Resilience and Related Factors for Patients with Breast Cancer

Eunmi Kim; Sanghee Kim; Sue Kim; Yoonju Lee

doi:10.5388/aon.2015.15.4.193

Journal List > Asian Oncol Nurs > v.15(4) > 1081844

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Kim, Kim, and Lee: Resilience and Related Factors for Patients with Breast Cancer

Original Article

Asian Oncology Nursing 2015; 15(4): 193-202.

Published online: 31 December 2015

DOI: https://doi.org/10.5388/aon.2015.15.4.193

Resilience and Related Factors for Patients with Breast Cancer

Eunmi Kim¹, Sanghee Kim¹, Sue Kim¹, Yoonju Lee²

¹College of Nursing·Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.

²College of Nursing, Pusan National University, Busan, Korea.

Address reprint requests to: Kim, Sanghee. College of Nursing & Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel : +82-2-2228-3388, Fax: +82-2-392-5440, sangheekim@yuhs.ac

Received 8 September 2015 Revised 11 December 2015 Accepted 23 December 2015

(open-access):

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 examine factors influencing resilience in breast cancer patients.

Methods

The data were collected using structured questionnaires from 106 breast cancer patients who are members of a self-help group. The data were analyzed using descriptive statistics, a t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression in SPSS WIN version 21.0.

Results

Resilience was significantly negatively correlated to depression and positively correlated to hope and family support. However, resilience was not significantly correlated to anxiety. In the regression analysis, factors influencing resilience were reported as hope, religion, lymph node metastasis, surgery side, and time since surgery, which explained 34.1% of the variation.

Conclusion

The resilience scores of women with breast cancer were higher when depression was lower, hope was higher, and greater family support. This means that reducing depression and increasing hope and family support are necessary when developing and implementing nursing interventions. The results of this study also show the importance of hope in explaining resilience in patients with breast cancer. Therefore, nurses should focus on encouraging hope when they develop programs in order to implement more effective interventions to improve breast cancer patients' resilience.

Keywords: Resilience, Breast Neoplasms

Figures and Tables

Fig. 1

The conceptual framework.

Table 1

Differences in Resilience by Participant Characteristics (N =106)

Factors	Characteristics	Categories	M ± SD or n (%)	Resilience M ± SD	t or F (p)
Sociodemographic factors	Age (year)		54.1 ± 7.65		0.68 (.505)
		<50	23 (21.7)	70.13 ± 18.06
		50~59	57 (53.8)	71.37 ± 19.39
		≥ 60	26 (24.5)	65.96 ± 21.13
	Marital state	Married	92 (86.8)	69.21 ± 20.45	1.17 (.249)
	Marital state	Single, divorced, widowed	14 (13.2)	73.50 ± 11.07	1.17 (.249)
	Education level	≤ Middle school	26 (24.5)	61.73 ± 23.59	- 2.48 (.015)
	Education level	≥ High school	80 (75.5)	72.39 ± 17.35	- 2.48 (.015)
	Occupational status	Homemaker	81 (76.4)	68.57 ± 18.85	1.10 (.334)
		Full time	10 (9.4)	78.20 ± 13.18
		Part time	15 (14.2)	70.67 ± 25.41
	Religion	No	29 (27.4)	75.10 ± 15.80	3.01 (.085)
	Religion	Yes	77 (72.6)	67.77 ± 20.44	3.01 (.085)
	Family income per month (10,000 won)	< 200	30 (28.3)	67.03 ± 20.71	1.70 (.187)
		200~300	35 (33.0)	67.00 ± 19.54
		≥ 300	41 (38.7)	74.15 ± 18.16
Disease-related factors	Time since diagnosis (year)		4.57 ± 3.78		1.45 (.239)
		<2	28 (26.4)	65.21 ± 19.36
		2~5	39 (36.8)	69.44 ± 22.73
		≥ 5	39 (36.8)	73.38 ± 15.43
	Time since surgery (year)		4.52 ± 3.78		1.22 (.298)
		<2	31 (29.2)	65.61 ± 20.31
		2~5	37 (34.9)	69.97 ± 22.23
		≥ 5	38 (35.9)	72.97 ± 15.41
	Surgery side	Unilateral breast	100 (94.3)	70.85 ± 19.09	2.37 (.020)
	Surgery side	Bilateral breast	6 (5.7)	51.83 ± 18.68	2.37 (.020)
	Type of surgery	Breast conserving surgery	53 (50.0)	73.19 ± 19.21	1.82 (.071)
	Type of surgery	Modified radical mastectomy	53 (50.0)	66.36 ± 19.34	1.82 (.071)
	Reconstruction surgery	No	97 (91.5)	68.93 ± 20.04	- 2.94 (.008)
	Reconstruction surgery	Yes	9 (8.5)	78.89 ± 8.10	- 2.94 (.008)
	Lymph node metastasis	No	53 (50.0)	65.98 ± 21.88	- 2.03 (.045)
	Lymph node metastasis	Yes	53 (50.0)	73.57 ± 16.09	- 2.03 (.045)
	Self-identified TNM Stage	Stage 0	5 (4.7)	75.60 ± 17.45	1.23 (.299)
		Stage I	19 (17.9)	64.63 ± 23.06
		Stage II	56 (52.8)	73.05 ± 17.62
		Stage III	24 (22.7)	64.83 ± 20.63
		Stage IV	2 (1.9)	71.50 ± 19.09
	Chemotherapy	Never	13 (12.3)	61.38 ± 25.07	- 1.67 (.098)
	Chemotherapy	Experienced	93 (87.7)	70.94 ± 18.45	- 1.67 (.098)
	Radiation therapy	Never	36 (34.0)	68.53 ± 21.32	- 0.47 (.639)
	Radiation therapy	Experienced	70 (66.0)	70.41 ± 18.61	- 0.47 (.639)
	Hormone therapy	Never	19 (17.9)	80.68 ± 11.63	2.77 (.006)
	Hormone therapy	Experienced	87 (82.1)	67.39 ± 20.09	2.77 (.006)
	Targeted therapy	Never	90 (84.9)	70.94 ± 19.11	1.47 (.143)
	Targeted therapy	Experienced	16 (15.1)	63.19 ± 20.95	1.47 (.143)
	Ovarian function suppression therapy	Never	97 (91.5)	69.14 ± 20.13	- 2.17 (.042)
	Ovarian function suppression therapy	Experienced	9 (8.5)	76.56 ± 8.15	- 2.17 (.042)
	Recurrence	No	79 (74.5)	70.24 ± 20.42	0.42 (.675)
	Recurrence	Yes	27 (25.5)	68.41 ± 16.76	0.42 (.675)
	Self-identified menopausal status	Premenopausal	14 (13.2)	75.79 ± 18.39	1.24 (.217)
	Self-identified menopausal status	Postmenopausal	92 (86.8)	68.86 ± 19.59	1.24 (.217)

