Hye Young Kim; Hyang Sook So

doi:10.4040/jkan.2012.42.1.105

Articles

Page Path: HOME > J Korean Acad Nurs > Volume 42(1); 2012 > Article

Original Article
A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer: Hye Young Kim, Hyang Sook So; Journal of Korean Academy of Nursing 2012;42(1):105-115.
DOI: https://doi.org/10.4040/jkan.2012.42.1.105
Published online: February 29, 2012

¹Assistant Professor, Department of Nursing, Gwangju Women's University, Gwangju, Korea.

²Professor, College of Nursing, Chonnam National University, Gwangju, Korea.

Address reprint requests to: So, Hyang Sook. College of Nursing, Chonnam National University, 5, Hak-1dong, Dong-gu, Gwangju 501-746, Korea. Tel: +82-62-220-4361, +82-62-530-4930, FAX: +82-62-227-4009, hsso@chonnam.ac.kr

• Received: March 30, 2011 • Accepted: February 5, 2012

14 Views
0 Download

prev next

Full Article

Download PDF

Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984).
Methods
Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version.
Results
Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer.
Conclusion
The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.
Keywords: Breast cancer; Adjustment; Structural model; Social support; Uncertainty

This article is based on a part of the first author's doctoral thesis from Chonnam National University.

REFERENCES

1. Bae B.L. Structural equation modeling with AMOS 7. 2007;Seoul, Chung Ram Book Publisher.
2. Ben-Zur H., Gilbar O., Lev S. Coping with breast cancer: Patient, spouse, and dyad models. Psychosomatic Medicine. 2001;63:32–39.Article PubMed
3. Budin W.C. Psychosocial adjustment to breast cancer in unmarried women. Research in Nursing and Health. 1998;21:155–166.Article PubMed
4. Carver C.S., Pozo C., Harris S.D., Noriega V., Scheier M.F., Robinson D.S., et al. How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology. 1993;65:375–390.Article PubMed
5. Cho O.H. Uncertainty, anxiety and coping with mastectomy for breast cancer. Journal of Korean Academy of Nursing. 2000;30:1006–1017.Article PDF
6. Christman N.J., McConnell E.A., Pfeiffer C., Webster K.K., Schmitt M., Ries J. Uncertainty, coping, and distress following myocardial infarction: Transition from hospital to home. Research in Nursing and Health. 1988;11(2):71–82.Article PubMed
7. Cohen F., Lazarus R.S. Stone G.C., Cohen F., Adler N.E. Coping with the stress of illness. In: Health psychology: A handbook. 1979;San Francisco, Jossey-Bass. 217–254.
8. Davis L.A. Hardiness, social support, uncertainty, and adjustment in women clinically free of breast cancer. 1997;Brimingham, U.S.A, Alabama University. Unpublished doctoral dissertation.
9. Derogatis L.R., Lopez M. The psychosocial adjustment to illness scale: Administration, scoring, and procedures manual I. 1983;Baltimore, Clinical Psychometric Research.
10. Dukes H.K., Holahan C.K. The relation of social support and coping to positive adaptation to breast cancer. Psychology and Health. 2003;18:15–29.Article
11. Folkman S., Lazarus R.S. If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology. 1985;48:150–170.Article PubMed
12. Gotay C. The experience of cancer during early and advanced stages: The views of patients and their mates. Social Science and Medicine. 1984;18:605–613.Article PubMed
13. Hoskins C.N., Budin W.C. Measurement of psychosocial adjustment to breast cancer: A unidimensional or multidimensional construct. Psychological Reports. 2000;87:649–663.Article PubMed
14. Kim G.S. Analysis structural equation modeling. 2007;Seoul, SPSS Academy Series.
15. Kirsner R.S., Ma F., Fleming L.E., Federman D.D., Rapido E., Duncan R., et al. Earlier stage at diagnosis and improved survival among Medicare HMO patients with breast cancer. Journal of Women's Health. 2010;19:1619–1624.Article
16. Lazarus R.S., Folkman A. Monat A., Lazarus R. Stress and coping: Some current issues and controversies. In: Stress and coping: An anthology. 1984;New York, NY, Columbia university press. 1–11.
17. Lee Y.J., Ham E.M., Kim K.S. A correlational study on uncertainty, coping and depression of cancer patients. Journal of Korean Academy of Nursing. 2001;31:244–256.Article PDF
18. Mazanec S.R., Daly B.J., Douglas S., Musil C. Predictors of psychosocial adjustment during the postradiation treatment transition. Western Journal of Nursing Research. 2011;33:540–559. http://dx.doi.org/10.1177/0193945910382241.Article PubMed PDF
