in Cancer

, Volume 26, Issue 6, pp 1755–1761 | Cite as

Associations among physical symptoms, fear of cancer recurrence, and emotional well-being among Chinese American breast cancer survivors: a path model

  • Dalnim ChoEmail author
  • Qiao Chu
  • Qian LuEmail author
Original Article



Most existing studies on fear of cancer recurrence (FCR) are exploratory without theoretical underpinnings and have been conducted among non-Hispanic Whites. Based on theoretical models, we hypothesized that more physical symptoms (pain and fatigue) would be associated with higher FCR, which, in turn would be related to lower emotional well-being among Chinese American breast cancer survivors.


Participants were 77 Chinese American women who were diagnosed with breast cancer of stages 0–III. A cross-sectional path analysis was conducted with a bootstrapping method.


The final model showed that indirect paths from pain interference to emotional well-being and from fatigue to emotional well-being via FCR were significant. That is, higher levels of pain interference and fatigue were associated with higher FCR, which was further related to lower emotional well-being.


To our best knowledge, this is the first theory-driven study that investigates FCR experiences among Chinese American breast cancer survivors. Our study might provide a more comprehensive understanding of FCR as it simultaneously shows predictors and a psychological consequence of FCR. Results need to be replicated in large, racially/ethnically diverse samples and longitudinal studies.


Fear of cancer recurrence Pain Fatigue Quality of life Asian American 



This research was funded by the American Cancer Society (MRSGT-10-011-01-CPPB: PI Qian Lu). We thank to Toyin Ayilara for her proofreading.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Psychological SciencesUniversity of ConnecticutStorrsUSA
  2. 2.Health Disparities ResearchThe University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.Department of PsychologyUniversity of HoustonHoustonUSA

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