Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy

Yeong Kyong Oh; Seon Young Hwang

doi:10.4040/jkan.2018.48.1.50

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Oh and Hwang: Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy

Original Article

J Korean Acad Nurs 2018;48(1):50-58.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.1.50

Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy

Yeong Kyong Oh¹, Seon Young Hwang^2,

¹Graduate School, Hanyang University, Seoul

²School of Nursing · The Research Institute of Nursing Science, Hanyang University, Seoul, Korea

Address reprint requests to : Hwang, Seon Young School of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea Tel: +82-2-2220-0702 Fax: +82-2-2220-1163 E-mail: seon9772@hanyang.ac.kr

Received 28 June 2017 Revised 29 January 2018 Accepted 30 January 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.

Methods

This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.

Results

Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (b=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (b=.17, p=.026), social well-being (SWB) (b=.49, p=.010), and functional well-being (FWB) (b=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (b=-.07, p=.024), SWB (b=-.19, p=.008), and FWB (b=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB.

Conclusion

Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

Keywords: Breast neoplasms, Quality of Life, Uncertainty, Spouses, Marriage

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Figure 1.

Conceptual framework of this study.

Figure 2.

Pathway model of uncertainty, marital intimacy and quality of life in this study.

Table 1.

Subject Characteristics and Analysis of Differences in Uncertainty, Marital Intimacy and Quality of Life (N=154)

Variables	Categories	n (%)	t/F (p)
			Uncertainty	Marital intimacy	Quality of life
					PWB	SWB	EWB	FWB
Age (yr)	<40	35 (22.7)	1.94 (.058)	−1.81 (.077)	1.77 (.082)	−1.32 (.192)	0.99 (.325)	−1.85 (.068)
	40~50	119 (77.3)
Religion	Yes	91 (59.1)	−0.86 (.393)	0.44 (.661)	−0.69 (.491)	0.17 (.868)	0.05 (.962)	1.03 (.305)
	No	63 (40.9)
Education	≤High school	37 (24.0)	6.60 (.002)	3.81 (.024)	0.61 (.545)	2.04 (.133)	0.40 (.671)	0.14 (.866)
	College	104 (67.5)
	≥Graduate school	13 (8.4)
Monthly income	<300	26 (16.9)	2.45 (.066)	2.23 (.087)	0.86 (.463)	4.23 (.007)	2.90 (.037)	2.42 (.068)
(10,000 KRW)	300~500	57 (37.0)
	501~700	35 (22.7)
	>700	36 (23.4)
Occupation	Employed	80 (51.9)	−0.53 (.598)	1.14 (.258)	0.40 (.693)	0.87 (.385)	−0.00 (.998)	2.01 (.047)
	Unemployed	74 (48.1)
Period after	<3	100 (64.9)	−1.07 (.286)	−1.05 (.297)	−2.17 (.032)	−1.24 (.218)	−0.22 (.827)	−1.48 (.141)
diagnosis	≥3	54 (35.1)
(month)
Method of	Breast conserving	112 (72.7)	1.66 (.101)	−1.13 (.264)	−2.49 (.014)	−2.23 (.029)	−3.34 (.001)	−2.63 (.010)
surgery	Operation
	Total mastectomy	42 (27.3)
Cancer stage	0, I	76 (49.4)	0.63 (.595)	0.02 (.997)	4.02 (.009)	0.76 (.519)	0.98 (.403)	0.39 (.761)
	II	52 (33.8)
	III	21 (13.6)
	IV	5 (3.2)

EWB=Emotional well-being; FWB=Functional well-being; PWB=Physical well-being; SWB=Social well-being; KRW=Korean won.

Table 2.

Correlation among Variables in Breast Cancer Patients (N=154)

Variables	Uncertainty r (p)	Marital intimacy r (p)
Uncertainty	1
Marital intimacy	−.39 (<.001)	1
Quality of life
PWB	−.25 (.002)	.25 (.002)
SWB	−.47 (<.001)	.59 (<.001)
EWB	−.50 (<.001)	.22 (.006)
FWB	−.51 (<.001)	.52 (<.001)

EWB=Emotional well-being; FWB=Functional well-being; PWB=Physical well-being; SWB=Social well-being.

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