Influences of Uncertainty and Social Support on the Quality of Life among Elderly Cancer Patients

Kyung Ok Kim; Jung A Kim

doi:10.5388/aon.2017.17.3.180

Journal List > Asian Oncol Nurs > v.17(3) > 1081903

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim and Kim: Influences of Uncertainty and Social Support on the Quality of Life among Elderly Cancer Patients

Original Article

Asian Oncol Nurs 2017;17(3):180-187.

Published online: 5 September 2017

DOI: https://doi.org/10.5388/aon.2017.17.3.180

Influences of Uncertainty and Social Support on the Quality of Life among Elderly Cancer Patients

Kyung Ok Kim¹, Jung A Kim²

¹Graduate School of Nursing, Hanyang University, Seoul, Korea

²Division of Nursing, Hanyang University, Seoul, Korea

^∗ This article is a revision of the first author's master's thesis from Hanyang University.

Address reprint requests to: Kim, Jung A Division of Nursing, Hanyang University, 222 Wangsimniro, Sungdong-gu, Seoul, Korea Tel: +82-2-2220-0799 Fax: +82-2-2295-2074 E-mail: joyhippo@hanyang.ac.kr

Received 30 Jun 201729 Aug 2017 Accepted 15 Sep 2017

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.

초록

Purpose

The purpose of this study was to determine the influences of uncertainty and social support on the quality of life among elderly cancer patients.

Methods

A descriptive correlational study was conducted with 128 patients aged over 65 who were diagnosed with cancer from either the cancer center or the university hospital. Data were collected from October 8^th, to November 6^th, 2013 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression with the SPSS/ WIN 18.0 program.

Results

Uncertainty and quality of life showed significant negative correlation (r=-.48, p<.001). The predictors of quality of life were ambiguity as subunit of uncertainty, severeness of pain and primary caregiver. These explained 41% of the variance (F=4.47, p=.037) and the most influential factor was ambiguity.

Conclusion

This study demonstrated that the quality of life was influenced by ambiguity and personal characteristics. The result suggests that intervention programs to reduce the level of uncertainty and pain of patients could improve the quality of life among elderly cancer patients.

Keywords: Uncertainty, Social Support, Quality of Life, Aged, Neoplasms

REFERENCES

1. National Cancer Information Center (KR). Prevalence rates [Internet]. Available from. http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_040401000000. [Accessed December 22, 2016].

2. Lim YO, Kim YJ, Yoon HS. Quality of life of older cancer patients in comparison with older chronic disease patients and middle-aged cancer patients. Korean J Soc Welf. 2013; 65:367–93.

3. Kang IO, Yun YH. Preliminary investigation of the quality of life in the elderly with cancer. Korean Acad Fam Med. 2004; 25:678–86.

4. Padilla GV, Ferrell B, Grant MM, Rhiner M. Defining the content do-main of quality of life for cancer patients with pain. Cancer Nurs. 1990; 13:108–15.

5. Baumann R, Pütz C, Röhrig B, Höffken K, Wedding U. Health-related quality of life in elderly cancer patients, elderly non-cancer patients and an elderly general population. Eur J Cancer Care (Engl). 2009; 18:457–65.

6. Sammarco A, Konecny LM. Quality of life, social support, and uncertainty among Latina breast cancer survivors. Oncol Nurs Forum. 2008; 35:844–9.

7. Mishel MH. Uncertainty in illness. Image J Nurs Sch. 1988; 20:225–32.

8. Kang YH. Review on mid-range nursing theory: uncertainty in illness theory. Korean J Nurs Query. 2006; 15:120–33.

9. Cha K, Kim K. Impact of uncertainty on resilience in cancer patients. Asian Oncol Nurs. 2012; 12:139–46.

10. Bailey JM, Nielsen BI. Uncertainty and appraisal of uncertainty in women with rheumatoid arthritis. Orthop Nurs. 1993; 12:63–7.

11. Honkasalo ML. Enduring as a mode of living with uncertainty. Health Risk Soc. 2008; 10:491–503.

12. Bottomley A, Jones L. Social support and the cancer patient? a need for clarity. Eur J Cancer Care (Engl). 1997; 6:72–7.

13. Nam KH, Tae YS, Kim CS, Lee SM. Influence of uncertainty and uncertainty appraisal on quality of life in prostate cancer patients after prostatectomy. Asian Oncol Nurs. 2017; 17:45–54.

14. Park HS, Lee HJ, Ha JH. Factors influencing quality of life in patients with hepatocellular carcinoma receiving transarterial chemoemboliza-tion. J Korean Acad Fundam Nurs. 2015; 22:69–78.

15. Chung C, Kim MJ, Rhee MH, Do HG. Functional status and psychosocial adjustment in gynecologic cancer patients receiving chemotherapy. Korean J Women Health Nurs. 2005; 11:58–66.

16. Kim OS. Study on the correlation between perceived social support and the quality of life of hemodialysis patients. [dissertation]. Seoul: Seoul National Univ.;1993.

17. Lee EH. Development and psychometric evaluation of a quality of life scale for Korean patients with cancer (C-QOL). J Korean Acad Nurs. 2007; 37:324–33.

