The Impact of Social Cognitive Constructs on Dietary Behaviors in Breast Cancer Survivors

Hyenam Hwang

doi:10.5388/aon.2016.16.3.139

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Hwang: The Impact of Social Cognitive Constructs on Dietary Behaviors in Breast Cancer Survivors

Original Article

Asian Oncology Nursing 2016; 16(3): 139-146.

Published online: 30 September 2016

DOI: https://doi.org/10.5388/aon.2016.16.3.139

The Impact of Social Cognitive Constructs on Dietary Behaviors in Breast Cancer Survivors

Hyenam Hwang

College of Nursing, Dongyang University, Yeongju, Korea.

Address reprint requests to: Hwang, Hyenam. Department of Nursing, Dongyang University, 145 Dongyangdaero, Punggi, Youngju, Gyeongbuk, 36040, Korea. Tel: +82-54-630-1722, Fax: +82-54-630-1179, hnhwang@dyu.ac.kr

Received 17 September 2016 Revised 28 September 2016 Accepted 28 September 2016

(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

Cancer survivors have experienced a specific and unique situation. Diet plays an important role in cancer risk and it is important influences on health. The purpose of this study was to explore the impact of social cognitive constructs, which is defined in Bandura's social cognitive theory, on dietary behaviors in breast cancer survivors.

Methods

A cross-sectional correlational design was used. Social cognitive constructs included nutritional self-efficacy, dietary goal-setting, outcome expectations for nutrition, negative impact of cancer, and social support. Stepwise multiple regression was applied to examine the impact of social cognitive constructs on dietary behaviors.

Results

One hundred and fifty-one breast cancer survivors completed the questionnaire. Stepwise regression analyses revealed that 19.9% of the variance in dietary behaviors was explained by these social cognitive variables. Family support, dietary goal-setting, negative impact of cancer, and nutritional self-efficacy were significant predictors of dietary behaviors.

Conclusion

A lack of social cognitive understanding about cancer survivors could result in less than adequate care for their health due to inadequate advice on their lifestyle choices, which may impede their opportunities to live healthy lives after overcoming the cancer. The knowledge from this study will help guide the development of social cognitive interventions.

Keywords: Breast Neoplasms, Diet, Behavior, Health Promotion

Figures and Tables

Table 1

The Scores of Dietary Behaviors and Social Cognitive Determinants (N=151)

Variables	Possible range	Min.	Max.	M±SD
Dietary behaviors	9~36	15	36	26.10±3.88
Nutritional self-efficacy	5~20	9	20	15.64±1.98
Dietary goal-setting	14~70	2	61	44.77±4.92
Outcome expectations for fruit and vegetable	10~50	29	49	35.78±3.95
Outcome expectations for low fat foods	10~50	26	46	34.79±3.77
Negative impact of cancer	20~100	35	91	66.11±11.28
Family support	8~40	20	40	32.25±4.95

Table 2

Correlations among Dietary Behaviors and Social Cognitive Determinants (N=151)

Variables	SE	GS	F/ V	LFF	NI	FS
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Dietary behaviors	.19 (.021)	.30 (<.001)	.11 (.172)	.07 (.406)	.16 (.051)	.30 (<.001)
Nutritional self-efficacy	-	.14 (.082)	.25 (.002)	.09 (.277)	-.19 (.018)	.06 (.472)
Dietary goal-setting		-	.08 (.343)	.04 (.630)	.15 (.070)	.07 (.387)
Outcome expectations for fruit/vegetable			-	.59 (<.001)	-.28 (<.001)	.11 (.190)
Outcome expectations for low fat foods				-	-.25 (.002)	.09 (.261)
Negative impact of cancer					-	-.15 (.066)
Family support						-

SE= Nutritional self-efficacy; GS= Dietary goal-setting; F/V= Outcome expectations for fruit/vegetable; LFF= Outcome expectations for low fat foods; NI= Negative impact of cancer; FS= Family support.

Table 3

Differences of Dietary Behaviors by Characteristics (N=151)

Variables	Category	n (%)	M±SD	t or F (p)
Age (year) (M±SD=53.0±6.35)	≤39	5 (3.3)	27.60±2.79	0.34 (.799)
	40~49	29 (19.2)	25.90±4.35
	50~59	100 (66.2)	26.02±3.90
	≥60	17 (11.3)	26.47±3.28
Having a husband/partner	Yes	138 (91.4)	26.16±3.89	0.62 (.537)
Having a husband/partner	No	13 (8.6)	25.46±3.91	0.62 (.537)
Educational level	≤Middle school	18 (11.9)	26.33±3.94	0.73 (.482)
	High school	83 (55.0)	25.76±4.02
	≥College	50 (33.1)	26.58±3.63
Employment status	Employed	34 (22.5)	27.47±2.40	3.15 (.002)
Employment status	Unemployed	117 (77.5)	25.70±4.14	3.15 (.002)
Menopausal status	Menopausal	130 (86.1)	26.22±3.80	0.91 (.362)
Menopausal status	Premenopausal	21 (13.9)	25.38±4.39	0.91 (.362)
Stage of disease	0	8 (5.3)	24.75±2.76	2.88 (.038) Scheffeé (none)
	1	37 (24.5)	26.68±3.48
	2	73 (48.3)	25.36±4.12
	3 or 4	33 (21.9)	27.42±3.61
Duration since diagnosis (year)	<2	15 (10.0)	27.00±4.21	0.51 (.679)
	2~5	50 (33.1)	26.30±3.72
	5~10	68 (45.0)	25.91±3.68
	>10	18 (11.9)	25.50±4.85
Recurrence or not	Recurrence	29 (19.2)	27.38±2.99	2.00 (.048)
Recurrence or not	No recurrence	122 (80.8)	25.80±4.01	2.00 (.048)

Table 4

Predictors for Dietary Behaviors (N=151)

Variables	B	SE	ß	t (p)
(Constant)	.61	4.110
Family support	.24	0.058	.30	4.06 (<.001)
Dietary goal-setting	.17	0.059	.22	2.90 (.004)
Negative impact of cancer	.07	0.026	.21	2.69 (.008)
Nutritional self-efficacy	.35	0.148	.18	2.35 (.020)
	Adj. R²=.199, F=10.30, p<.001, Durbin-Watson=1.79

Notes

This study was supported by grant from Dongyang University in 2014.

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