Volume 28, Issue 4 (Fall 2020)                   Avicenna J Nurs Midwifery Care 2020, 28(4): 45-61 | Back to browse issues page

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Soleyman Farokh M, Delavar A. The Impact of Personal, Family and Social Factors on Psychological Well-being of Patients with Breast Cancer to Develop a Structural Model. Avicenna J Nurs Midwifery Care 2020; 28 (4) :45-61
URL: http://nmj.umsha.ac.ir/article-1-2133-en.html
1- PhD Student, Islamic Azad University, Tehran Branch, Tehran, Iran
2- Professor of Research Methods and Statistics, Allameh Tabataba’i University, Tehran, Iran , delavar@atu.ac.ir
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✅ Thus, it can be acknowledged that, despite the difficult physical conditions that people with cancer face, it is possible to take appropriate social support to strengthen the resilience of these patients and finally, expect that the ability to adapt and cope with cancer will also increase in people with the disease.

Extended Abstract:   (932 Views)

Cancer is one of the most important diseases of the current century and the third leading cause of death after cardiovascular disease and accidents, and affects the psychological well-being of cancer patients. The aim of this study was to determine the effect of individual, family and social factors on the psychological well-being of patients with breast cancer in order to develop a structural model.

Figure 1: Conceptual model of research

Figure 1. Conceptual model of research


Materials and Methods

The present study was descriptive in the form of structural equation modeling. Its statistical population consisted of all women with breast cancer being treated in medical centers and specialized hospitals for cancer in Tehran in the first quarter of 2019 (1350 people). The statistical sample was determined based on the research plan of 300 people and using multi-stage clustering method, clustering of medical centers based on geographical areas and then selection of a cluster was performed randomly. Data were collected using Reef's psychological well-being questionnaires, Baer et al.'s mindfulness, five neo-personality factors, Connor and Davidson's resilience, Ritchie and Fitzpatrick's family communication patterns, and Zymet's social support. Finally, the data were analyzed using multivariate linear regression test in the text of structural equation modeling and by AMOS software version 21.



The results of model analysis indicated that among the individual factors, the openness to experience, positively and neurosis has a negative effect on psychological well-being (P<0.01). Also, resilience and mindfulness have both positively increased mental well-being (P<0.01). In the case of familial factors and among the family communication patterns, the factor of orientation of conformity has reduced mental well-being (P<0.01). Finally, social support can increase psychological well-being (P<0.05).
Table 1. Descriptive statistics of scores of research variables
Variable source N The least The most M SD
Psychological well-being 300 45 70 56.50 5.73
Personality characteristics Psychiatry 300 22 49 36.79 5.36
Extraversion 300 25 52 38.74 5.57
Openness 300 23 50 36.38 5.14
Agreeableness 300 26 53 39.45 5.43
With conscience 300 26 60 41.85 6.99
Resilience 300 50 125 87.44 15.95
Mindfulness 300 98 138 119.36 9.06
social support 300 20 60 41.118 8.28
Family communication patterns Conversational orientation 300 29 70 49.45 9.65
Orientation of compliance 300 11 51 31.21
Figure 2. The hypothetical model of individual, family and social factors affecting psychological well-being
Figure 2. The hypothetical model of individual, family and social factors affecting psychological well-being
Table 3. Fits of the modified model of individual, family and social factors affecting psychological well-being
Index Supposed model Saturation model Independence model Acceptable amount Result
NPAR 37 77 22 - -
X2 11.840 0.000 828.922 - -
df 40 0 55 - -
X2/df 2.946 - 15.073 <3 Acceptable
CFI 0.957 1 0.000 0.8> Acceptable
[1]NFI 0.831 1 0.000 0.8> Acceptable
[2]IFI 0.863 1 0.000 0.8> Acceptable
RMSEA 0.067 - 0.217 0.07> Acceptable
[1]. Normed Fit Index (NFI)
[2]. Incremantal Fit Index (IFI)

Figure 4. Standard estimation model of individual, family and social factors affecting psychological well-being
Figure 4. Standard estimation model of individual, family and social factors affecting psychological well-being

Table 4. Standard correlation relationships between predictor variables
  Source of change Estimation Low limit High limit Level of significance
Social support ßà Conversational pattern 0.571 0.448 0.643 0.001
Resilience ßà Conformity pattern -0.244 -0.341 -0.146 0.001
Resilience ßà Mindfulness 0.211 0.113 0.299 0.001
Extraversion ßà Psychiatry -0.185 -0.277 -0.091 0.002
Agreeableness ßà Responsibility 0.524 0.456 0.598 0.001
responsibility ßà Extraversion 0.442 0.353 0.528 0.001
Agreeableness ßà Extraversion 0.304 0.214 0.401
Table 5. Multiple correlation squares of the effect of individual, family and social factors affecting psychological well-being
Source of change Estimation Low limit High limit Level of significance
Psychological well-being 0.333 0.250 0.381
Table 6. Indicators of standard relationships in the modified model
Predictive variable Predictor Estimation Low limit High limit Significance
Individual factors
Personality factors Being open 0.181 0.083 0.277 0.001
Extraversion 0.130 0.015 0.238 0.062
Neurosis -0.186 -0.271 -0.099 0.001
Resilience 0.346 0.243 0.441 0.001
Mindfulness 0.128 0.039 0.217 0.019
Social factors Social support 0.132 0.046 0.225 0.010
Family factors Family communication patterns Conversation -0.032 -0.141 0.079 0.613
Conformity -0.196 -0.285 -0.096


Regarding the effect of personality factors on well-being, some studies confirm the findings of the present hypothesis [30, 37]. Research results showed that personality traits (extraversion, neuroticism, openness to experience, optimism and conscience) predict psychological well-being [37]. A research has also shown that psychological well-being can decrease with increasing and neuroticism [49].
Also, the findings of this study regarding the positive effect of resilience on psychological well-being are consistent with some studies [22, 24, 25]. The results of another study showed that resilient people try harder to maintain their physical and mental health than other people because this feature helps them recover from stressful situations faster [22]. Research has also shown that a person with high resilience can identify positive meanings in difficulties and prevent negative emotions [24]. Another study showed that resilience has a positive effect on the components of environmental control, personal growth and self-acceptance of psychological well-being [25].
Regarding the positive and significant effect between mindfulness and psychological well-being, some studies confirm the findings of this study [20, 26, 28, 29, 50].
Additionally, regarding the negative effect of compliance orientation on psychological well-being, some studies have shown that different family functions can affect the psychological well-being of family members [21, 35, 36]. People who receive more emotional support from those around them have higher psychological well-being than others [21].
Finally, regarding the positive and significant effect between social support and psychological well-being, some studies have shown that social support can increase the level of mental well-being of individuals [23, 30-34]. Also, perceived social support increases the well-being of a person with cancer [23]. In addition, social support can be a predictor of psychological well-being; also, the effectiveness of social support is determined by various factors such as type, time and social support [31].



Thus, it can be acknowledged that, despite the difficult physical conditions that people with cancer face, it is possible to take appropriate social support to strengthen the resilience of these patients and finally, expect that the ability to adapt and cope with cancer will also increase in people with the disease.



We thank all the patients who patiently participated in this study despite many problems.


Conflicts of Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


Type of Study: Original Research | Subject: Nursing
Received: 2020/01/21 | Accepted: 2020/03/30 | Published: 2020/05/4

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