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Journal List > Korean J Adult Nurs > v.25(1) > 1076238

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Kwak and Byeon: Factors Influencing Resilience of Patients with Hematologic Malignancy
Original Research

Korean J Adult Nurs 2013;25(1):95-104.

Published online: 18 February 2013

DOI: https://doi.org/10.7475/KJAN.2013.25.1.95

Factors Influencing Resilience of Patients with Hematologic Malignancy

So Young Kwak1, Young Soon Byeon2,

1Division of Hematology, Yonsei University Health System, Severance Hospital, Seoul

2Division of Nursing Science, College of Health Science, Ewha Womans University, Seoul, Korea

Corresponding author: Byeon, Young Soon Division of Nursing Science, College of Health Science, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-2884, Fax: +82-2-3277-2850, E-mail: ysbyeon@ewha.ac.kr

Received 2 October 201217 February 2013       Accepted 21 February 2013

© 2013 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the level of resilience, family support, anxiety and depression in patients with hematologic malignancy, and to determine modifiable psychosocial factors that affect their resilience.

Methods

Data were collected from 104 patients undergoing curative therapy at 'S' hospital in Seoul. The data were collected from April to May, 2012. The questionnaires included Korean Version of Connor-Davidson Resilience Scale, Family Support Scale and Hospital Anxiety-Depression Scale. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression.

Results

Resilience had statistically significant correlation with family support (r=.43, p<.001), anxiety (r=-.49, p<.001) and depression (r=-.52, p<.001). Factors influencing resilience were depression, family support, anxiety and time since diagnosis with R-sq. value of 36%.

Conclusion

The results of the study show that family support, anxiety and depression have important influences on resilience of patients with hematologic malignancy. Thus, family support needs to be reinforced when developing and implementing nursing intervention, and nurses need to intervene to reduce anxiety and depression of patients with hematologic malignancy.

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Keywords: Hematologic neoplasms, Psychological resilience, Social support, Anxiety, Depression