Table 2

Levels of Resilience, Anxiety, Depression, Hope, and Family Support in Participants (N =106)

Variables	Categories	Possible score	n (%)	Total M ± SD	Min~Max
Resilience	Total	14~98		69.77 ± 19.49	14~97
	Very low	14~56	16 (15.1)
	Low	57~64	20 (18.9)
	On the low end	65~73	13 (12.2)
	Moderate	74~81	25 (23.6)
	Moderately high	82~90	25 (23.6)
	High	91~98	7 (6.6)
Anxiety	Total	0~21		6.72 ± 3.56	0~21
	Normal	0~7	71 (67.0)
	Mild	8~10	24 (22.6)
	Moderate~severe	11~21	11 (10.4)
Depression	Total	0~21		5.91 ± 3.87	0~16
	Normal	0~7	66 (62.3)
	Mild	8~10	23 (21.7)
	Moderate~severe	11~21	17 (16.0)
Hope	Total	29~116		82.91 ± 14.59	40~114
	Hopelessness	29~50	4 (3.7)
	Low hope	51~72	18 (17.0)
	Moderate hope	73~94	57 (53.8)
	Hopeful	95~116	27 (25.5)
Family support	Total	11~55		43.39 ± 10.61	13~55

Table 3

Correlations among Resilience, Anxiety, Depression, Hope, and Family Support (N =106)

Variables	Resilience	Anxiety	Depression	Hope	Family support
Variables	r (p)	r (p)	r (p)	r (p)	r (p)
Resilience	1
Anxiety	- .16 (.090)	1
Depression	- .26 (.007)	.69 ( < .001)	1
Hope	.40 (<.001)	-.14 (.150)	-.26 (.007)	1
Family support	.23 (.016)	-.30 (.001)	-.35 (<.001)	.58 (<.001)	1

Table 4

Factors affecting Resilience (N =106)

Variables	Resilience
Variables	B	SE	β	t	p	R²	VIF
(Constant)	53.92	19.39		2.78	.006
Hope	0.50	0.11	.37	4.61	<.001	.16	1.02
Religion	- 5.10	1.54	- .26	- 3.30	.001	.22	1.00
Lymph node metastasis	8.55	3.15	.22	2.70	.008	.26	1.00
Surgery side	- 17.70	6.92	- .21	- 2.55	.012	.30	1.03
Time since surgery	4.52	1.97	.18	2.29	.024	.34	1.01
Hormone therapy			- .14	- 1.72	.087		1.06
	R²=.34, Adjusted R²=.30, F=10.33, p<.001.

Notes

This article is based on a part of the first auther's master's thesis from Yonsei University.