18. Ahn HJ, Tae YS, Han YI. The relationship between spiritual health and uncertainty in cancer patients having chemotherapy. J Korean Oncol Nurs. 2007; 7:107–18.

19. Mishel MH. Theories of uncertainty in illness. Smith MJ, Liehr PR, editors. Middle range theory for nursing. 3rded. New York, NY: Springer;2014. p. 53–86.

20. Kim S, Ruy S. Influence of social support for a cancer patient undergoing radiation treatment on quality of life. J Korean Soc Radiol. 2016; 10:145–52.

21. Lee ES, Park JS. The comparison of health promotion behavior, post traumatic growth and quality of life according to stages of survivorship in patients with female genital neoplasm. Korean J Adult Nurs. 2013; 25:312–21.

22. Ferrell BR, Dow KH, Grant M. Measurement of the quality of life in cancer survivors. Qual Life Res. 1995; 4:523–31.

23. Sammarco A. Perceived social support, uncertainty, and quality of life of younger breast cancer survivors. Cancer Nurs. 2001; 24:212–9.

24. Esbensen BA, Osterlind K, Roer O, Hallberg IR. Quality of life of elderly persons with newly diagnosed cancer. Eur J Cancer Care (Engl). 2004; 13:443–53.

25. Cicero V, Lo Coco G, Gullo S, Lo Verso G. The role of attachment di-mensions and perceived social support in predicting adjustment to cancer. Psychooncology. 2009; 18:1045–52.

26. Jeong SH. Relationship among spiritual well-being, family support and quality of life of the elderly with cancer [dissertation]. Daegu: Catholic Univ. Daegu;2012.

27. Han SS, Shin IS, Kim YJ. Factors that influence quality of life in cancer patients. Korean J Health Promot Dis Prev. 2009; 9:33–40.

Table 1.

Demographic and Illness-related Characteristics and Quality of Life (N=128)

Characteristics	Categories	n (%)	Quality of life	t or F	p	Duncan
Characteristics	Categories	n (%)	M ± SD	t or F	p	Duncan
Age (year)	65~69	65 (50.8)	3.33 _± 0.46	1.77	.080
	≥ 70	63 (49.2)	3.19 ± 0.49
Gender	Male	63 (49.2)	3.34 _± 0.43	1.80	.074
	Female	65 (50.8)	3.19 ± 0.51
Religion	No	54 (42.2)	3.26 ± 0.45	0.32	.811
	Christian	40 (31.3)	3.22 ± 0.53
	Catholic	5 (3.9)	3.44 ± 0.55
	Buddhism	29 (22.6)	3.28 _± 0.46
Spouse	Yes	100 (78.1)	3.27 ± 0.48	-0.22	.830
	No	28 (21.9)	3.24 _± 0.49
Education level	No	12 (9.4)	3.08 ± 0.43	1.14	.343
	Elementary school	39 (30.5)	3.24 ± 0.52
	Middle school	29 (22.6)	3.29 ± 0.39
	High school	35 (27.3)	3.24 ± 0.48
	≥ College	13 (10.2)	3.47 _± 0.54
Monthly income	＜100	100 (78.1)	3.26 ± 0.51	0.02	.979
(10,000 won)	100~200	22 (17.2)	3.28 _± 0.33
	＞200	6 (4.7)	3.28 ± 0.36
Period after	＜6M	42 (32.8)	3.31 ± 0.44	0.34	.851
diagnosis (year)	6M~1	20 (15.6)	3.19 ± 0.43
	1~2	21 (16.4)	3.27 ± 0.43
	2~3	17 (13.3)	3.30 _± 0.49
	＞3	28 (21.9)	3.20 ± 0.60
Type of diagnosis	Cervix uteri	13 (10.2)	3.44 _± 0.59	1.28	.258
	Ovarian	17 (13.3)	3.00 ± 0.49
	Stomach	19 (14.8)	3.28 ± 0.51
	Lung	15 (11.7)	3.22 ± 0.42
	Prostate	10 (7.8)	3.32 ± 0.40
	Thyroid	3 (2.4)	3.37 _± 0.29
	Colon rectal	21 (16.4)	3.27 ± 0.51
	Breast	6 (4.7)	3.09 ± 0.46
	bladder	9 (7.0)	3.54 ± 0.32
	Others	15 (11.7)	3.24 ± 0.43
Primary care giver	Spouse	70 (54.7)	3.34 _± 0.42	3.08	.030	A
	Offspring	45 (35.2)	3.20 ± 0.54			A
	Private care giver	9 (7.0)	2.87 ± 0.49			B
	Others	4 (3.1)	3.42 ± 0.20			A
Perceived patient's	Improved	97 (75.8)	3.33 ± 0.41	14.07	＜.001	A
illness state	Not change	21 (16.4)	3.27 ± 0.54			A
	Becoming worse	10 (7.8)	2.56 ± 0.45			B
Metastasis	Yes	53 (41.4)	3.08 _± 0.52	-3.75	＜.001
	No	75 (58.6)	3.39 ± 0.41
Recurrence	Yes	32 (25.0)	3.06 _± 0.56	-2.75	.007
	No	96 (75.0)	3.33 ± 0.43
Pain scale	0	43 (33.6)	3.51 ± 0.32	20.14	＜.001	A
	1~4	74 (57.8)	3.21 ± 0.47			A
	≥ 5	11 (8.6)	2.64 ± 0.37			B

Table 2.

