Psychosocial profiles and pain management patterns among Asian American breast cancer survivors: A cluster analysis

Background: Asian American breast cancer survivors represent a diverse population with unique psychosocial needs, yet limited research has identified subgroups based on psychological well-being, pain management beliefs, and social support. Understanding heterogeneity in psychosocial profiles may inform culturally tailored survivorship care. This study aimed to identify distinct psychosocial subgroups among Asian American breast cancer survivors and examine differences in depressive symptoms, pain management attitudes and barriers, social influence, quality of life, coping self-efficacy, loneliness, and perceived social support among the subgroups. Methods: This is part of an ongoing clinical trial among Asian American breast cancer survivors. Only the baseline data were used for this analysis. A total of 106 women were included in the analysis. K-means cluster analysis was conducted on psychosocial variables, including depressive symptoms, attitudes, and perceived barriers to cancer pain management, social influence, self-efficacy, loneliness, and social support. The optimal number of clusters (k = 3) was determined by silhouette analysis. One-way ANOVA with Tukey post-hoc tests compared psychosocial outcomes across clusters. Results: Three meaningful clusters emerged. Cluster 1 (resilient and supported survivors, N = 30) displayed the lowest depressive symptoms, strongest social support, positive pain attitudes, and highest quality of life and coping self-efficacy. Cluster 2 (psychologically vulnerable and socially isolated survivors, N = 30) demonstrated the highest depressive symptoms, greatest pain management barriers, and lowest levels of coping self-efficacy, quality of life, and perceived social support, along with the highest loneliness scores. Cluster 3 (moderately coping survivors, N = 46) showed intermediate levels across all psychosocial indicators and perceived attitudes towards pain and pain management barriers. All psychosocial and quality-of-life outcomes significantly differed across subgroups (p < .001). Conclusion: Asian American breast cancer survivors demonstrate significant psychosocial heterogeneity. Future culturally responsive, tailored interventions need to target the psychologically vulnerable, socially isolated subgroup, and address emotional distress, social connection, and pain-related attitudes in survivorship care. Findings support cluster-informed personalization strategies in technology-based survivorship programs.