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)
Introduction

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.

 

Results

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
8.14
 
 
 
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
0.001
 
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
0.024
 
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
0.001
 


 
Discussion

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].


 

Conclusion

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.

 

Acknowledgments

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

References
1. Monfared A, Pakseresht S, Ghanbari Khanghah A, Atrkar-Roshan Z. Health-Related Quality of Life and its related factors among women with breast cancer. J Holis Nurs Midwifery. 2013; 23(2):52-62.
2. Momeni T, Musarezaie A, Karimian J, Ebrahimi A. The relationship between spiritual well-being and depression in Iranian breast cancer patients. Health Inform Manag. 2011; 8(8):1007-16.
3. Mardani Hamule M, Shahraky Vahed A. The Assessment of Relationship between Mental Health and Quality of Life in Cancer Patients. Sci J Hamadan Univ Med Sci. 2009; 16(2):33-8.
4. Matsushita T, Matsushima E, Maruyama M. Psychological state, quality of life, and coping style in patients with digestive cancer. Gen Hospital Psych. 2005; 27(2):125-32. [DOI:10.1016/j.genhosppsych.2004.10.006] [PMID]
5. Bekelman DB, Dy SM, Becker DM, Wittstein IS, Hendricks DE, Yamashita TE, et al. Spiritual well-being and depression in patients with heart failure. J General Inter Med. 2007; 22(4):470-7. [DOI:10.1007/s11606-006-0044-9] [PMID] [PMCID]
6. Kamian S, Taghdisi MH, Azam K, Estebsari F. Evaluating Effectiveness of Spiritual Health Education on Increasing Hope among Breast Cancer Patients. Iran J Health Educ Health Prom. 2014; 2(3):208-14.
7. Hayati F, Shahsavari A, Mahmodi M. relation psychic convenience with individual factors of patients with breast cancer in hospitals of Tehran University of Medical Science. J Iran Breast Disease. 2009; 2(1):23-8.
8. Kaliampos A, Roussi P. Religious beliefs, coping, and psychological well-being among Greek cancer patients. J Health Psych. 2015; (1):1-11.
9. Yeung NC, Lu Q. Perceived stress as a mediator between social support and posttraumatic growth among Chinese American breast cancer survivors. Cancer Nurs. 2018; (41):53‑61. [DOI:10.1097/NCC.0000000000000422] [PMID] [PMCID]
10. Castro E, Ponciano C, Meneghetti B. Quality of Life, Self-Efficacy and Psychological Well-Being in Brazilian Adults with Cancer: A Longitudinal Study. Sci Res. 2012; 4(3):304-9. [DOI:10.4236/psych.2012.34043]
11. Vin-Raviv N. Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study. J Natl Cancer Inst. 2013; 105(8):563-72. [DOI:10.1093/jnci/djt024] [PMID] [PMCID]
12. Pintado S. Self-concept and emotional well-being in patients with breast cancer. Revista Iberoamericana Psicología Salud. 2017; 8(2): 76-84. [DOI:10.23923/j.rips.2017.08.007]
13. Seligman M. Flourish: A visionary new understanding of happiness and well-being. New York: Free Press; 2011.
14. Kun A, Balogh P, Krasz KG. Development of the work-related well-being questionnaire based on Seligman's PERMA model. Soc Manag Sci. 2017; (25):56-63. [DOI:10.3311/PPso.9326]
15. Seligman ME. Fundamental assumptions. Psychologist. 2003 Mar;16(3):126.
16. Hefferon K, Boniwell I. Pozitif psikoloji kuram, araştırma ve uygulamalar [Positive psychology Theory, study and practices] (T. Doğan, Trans.). Ankara, Turkey: Nobel Yayın Dağıtım; 2014.
17. Compton WC, Hoffman E. Positive psychology: The science of happiness and flourishing. Belmont. 2012; CA: Wadsworth.
18. Kenyon M, Mayer DK, Owens, AK. Late and long-term effects of breast cancer treatment and surveillance management for the general practitioner. J Obst Gynecol Neonat Nurs. 2014; 43(3):382-98. [DOI:10.1111/1552-6909.12300] [PMID]
