Identifying adaptive versus maladaptive coping strategies in Latina patients with early-stage breast cancer.

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413 Background: Latina breast cancer survivors (BCS) report increased symptom burden and worse health-related quality of life (HRQoL) compared to non-Latina BCS. However, the association between symptom burden and HRQoL in this population and how specific coping strategies influence HRQoL remains understudied. This study aims to assess the impact of symptom burden on HRQoL and identify adaptive versus maladaptive coping strategies among Latina BCS. Methods: Forty-eight Latina stage I-III BCS at Memorial Sloan Kettering Cancer Center completed surveys assessing HRQoL (Functional Assessment of Cancer Therapy-General), symptom severity and interference (MD Anderson Symptom Inventory), and coping (Brief COPE). Pearson correlation test, age-adjusted regression models, and mediation analyses were used to examine the associations between coping, symptom burden, and HRQoL (p < 0.05). Results: Of 48 Latina BCS (mean age 58.7 ± 9.2), most were in active treatment (54%). Fatigue (89.6%), problems with memory (87.5%), and disturbed sleep (83.3%) were the most reported symptoms, while nausea (33.3%) and vomiting (14.6%) were the least common. Greater symptom severity (p = 0.001) and interference (p < 0.001) were both associated with lower HRQoL. Latina BCS commonly coped through acceptance, planning, and self-distraction (100%), emotional support and active coping (97.9%), positive reframing (93.8%), denial (83.3%), venting (64.6%), and humor (50%). Behavioral disengagement (20.8%) and substance use (4.2%) were less used coping strategies. Emotional support (β, 8.78; SE, 2.58; p = 0.001), active coping (β, 7.23; SE, 2.28; p = 0.003), self-distraction (β, 7.93; SE, 2.56; p = 0.003), and planning (β, 9.11; SE, 2.83; p = 0.002) were associated with higher HRQoL. Conversely, behavioral disengagement (β, -9.91; SE, 3.85; p = 0.014), venting (β, -5.48; SE, 2.41; p = 0.028), and substance use (β, -11.8; SE, 5.48; p = 0.037) were associated with worse HRQoL. Mediation analyses showed that greater substance use and venting predicted increased symptom interference (p = 0.009, p = 0.023, respectively), which led to lower HRQoL (p = 0.009, p = 0.016, respectively). Conclusions: Latina BCS experiencing lower symptom burden reported significantly better HRQoL. Adaptive coping strategies (emotional support, active coping, self-distraction, and planning) correlated with higher HRQoL, whereas maladaptive strategies (behavioral disengagement, venting, and substance use) were linked to lower HRQoL. While adaptive coping strategies were frequently used by Latina BCS, maladaptive approaches, like venting, were also common. Future interventions should focus on promoting adaptive coping while simultaneously discouraging maladaptive coping in Latina BCS to improve their HRQoL.

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