References

1. GLOBOCAN 2012. Estimated cancer incidence, mortality and prevalence worldwide in 2012. Lyon: International Agency for Research on Cancer;Accessed September 1, 2014. http://globocan.iarc.fr/Pages/fact_sheets_cancer.

2. Korea Breast Cancer Society. Breast cancer factors & figures in Korea. Seoul: Korea Breast Cancer Society;2014. Accessed October, 2014. http://www.kbcs.or.kr/journal/file/2014_Breast_Cancer_Facts_and_Figures_updated.pdf.

3. Brem S, Kumar NB. Management of treatment-related symptoms in patients with breast cancer: current strategies and future directions. Clin J Oncol Nurs. 2011; 15:63–71.

4. Ryu YM, Yi MS. The factors influencing quality of life in women with breast cancer. Asian Oncol Nurs. 2013; 13(3):121–127.

5. Ahn JY. The influence of symptoms, uncertainty, family support on resilience in patients with breast cancer receiving chemotherapy [master's thesis]. Seoul: Seoul National Univ.;2014.

6. Kim JH. Resilience. Seoul: Seoul Wisdom house;2011.

7. Ha BY. Effects of resilience, post-traumatic stress disorder on the quality of life in patients with breast cancer [master's thesis]. Jinju: Gyeongsang National Univ.;2014.

8. Imm SJ. The factors influencing the resilience in stroke patients at home [master's thesis]. Seoul: Seoul National Univ.;2013.

9. Kwak SY, Byeon YS. Factors influencing resilience of patients with hematologic malignancy. Korean J Adult Nurs. 2013; 25(1):95–104.

10. Wagnild GM, Young HM. Resilience among older women. Image J Nurs Sch. 1990; 22(4):252–255.

11. Polk L. Toward a middle-range theory of resilience. ANS Adv Nurs Sci. 1997; 19(3):1–13.

12. Kim SR, Chung SJ, Shin NM, Shin HW, Kim MS, Lee SJ. Resilience in patients with parkinson's disease. J Korean Acad Adult Nurs. 2010; 22(1):60–69.

13. Kim JI, Byeon YS. A study on the factors affecting resilience in patients with colon cancer. Asian Oncol Nurs. 2013; 13(4):256–264.

14. Lee EK. A study on factors affeting cancer patients. J Korean Acad Soc Nurs Edu. 2007; 13(1):52–58.

15. Kim JY. The effect of hope and family support of depressed patients to their resilience [master's thesis]. Seoul: Ewha Women Univ.;2010.

16. Yang KS. The structural equation model on resilience of breast cancer patients receiving chemotherapy [dissertation]. Seoul: Ewha Women Univ.;2014.

17. Wagnild GM, Young HM. Development and psychometric evaluation of the resilience scale. J Nurs Meas. 1993; 1(2):165–178.

18. Wagnild GM. The Resilience Scale user's guide for the US English version of the Resilience Scale and the 14-Item Resilinece Scale (RS-14). Worden, MT: The Resilience Center;2010.

19. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67:361–370.

20. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–296.

21. Nowotny ML. Assessment of hope in patient with cancer: Development of an instrument. Oncol Nurs Forum. 1989; 16:57–61.

22. Choi SS. A correlational study on spiritual wellbeing, hope and perceived health status of urban adults [dissertation]. Seoul: Yonsei Univ.;1990.

23. Cobb S. Social support as a moderator of life stress. Psychosomatic Medicine. 1976; 38(5):300–314.

24. Kang HS. An experimental study of the effects of reinforcement education for rehabilitation on hemiplegia patients' self-care activities [dissertation]. Seoul: Yonsei Univ.;1984.

25. Cho EA, Oh HE. Effects of laughter therapy on depression, quality of life, resilience and immune responses in breast cancer survivors. J Korean Acad Nurs. 2011; 41(3):285–293.

26. Kim HJ, Kim SH, Lee HK, Oh SE. Factors affecting symptom experiences of breast cancer patients: based on the theory of unpleasant symptoms. Asian Oncol Nurs. 2014; 14(1):7–14.

27. Tae YS, Kwon SH, Choi JH, Lee AR. Predictive factors for depression in breast cancer survivors. Asian Oncol Nurs. 2013; 13(3):113–120.

28. Tae YS, Kim MY. Influencing factors on hope among patients with breast cancer. Asian Oncol Nurs. 2009; 9(2):86–94.

29. Tae YS, Kim MY. Relationship betweem family support, perceived health status, and self-esteem in Korean women with breast cancer. Asian Oncol Nurs. 2011; 11(1):41–48.

30. Lee HS. A study of the influence of perceived family support by breast cancer patients in breast cancer treatment groups [master's thesis]. Daejeon: Chungnam National Univ.;2009.

TOOLS

Similar articles