Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor

Hyunsook Kim; Myoungha Lee; Hyeyoung Kim; Juhee Nho

doi:10.4069/kjwhn.2018.24.2.163

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Kim, Lee, Kim, and Nho: Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor

Orginal Article

Korean J Women Health Nurs 2018;24(2):163-173.

Published online: 20 June 2018

DOI: https://doi.org/10.4069/kjwhn.2018.24.2.163

Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor

Hyunsook Kim¹, Myoungha Lee^2,, Hyeyoung Kim², Juhee Nho²

¹Graduate School, College of Nursing, Chonbuk National University, Jeonju, Korea

²College of Nursing · Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea

Corresponding author: Lee, Myoungha College of Nursing, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Korea. Tel: +82-63-270-3122, Fax: +82-63-270-3127, E-mail: leemh@jbnu.ac.kr

Received 13 April 201821 May 2018 Accepted 26 May 2018

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

To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor.

Methods

With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression.

Results

The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were 1.57±0.51, 0.37±0.64, 3.62±0.67, and 4.00±0.45, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment.

Conclusion

In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

Keywords: Breast tumor, Psychosocial adjustment, Social support, Body images, Physical discomforts

References

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Table 1.

Differences in Psychosocial Adjustment according to Participants' Characteristics (N=183)

Variables	Categories	n (%) or M±SD	Psychosocial adjustment
Variables	Categories	n (%) or M±SD	M±SD	t or F (p)	Scheffé
Age (year)	＜40 40∼49	24 (13.1) 105 (57.4)	4.13±0.31 3.98±0.46	1.11 (.333)
	＞49	54 (29.5) 46.47±6.70	3.99±0.44
Married state	Married Single	162 (88.5) 3 (1.6)	4.02±0.43 3.86±0.23	1.55 (.215)
	Etc	18 (9.8)	3.84±0.56
Educational level	＜High school^a High school^b	8 (4.4) 99 (54.1)	3.44±0.72 3.96±0.41	10.77 (＜.001)	a＜b＜c
	≥College^c	76 (41.5)	4.12±0.39
Occupation	Yes No	132 (72.1) 51 (27.9)	4.02±0.43 3.96±0.44	–0.71 (.479)
Monthly income (10,000 won)	＜300	30 (15.8)	3.91±0.46	2.64
	300∼499	56 (30.9)	3.94±0.49	(.072)
	≥500	95 (52.5)	4.01±0.39
Number of surgical removal of benign breast tumor	1^a 2^b	109 (59.9) 64 (35.2)	3.93±0.45 4.13±0.41	4.95 (.008)	a＜b
	≥3^c	9 (4.9)	3.98±0.30
Experience of surgical removal of benign breast tumor in family	Yes No	47 (25.7) 136 (74.3)	4.04±0.44 3.99±0.44	–0.65 (.515)
Mammography cycle	1	113 (62.4)	4.06±0.40	3.25	d＜a
(every year)	2	46 (25.4)	3.93±0.38	(.023)
	≥3	6 (3.3)	3.96±0.66
	None	16 (8.8)	3.72±0.66
Breast ultrasonography cycle (every year)	1 2	117 (65.7) 36 (20.2)	4.09±0.37 3.91±0.40	6.92 (.001)	d＜a
	≥3 None	10 (5.6) 15 (8.4)	3.84±0.22 3.61±0.67
Cancer insurance status	Yes No	179 (97.8) 4 (2.2)	3.45±0.50 4.01±0.43	–2.55 (.012)
Menstruation	Regular^a Irregular^b Menopause^c	99 (54.1) 45 (24.6) 39 (21.3)	4.10±0.42 3.82±0.48 3.96±0.37	6.62 (.002)	a＞b, c
Body Mass Index (kg/m²)	＜18.5	6 (3.4)	4.14±0.27	2.35
	18.5∼22.9 23.0∼24.9	122 (68.2) 30 (16.8)	3.94±0.47 4.12±0.38	(.074)
	≥25	21 (11.7) 22.06±2.59	4.14±0.36
Health status	1∼3	2 (1.1)	3.87±0.24	0.94
	4∼6	85 (46.4)	3.96±0.38	(.394)
	＞6	96 (52.5)	4.04±0.49
		6.53±1.64

Table 2.

Levels of Physical Discomfort, Body Image, Family Support, and Psychosocial Adjustment (N=183)

Variables	M±SD	Possible range
Physical discomfort	1.57±0.51	1∼5
Postoperative pain	2.06±0.85	1∼5
Postoperative contusion	2.00±0.94
Breast lump	1.68±0.91
Frozen shoulder	1.67±0.92
Postoperative edema	1.58±0.79
Postoperative retraction	1.42±0.83
General weakness	1.42±0.72
Postoperative skin heating	1.39±0.66
Fever sign	1.24±0.56
Surgical incision site inflammation	1.23±0.58
Body image	0.37±0.64	0∼3
Family support	3.62±0.67	1∼5
Psychosocial adjustment	4.00±0.45	1∼5

Table 3.

Relationships among Research Variables (N=183)

Variables	Body image	Physical discomfort	Family support
Variables	r (p)	r (p)	r (p)
Physical discomfort			–.22 (.003)
Body image		.37 (＜.001)	–.42 (＜.001)
Psychosocial adjustment	–.68 (＜.001)	–.39 (＜.001)	.61 (＜.001)

Table 4.

Influencing Factors on Psychosocial Adjustment (N=183)

Variables	B^†	SE	β	t	p
(Constant)	2.99	0.20		14.85	＜.001
Family support	0.27	0.04	.41	7.59	＜.001
Body image	–0.20	0.03	–.35	–6.22	＜.001
Physical discomfort	–0.16	0.05	–.19	–3.57	＜.001
Number of surgical removal of benign breast tumor (1=2)^‡	0.14	0.05	.15	3.09	.002
Cancer insurance status (1=yes)^‡	0.34	0.15	.12	2.30	.023

R²=.59, Adj. R²=.574, F=48.16, p＜.001

SE=standard errors; ^†Unstandardized coefficients; ^‡Dummy variable: Cancer insurance status (1=yes 0=no).

Number of surgical removal of benign breast tumor (1=2, 0=1, 0=≥3),

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