19. Mishel M.H. The measurement of uncertainty in illness. Nursing Research. 1981;30:258–263.PubMed
20. Mishel M.H. Uncertainty in illness. Journal of Nursing Scholarship. 1988;20:225–232.Article
21. Mishel M.H., Sorenson D. Revision of the ways of coping checklist for a clinical population. Western Journal of Nursing Research. 1993;15:59–76.Article PubMed PDF
22. National cancer statistics. National Cancer Information Center. 2008;Retrieved October 10, 2008. from http://www.cancer.go.kr.
23. Samarel N., Leddy S.K., Greco K., Cooley M.E., Torres S.C., Tulman L., et al. Development and testing of the symptom experience scale. Journal of Pain and Symptom Management. 1996;12:221–228.Article PubMed
24. Saneha C. Relationships among optimism, cognitive appraisal, coping strategies, and psychosocial adjustment in Thai women newly diagnosed with breast cancer. 2006;03;In: Poster session presented at the 9th East Asian Forum of Nursing Scholars; Bangkok.
25. Scheier M.F., Carver C.S., Bridges M.W. Distinguishing optimism from neuroticism and trait anxiety, self mastery, and self-esteem: A reevaluation of the life orientation test. Journal of Personality and Social Psychology. 1994;67:1063–1078.Article PubMed
26. So H.S. Changes on the uncertainly, ways of coping, and depression for patients with uterine cervical cancer during the early adaptation process: A longitudinal study. 1996;Seoul, Yonsei University. Unpublished doctoral dissertation.
27. Tae Y.S., Kang E.S., Lee M.H., Park G.J. The relationship among percieved social support, hope and quality of life of cancer patients. Korean Journal of Rehabilitation Nursing. 2001;4:219–231.
28. Thewes B., Butow P., Girgis A., Pendlebury S. The psychosocial needs of breast cancer survivors: A qualitative study of the shared and unique needs of younger versus older survivors. Psycho-oncology. 2004;13:177–189. http://dx.doi.org/10.1002/pon.710.Article PubMed
29. Vos P.J., Garssen B., Visser A.P., Duivenvoorden H.J., de Haes H.C. Early stage breast cancer: Explaining level of psychosocial adjustment using structural equation modeling. Journal of Behavioral Medicine. 2004;27:557–580.Article PubMed PDF
30. Westbrook J.M. Attachment, optimism, coping, and social support as predictors of psychosocial and psychological adjustment in women with breast cancer. 2005;Santa Barbara, U.S.A, Fielding Graduate University. Unpublished Doctoral dissertation.

Figure 1

Path diagram for hypothetical model.

x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability;

y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Figure 2

Path diagram for the final model.

x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability;

y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Table 1

Descriptive Statistics of Variables (N=198)

VIF=Variation inflation factor.

Table 2

Correlation among the Research Variables (N=198)

x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability;

y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer

J Korean Acad Nurs. 2012;42(1):105-115. Published online February 29, 2012

DOI: https://doi.org/10.4040/jkan.2012.42.1.105

XML Download

Figure

We recommend

Related articles

A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer

Figure 1 Path diagram for hypothetical model. x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability; y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Figure 2 Path diagram for the final model. x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability; y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Figure 1

Figure 2

A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer

Table 1

Descriptive Statistics of Variables (N=198)

VIF=Variation inflation factor.

Table 2

Correlation among the Research Variables (N=198)

x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability;

y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.

Table 1 Descriptive Statistics of Variables (N=198)

VIF=Variation inflation factor.

Table 2 Correlation among the Research Variables (N=198)

x1=Symptom experience; x2=Ambiguity; x3=Complexity; x4=Unpredictability;

y1=Family support; y2=Medical staff support; y3=Optimism; y4=Problem focused coping; y5=Emotional focused coping; y6=Psychosocial adjustment.