19. Leustek J, Theiss J. Family communication patterns that predict perceptions of upheaval and psychological well-being for emerging adult children following late-life divorce. J Family Stud. 2017; 52(23):1-20. [DOI:10.1080/13229400.2017.1352531]
20. Sarenmalm EKh, Mårtensson L, Andersson B, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017; (2):1108-22. [DOI:10.1002/cam4.1052] [PMID] [PMCID]
21. Kollberg S, Wilderang U, Thorsteinsdottir T, Hugosson J, Wiklund P, Bjartell A, et al. Psychological Well-being and Private and Professional Psychosocial Support after Prostate Cancer Surgery: A Follow-up at 3, 12, and 24 Months after Surgery. Eur Urol Focus. 2015; (15):1-8. [DOI:10.1016/j.euf.2015.10.005] [PMID]
22. Vinayak S, Judge J. Resilience and Empathy as Predictors of Psychological Wellbeing among Adolescents. Int J Health Sci Res. 2018; 8(4):192-200.
23. Hu T, Xiao J, Peng J, Kuang X, He B. Relationship between resilience, social support as well as anxiety/depression of lung cancer patients: A cross‑sectional observation study. J Can Res Ther. 2018; (14):72-7. [DOI:10.4103/jcrt.JCRT_849_17] [PMID]
24. Chow M, Tang W, Chan W, Sit W, Choi K. Resilience and well-being of university nursing students in Hong Kong: a cross-sectional study. BMC Medical Education. 2018; (18):2-8. [DOI:10.1186/s12909-018-1119-0] [PMID] [PMCID]
25. Sagone E, De Caroli ME. Relationships between psychological well-being and resilience in middle and late adolescents. Procedia-Soc Behav Sci. 2014; (141):881-7. [DOI:10.1016/j.sbspro.2014.05.154]
26. Sisk D. Mindfulness and Its Role in Psychological Well-Being. Psych Res. 2017; 7(10):530- 5. [DOI:10.17265/2159-5542/2017.10.002]
27. Klainin-Yobas P, Ramirez D, Fernandez Z, Sarmiento J, Thanoi W. Examining the predicting effect of mindfulness on psychological well-being among undergraduate students: A structural equation modelling approach. Person Ind Differ. 2016; (91):63-8. [DOI:10.1016/j.paid.2015.11.034]
28. Bränström B, Kvillemo P, Brandberg Y, Moskowitz J. Self-report Mindfulness as a Mediator of Psychological Well-being in a Stress Reduction Intervention for Cancer Patients-A Randomized Study. Ann Behav Med. 2010; (39):151-61. [DOI:10.1007/s12160-010-9168-6] [PMID]
29. Grace A, Itunuoluwa A, Moyinoluwa O. Social Support and Personality Traits as Predictors of Psychological Wellbeing of Postpartum Nursing Mothers in Oyo State, Nigeria. Int J Car Sci. 2018; 11(2):704-18.
30. Katagami E, Tsuchiya H. Effects of Social Support on Athletes' Psychological Well-Being: The Correlations among Received Support, Perceived Support, and Personality. Psych. 2016; (7):1741-52. [DOI:10.4236/psych.2016.713163]
31. Rani K. Perceived Social Support and Psychological Well-Being: Testing the Unique Association and Gender Differences among Young Working Adults. Int J India Psych. 2016; 3(2):98-113. [DOI:10.25215/0302.065]
32. Olukolade O, Alao T, Adebisi A. The Role of social support and need for achievement on psychological well-being of below the knee amputees. IOSR J Hum Soc Sci. 2013; 18(1):23-7. [DOI:10.9790/0837-1812327]
33. Batool S, Ahmad A. Impact of Perceived Social Support on Psychological Well-being of Teenagers. Sci J Psych. 2013; 1-6. doi: 10.7237/sjpsych/267
34. Ahmadi S, Hosseini SM, Samani S. The Relationship between Family Communication Patterns and Adolescent Psychological Well-Being with Mediation of Identity Dimensions. Paper presented at The Second National Conference on Family Psychology. Tehran, Iran; 2014.
35. Akhbarati F, Bashardost S. Predicting psychological well-being based on family functioning and students' basic psychological needs. Special Proceedings of the Third International Conference on Psychology and Educational Sciences. 2017; 374-9.
