✅ 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.
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
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.
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 |
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 |
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 |
Source of change | Estimation | Low limit | High limit | Level of significance |
Psychological well-being | 0.333 | 0.250 | 0.381 |
0.024 |
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 |
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.
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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