| The purpose of this study was twofold: (i) to compare the differences in QOL outcomes for Korean American and Korean breast and gynecologic cancer survivors living in the United States and Korea, respectively, and (ii) to examine the associations among social support and QOL across the two groups. To identify multiple dimensions of health status and psychosocial outcomes, three standardized English-language QOL measures were translated and then administered to 51 Korean Americans and 110 Koreans. Social support components were measured by items assessing multiple aspects, including perceived social support, use of services, network size, diversity, embedded networks, and barriers to follow-up care. A modified structural model tested for the two groups demonstrated that the relation of social support to QOL outcomes differs between Korean Americans and Koreans. As a result, a unique structural model was created for each. The findings show that for Korean Americans, financial impact, current medical situation, health insurance, language barriers, and network diversity directly influenced QOL, but embedded network indirectly influenced QOL through perceived social support. For Korean participants, not only financial impact but side effects, type of cancer, and embedded network directly affected QOL, while network diversity also did so indirectly through perceived social support and need for services. Thus, perceived social support directly influenced QOL for both groups. Evidence that social support elements influence QOL for both Korean American and Korean survivors serves as a rationale for developing psychosocial interventions that (a) enhance cancer survivors' social participation and (b) diminish barriers to follow-up care. These goals suggest the need for a unique intervention model that addresses the different cultural background, thereby ultimately improving QOL. |