36. Ullah F. Personality Factors as Determinants of Psychological Well-Being among University Students. Int J India Psych. 2017; 4(2):5-16.
37. Khanjani M, Shahidi Sh, Fathabadi J, Mazaheri MA, Shokri, O. Factor structure and psychometric properties of the Ryff's scale of Psychological well-being, short form (18-item) among male and female students. Thought Behav Clin Psych. 2014; 8(32):27-36.
38. Alipoor Z. The Effectiveness of Acceptance and Commitment-Based Education on Resiliency for Migraineurs. Thesis in Master of Science, Islamic Azad University, Hamadan Branch; 2015.
39. Anisi J, Majdian M, Joushan Lu M, Gohari Kamel Z. Validity and Reliability of the NEO Five-Factor Short Form Questionnaire in Students. J Behav Sci. 2011; 4(18):351 5.
40. Buchheld N, Grossman P, Walach H. Measuring mindfulness in insight meditation (Vipassana) and meditation- based psychotherapy: The development of the Freiburg Mindfulness Inventory (FMI). J Medit Medit Res. 2002; 1, 11-34.
41. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Person Soc Psych. 2003; 84, 822-48. [DOI:10.1037/0022-3514.84.4.822] [PMID]
42. Feldman G, Hayes A, Kumar S, Greeson J, Laurenceau J. Mindfulness and emotion regulation: The development and initial validation of the cognitive and affective mindfulness scalerevised (CAMS-R). J Psych Behav Assess. 2007; 29(3):177-90. [DOI:10.1007/s10862-006-9035-8]
43. Chadwick P, Hember M, Symes J, Peters E, Kuipers E, Dagnan, D. Responding mindfully to unpleasant thoughts and images: reliability and validity of the Southampton mindfulness questionnaire (SMQ). Brit J Clin Psych. 2008; 47(4):451-5. [DOI:10.1348/014466508X314891] [PMID]
44. Edwards DJA. Developing Evidence-Based Practice: The Role of Case-Based Research. Profession Psych: Res Practice. 2004; 35(6):589-97. [DOI:10.1037/0735-7028.35.6.589]
45. Salimi A, Jokar B, Nikpour R. Internet Communication in Life: Investigating the Role of Perceived Social Support and Loneliness in Internet Use. Psych Stud. 2009; 5(3):102-81.
46. Koshtaran T. The Relationship between Family Communication Patterns and Resilience in Shiraz University Students. Knowl Res Appl Psych. 2017; (39):43-55.
47. Gamst G, Guarino AH. Applied Multivariate Research (Design and Interpretation). Translated by H. Pasha Sharifi, V. Farzad, S. Rezakhani, H. Hassanabadi, B. Izanloo, M. Habibi editors. Tehran: Iran National Library; 2012.
48. Husted H. The Relationship Between Psychological Well-Being and Successfully Transitioning to University Undergraduate Honors Theses. London: King's University College at Western University Canada; 2017.
49. Cassidy O. The Effects of Mindfulness, Sociability, Self Control and Yoga on Mental Health. Submission of Thesis to Norma Smurfit Library, National College of Ireland; 2017.
50. Souri H, Hejazi E, Ejei M. The Relationship between Resilience and Psychological Well-Being: A Mediator of Optimism. Knowl Res Appl Psych. 2013; 15(1):5-15.
51. Goudarz M, Foroughan M, Makarem A, Rashedi V. Relationship between Social Support and Subjective Well-Being in Older Adults. Salmand: Iran J Age. 2015; 10(3):110-9.
52. Abutalebi F, Khamsan A, Rastegomqadam M. The Relationship between Perceived Social Support with Mental Well-being and Academic Achievement of Preschool Girls. J Edu Psych. 2017; 14(48):147-68.
53. Shaheen M, Schindler L, Saar‐Ashkenazy R, Bani Odeh K, Soreq H, Friedman A, et al. Victims of war-Psychoendocrine evidence for the impact of traumatic stress on psychological well‐being of adolescents growing up during the Israeli-Palestinian conflict. Psychophys. 2020; 57(1):e13271. [DOI:10.1111/psyp.13271] [PMID]

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