Seulgi Ryu

Breast cancer is the most diagnosed cancer among women in the United States, with a greater increase in incidence among Asian American women than among others. Despite having resided in the United States for decades, Asian American breast cancer survivors face unique cultural challenges, including stigma and reluctance to disclose their illness. We present a Viewpoint to discuss practical issues encountered in implementing a culturally tailored, technology-based program aimed at reducing pain and depressive symptoms in Asian American breast cancer survivors. This Viewpoint is a simple ancillary content analysis of meeting minutes and research diaries from a parent study of cancer pain management; here, we identify themes related to practical issues in conducting a culturally tailored, technology-based intervention among Asian American breast cancer survivors with pain and depressive symptoms. Key issues identified include (1) reluctance to disclose, (2) variability in engagement based on disease status, (3) the need for personalized support, and (4) intraethnic differences related to various factors. Suggestions for future research include (1) tailoring communication to participants’ preferences while building trust over time, (2) applying flexible care strategies, (3) assessing individual needs early and adapting materials based on feedback, (4) matching participants with interventionists according to language and level of acculturation, and (5) respecting differences in cultural identities between ethnic subgroups. Addressing these challenges can improve the effectiveness of technology-based interventions for racial or ethnic minority groups.

Purpose: This study aimed to examine the relationship between stigma and self-management among patients undergoing hemodialysis and to identify the key factors influencing their self-management practices. Methods: A convenience sample of 139 hemodialysis patients, aged 18 years or older with an arteriovenous fistula, was recruited from online websites designed for patients undergoing hemodialysis in South Korea. Data were collected using a self-reported questionnaire that assessed demographic and clinical characteristics, self-management behavior, and stigma. Data analysis included descriptive statistics, the independent t-test, one-way analysis of variance, Pearson r correlations, and hierarchical regression analysis to evaluate the influence of stigma on self-management. Results: Hierarchical regression analysis showed that demographic and clinical characteristics accounted for 25.1% of the variance in self-management, and the inclusion of stigma increased the explained variance to 31.4%. Significant predictors included the number of hemodialysis sessions per week (≥3) (β=–.38, p<.001), stigma (β=–.27, p<.001), monthly household income (≥4 million won) (β=.24, p=.014), and marital status (single) (β=–.18, p=.028). Conclusion: The findings highlight the substantial impact of stigma and treatment burden on self-management, while socioeconomic status and marital support serve as protective factors. Targeted interventions that reduce stigma and strengthen support systems are warranted.

BACKGROUND Breast cancer is the most diagnosed cancer among women in the U.S., with a greater increase in incidence among Asian American women than among others. Despite having resided in the U.S. for decades, Asian American breast cancer survivors face unique cultural challenges, including stigma and reluctance to disclose their illness. OBJECTIVE This study aimed to discuss practical issues encountered in implementing a culturally tailored, technology-based program aimed at reducing pain and depressive symptoms in Asian American breast cancer survivors. METHODS This study was analyzed using simple content analysis based on meeting minutes and research diaries from the parent study to identify themes related to practical issues in conducting a culturally tailored, technology-based intervention among Asian American breast cancer survivors with pain and depressive symptoms. RESULTS Key issues identified include (a) reluctance to disclose; (b) variability in engagement, based on disease status; (c) need for personalized support; and (d) intra-ethnic differences related to various factors. CONCLUSIONS Suggestions for future research include (a) tailoring communication to participants’ preferences while building trust over time, (b) applying flexible care strategies, (c) assessing individual needs early and adapting materials based on feedback, (d) matching participants with interventionists according to language and level of acculturation, and (e) respecting differences in cultural identities between ethnic subgroups. Addressing these challenges can improve the effectiveness of technology-based interventions for racial/ethnic minority groups CLINICALTRIAL ClinicalTrials.gov NCT06085313; https://clinicaltrials.gov/study/NCT06085313