Degrees of Uncertainty, Social Support and Quality of Life

Variables	M ± SD	Item M ± SD	Possible range	Actual range
Uncertainty	81.17 ± 10.51	2.46 ± 0.32	33~165	50~107
Ambiguity	35.78 ± 6.80	2.75 ± 0.52	13~65	18~53
Complexity Unpredictableness	15.57 ± 2.0514.99 _± 1.98	2.22 ± 0.292.99 _± 0.39	7~35 5~25	9~21 9~20
Inconsistency	14.82 ± 2.56	2.12 ± 0.36	7~35	8~20
Social support	103.07 ± 10.93	4.29 ± 0.45	24~120	60~120
Family support	52.57 ± 7.93	4.38 ± 0.66	12~60	24~60
Medical support	50.49 ± 6.35	4.20 ± 0.53	12~60	36~60
Quality of life	47.50 ± 10.05	2.26 ± 0.48	0~84	15~69
Physical status Emotional status	16.65 ± 4.0615.35 _± 4.75	2.77 ± 0.672.56 _± 0.79	0~24 0~24	5~24 2~24
Coping capabilities Worried status	9.06 ± 2.403.55 ± 2.41	2.26 ± 0.601.77 ± 1.20	0~160~8	1~130~8
Social status	2.87 ± 2.40	0.95 ± 0.80	0~12	0~12

Table 3.

Correlations among Uncertainty, Social Support and Quality of Life (N=128)

Variables		Uncertainty					Social suppoort			Quality of life
		Total score	I	A	C	U	Total score	FS	MS	Total score	PS	ES	SS	WS	CC
		r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Uncertainty T s	Total score	1
	I	.72(＜.001)	1
	A (	.91(＜.001)	.52 (＜.001)	1
	C (	.60(＜.001)	.43 (＜.001)	.32(＜.001)	1
	U (	.59(＜.001)	.29 (.001)	.35(＜.001)	.45 (＜.001)	1
Social support T s	Total score	-.14 (.129)	-.19 (.031)	-.09 (.314)	-.16 (.070)	.01 (.955)	1
	FS	-.04 (.694)	-.11 (.203)	.01 (.906)	-.15 (.099)	.07 (.423)	82(＜.001)	1
	MS	-.19 (.033)	-.19 (.035)	-.17 (.059)	-.09 (.294)	-.08 (.367)	.70(＜.001)	.16 (.069)	1
Quality of life T s	Total score (	-.48(＜.001)	-.24 (.007)	-.55 ＜.001)	-.10 (.265)	-.24 (.006)	.14 (.111)	.07 (.426)	.16 (.081)	1
	PS (	-.38(＜.001)	-.23 (.009)	-.47 ＜.001)	-.01 (.894)	-.08 (.373)	.11 (.226)	.01 (.900)	.17 (.053)	.76 (＜.001)	1
	ES (	-.34(＜.001)	-.14 (.104)	-.41(＜.001)	.01 (.955)	-.18 (.038)	.12 (.175)	.05 (.615)	.15 (.088)	.83 (＜.001)	.49 ＜.001)	1
	SS	-.23 (.009)	-.14 (.124)	-.16 (.080)	-.23 (.008)	-.24 (.006)	.06 (.500)	.12 (.172)	-.05 (.589)	.39 (＜.001)	.21 (.019)	.11 (.205)	1
	WS (	-.46(＜.001)	-.29 (.001)	-.46(＜.001)	-.15 (.095)	-.31 ＜.001)	.03 (.731)	-.02 (.815)	.08 (.376)	.55 (＜.001)	.23 (.010)	.42 (＜.001)	.08 (.395)	1
	CC	-.02 (.817)	.11 (.202)	-.08 (.389)	-.02 (.804)	.03 (.752)	.08 (.373)	.09 (.319)	.03 (.772)	.32 (＜.001)	.08 (.403)	.13 (.151)	-.03 (.728)	-.01 (.934)	1

I= Inconsistency; A= Ambiguity; C= Complexity; U= Unpredictableness; FS= Family support; MS= Medical support; PS= Physical status; ES= Emotional status; SS= Social status; WS= Worried status; CC= Coping capabilities.

Table 4.

Factors Influencing Quality of Life (N=128)

Varaible	Quality of life
Varaible	B	SE	β	t	p	Tolerance	VIF
(Constant)	93.68	3.82		24.50	＜.001
Ambiguity	-0.64	0.11	-.43	-5.93	＜.001	.88	1.13
Pain scale	-1.72	0.38	-.33	-4.53	＜.001	.89	1.13
Primary caregiver (Spouse=1)	2.91	1.38	.15	2.11	.037	.99	1.00

R²=.42, Adjusted R²=.41, F₌4.47, p ₌.037, Durbin-Watson₌2.26

TOOLS

Similar articles