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Table 1.
Resilience, Family Support, Anxiety, and Depression (N=104)
Variables Score n (%) or M±SD Min Max Possible score range
Resilience   71.07±13.25 28 97 0~100
Family support   47.43±7.51 24 55 11~55
Anxiety   6.04±3.33 0 18 0~21
0~7 (Normal) 81 (77.9)
8~10 (Mild) 16 (15.4)
11~21 (Moderate~severe) 7 (6.7)
Depression   7.10±3.68 0 20 0~21
0~7 (Normal) 58 (55.8)
8~10 (Mild) 31 (29.8)
11~21 (Moderate~severe) 15 (14.4)
Table 2.
Differences of Resilience, Family Support, Anxiety, and Depression according to Demographic and Medical Characteristics (N=104)
Characteristic Categories n (%) Resilience Family support Anxiety Depression
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Gender Male 56 (53.8) 72.05±12.77 -0.82 47.34±7.56 0.14 5.25±2.98 2.69 7.38±3.55 -0.83
Female 48 (46.2) 69.92±13.83 (.415) 47.54±7.53 (.892) 6.96±3.50 (.008) 6.77±3.84 (.407)
Age (year) ≤29 10 (9.6) 70.90±9.40 1.00 49.10±5.45 0.68 5.70±2.21 1.01 6.60±3.06 1.58
30~39 16 (15.4) 74.38±12.13 (.411) 49.19±4.64 (.610) 4.81±1.94 (.408) 5.19±2.76 (.186)
40~49 21 (20.2) 74.38±12.47   45.95±9.51   6.95±4.17   8.00±3.83  
50~59 32 (30.8) 69.69±13.25   47.81±7.04   6.25±2.97   7.50±3.98  
≥60 25 (24.0) 68.00±15.58   46.40±8.46   5.92±3.95   7.24±3.69  
Education ≤High school 63 (60.6) 70.27±14.48 -0.76 46.59±8.49 -1.56 6.10±3.66 0.22 6.84±4.03 -0.88
≥College 41 (39.4) 72.29±11.16 (.449) 48.73±5.54 (.122) 5.95±2.78 (.830) 7.49±3.08 (.384)
Religion No 29 (27.9) 67.28±13.23 -1.84 4 4 47.38±7.56 -0.05 6.21±3.41 0.32 8.03±3.37 1.63
Yes 75 (72.1) 72.53±13.05 (.069) 47.45±7.54 (.964) 5.97±3.32 (.750) 6.73±3.75 (.106)
Marital status Married 78 (75.0) 71.81±13.48 -0.99 47.13±8.19 0.91 6.21±3.47 -0.88 7.38±3.76 -1.39
Single 26 (25.0) 68.86±12.52 (.326) 48.35±4.94 (.367) 5.54±2.87 (.379) 6.23±3.35 (.167)
Occupation† Employeda b 47 (45.2) 73.68±11.42 2.94 48.17±6.95 0.37 5.23±2.47 2.39 6.66±3.17 0.83
Noneb c 23 (22.1) 64.22±14.98 (.037) 46.52±8.03 (.775) 6.13±3.52 (.073) 8.13±3.33 (.481)
Housewifec 30 (28.8) 72.43±13.87 a＞b 46.80±8.46   7.27±4.11   7.00±4.62  
Studentd 4 (3.8) 71.07±13.25   48.75±2.87   5.75±2.63   7.00±3.46  
Average monthly household income† (10,000 won) ＜100a 14 (13.5) 64.43±15.29 2.36 50.43±6.69 1.82 6.57±4.35 1.10 9.07±4.94 1.36
100~200b 20 (19.2) 71.35±13.21 (.045) 43.45±9.55 (.115) 6.70±3.81 (.367) 7.35±3.51 (.245)
200~300c 21 (20.2) 66.90±9.80 a＜d, f 47.00±6.43   6.48±3.66   7.29±3.85  
300~400d 19 (18.3) 77.16±11.58   48.11±7.09   4.53±2.32   5.95±2.82  
400~500e 14 (13.5) 70.71±13.44   48.71±5.85   5.93±2.84   6.36±3.52  
≥500f 16 (15.4) 75.06±14.37   48.44±7.39   6.06±3.33   6.81±3.19  
Primary caregiver Yes 88 (84.6) 70.19±13.29 1.59 47.66±7.27 -0.72 6.06±3.47 -0.13 7.11±3.78 -0.11
None 16 (15.4) 75.88±12.34 (.115) 46.19±8.87 (.474) 5.94±2.46 (.896) 7.00±3.16 (.910)
Diagnosis ML 50 (48.1) 72.88±10.83 1.34 48.70±7.05 2.13 5.68±2.84 1.04 6.60±3.19 0.92
AML 20 (19.2) 67.20±14.98 (.265) 47.85±5.16 (.124) 6.95±3.52 (.356) 7.75±4.84 (.403)
MM, SAA, MDS 34 (32.7) 70.68±15.73   45.32±8.93   6.03±3.84   7.44±3.59  
Time since diagnosis ＜1 year 62 (59.6) 73.58±12.22 2.41 49.34±5.45 3.00 6.05±3.32 0.04 7.03±3.50 -0.21
≥1 year 42 (40.4) 67.36±13.96 (.018) 44.62±9.16 (.004) 6.02±3.38 (.971) 7.19±3.98 (.831)
Previous treatment Chemotherapy 75 (72.1) 72.09±13.17 1.27 48.59±6.30 2.18 5.91±3.35 -0.65 6.84±3.77 -1.14
CMT 29 (27.9) 68.41±13.30 (.206) 44.45±9.47 (.036) 6.38±3.30 (.518) 7.76±3.40 (.256)
Relapse Yes 24 (23.1) 71.38±13.68 0.13 45.79±9.03 -1.22 6.88±3.85 1.41 8.79±4.27 2.65
No 80 (76.9) 70.97±13.20 (.898) 47.93±6.98 (.224) 5.79±3.14 (.161) 6.59±3.35 (.009)

ML=malignant lymphoma; AML=acute myelogenous leukemia; MM=multiple myeloma; SAA=severe aplastic anaemia; MDS=myelodysplastic; CMT=combined modality treatment (Chemotherapy+radiotherapy, Chemotherapy+hematopoietic stem cell transplantation, Chemotherapy+radiotherapy+hematopoietic stem cell transplantation).

† Scheffé test.

Table 3.
Correlation between Resilience and Family Support, Anxiety and Depression (N=104)
Variables Resilience Family support Anxiety
r (p) r (p) r (p)
Family support .43 (＜.001)    
Anxiety -.49 (＜.001) -.34 (＜.001)  
Depression -.52 (＜.001) -.38 (＜.001) .68 (＜.001)
Table 4.
Stepwise Multiple Linear Regression of Resilience (N=104)
Variables Resilience
B SE β t p Tolerance VIF
(Constant) 69.75 9.24   7.55 ＜.001    
Depression -1.02 0.40 - -.28 -2.57 .012 .51 1.97
Family support 0.34 0.16 .19 2.11 .038 .75 1.34
Anxiety -0.94 043 - -.24 -2.16 .033 .52 1.91
Time since Diagnosis† -4.49 2.25 - -.17 -2.00 .048 .89 1.13
R2=.39, Adjusted R2=.36, F=15.53, p＜.001, Durbin-Watson=2.15

† Time since diagnosis (0=less than 1 year, 1=greater than or equal to 1 year).

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