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01-03-2024

Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors

Auteurs: Patricia B. Pedreira, Sara E. Fleszar-Pavlović, Emily A. Walsh, Blanca Noriega Esquives, Patricia I. Moreno, Dolores Perdomo, Aaron S. Heller, Michael H. Antoni, Frank J. Penedo

Gepubliceerd in: Journal of Behavioral Medicine

Abstract

Background

Familism, the cultural value that emphasizes feelings of loyalty and dedication to one’s family, has been related to both positive and negative outcomes in Hispanic cancer survivors. One potential source of observed inconsistencies may be limited attention to the family environment, as familism may be protective in a cohesive family whereas it can exacerbate distress in a conflictive family.

Purpose

The current study explored the associations of familism with general and disease-specific health-related quality of life (HRQoL) in Hispanic men who completed prostate cancer (PC) treatment, and whether family cohesion may help explain these relationships.

Methods

Hispanic men treated for localized PC (e.g., radiation, surgery) were enrolled in a randomized controlled stress management trial and assessed prior to randomization. Familism (familial obligation) was assessed using Sabogal’s Familism Scale and family cohesion was measured using the Family Environment Scale (ranging from high to low). The sexual, urinary incontinence, and urinary obstructive/irritative domains of the Expanded Prostate Cancer Index Composite – Short Form measured disease-specific HRQoL. The physical, emotional, and functional well-being subscales of the Functional Assessment of Cancer Therapy – General captured general HRQoL. Hierarchical linear regression and the SPSS PROCESS macro were used to conduct moderation analyses, while controlling for relevant covariates.

Results

Participants were 202 older men on average 65.7 years of age (SD = 8.0) who had been diagnosed with PC an average of 22 months prior to enrollment. Familism was not directly associated with general and disease-specific HRQoL. Moderation analyses revealed that greater familism was related to poorer urinary functioning in the incontinence (p = .03) and irritative/obstructive domains (p = .01), and lower emotional well-being (p = .02), particularly when family cohesion was low.

Conclusions

These findings underscore the importance of considering contextual factors, such as family cohesion, in understanding the influence of familism on general and disease-specific HRQoL among Hispanic PC patients. The combined influence of familism and family cohesion predicts clinically meaningful differences in urinary functioning and emotional well-being during the posttreatment phase. Culturally sensitive psychosocial interventions to boost family cohesion and leverage the positive impact of familistic attitudes are needed to enhance HRQoL outcomes in this population.

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Titel: Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors
Auteurs: Patricia B. Pedreira
Sara E. Fleszar-Pavlović
Emily A. Walsh
Blanca Noriega Esquives
Patricia I. Moreno
Dolores Perdomo
Aaron S. Heller
Michael H. Antoni
Frank J. Penedo
Publicatiedatum: 01-03-2024
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-024-00479-1