Health-related quality of life outcomes among cervical cancer survivors: Examining ethnic and linguistic differences

Background: This study aims to investigate the utility of an explanatory health-related quality of life (HRQOL) model for cervical cancer survivors. Specifically, this study focuses on the different patterns in the structural model of HRQOL by ethnic and language groups. Methods: Secondary data derived from 560 European- and Latina-American cervical cancer survivors was used. The study methodology was guided by the Contextual Model of health-related quality of life. Results: Structural equation modeling demonstrated significant differences in the overall structural models for HRQOL by ethnicity. For example, European-Americans showed significant association between radiation therapy and HRQOL, while life burden was related to sexual impact for Latina-Americans only. The results showed the significant mediating effects of general health status and psychological well-being between patient–doctor relationship and HRQOL, and between life burden and HRQOL, respectively, for all ethnic and language groups. While language group differences (limited English vs. English proficient) among Latina-Americans emerged in bivariate analyses; these distinctions were not upheld in the overall structural models. Conclusion: The unique contribution of the individual- and systemic-level components in predicting overall HRQOL outcome seems to vary by ethnic group membership. Our findings advance our understanding of the predictors and the association among the predictors of HRQOL. This study may contribute to the evolution of culturally and linguistically responsive HRQOL conceptual frameworks and instrumentation for vulnerable populations.