Quality of life, interpersonal relationships and coping strategies of the women with breast cancer and their husbands

Che Mohd Yusoff, Mohd Nasir (2009) Quality of life, interpersonal relationships and coping strategies of the women with breast cancer and their husbands. PhD thesis, University of Malaya.

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Official URL: http://dspace.fsktm.um.edu.my/handle/1812/497


Psychosocial morbidity such as the quality of life impairment; change in the pattern of interpersonal relationship and coping behavior are consequences of breast cancer on women’s life and their significant other, i.e. husband. The first objective of this study was to examine the effects of the treatment phases (prior-to, during and post-chemotherapy) on the quality of life (QOL), interpersonal relationship (IR) and coping strategies (C) of women with breast cancer and their husbands, as well as to examine the patterns and levels of QOL, IR and C among these couples, following breast cancer surgery. Secondly, it was done to observe the effects of the medical factors (types of surgery and breast cancer stages) and bio/socio-demographic factors (menopausal status and ethnicity) on the QOL, IR and C of the women with breast cancer and their husbands. Thirdly, it was done to determine factors predictive of women’s global health status, sexual attractiveness, relationship satisfaction and coping strategy post-chemotherapy. This study was carried out prospectively with three times evaluation: Phase one/ prior-chemotherapy following breast cancer surgery (seven weeks after diagnosis or three weeks after surgery), Phase two/ during chemotherapy (14 weeks after diagnosis or 10 weeks after surgery) and Phase three/ post-chemotherapy (23 weeks after diagnosis or 19 weeks after surgery). One hundred and fifty seven women with breast cancer (mean age: 48.29±8.85sd) and 157 husbands (52.21±9.01sd) participated in this study. Majority of the women had undergone mastectomy (79.4%, n=127). Over half of the women were diagnosed with stage two of breast cancer (56.9%, n=91). Various standardized self-administrated scales were used: Quality of life evaluation [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30), Breast Module (QLQ BR-23), Hospital Anxiety and Depression Scale (HADS), Blatt Menopausal Index (BMI)], Sexuality evaluation [Body Image Scale (BIS) and Sexual Attractiveness: Body Esteem Scale (SABES)], interpersonal relationship evaluation [Inventory of Socially Supportive Behaviour (ISSB), Level of Disclosure, Helpfulness of Disclosure, Criticism, Withdrawal, Empathy: Revised Barrett-Lennard Relationship Inventory (E-RBLRI), Dyadic Satisfaction: Dyadic Adjustment Scale (DS-DAS)] and coping strategy evaluation [Brief COPE]. Husbands answered similar scales for HADS, DS-DAS and Brief COPE and some scales were modified for this purpose. All scales were translated and validated locally to cater for the multicultural ethnicity of the Malaysian population. Medical and bio/socio-demographic data were also gathered. Results showed that couples’ psychological aspect (anxiety and depression), relationship satisfaction and most of the coping strategies (Active Coping, Planning, Positive Reframing, Acceptance, Using Emotional Support, Using Instrumental Support, Denial, Venting, Self-blame, Emotion-focused Strategies and Problem-focused Strategies) exhibited significant effects of time, where women obtained higher scores in all aspects than their husbands. Nevertheless, the types of surgery and breast cancer stages did not affect couples’ psychological aspect, relationship satisfaction and their coping strategies, the fact which contradicts with the menopausal status and ethnicity. The significant effect of time was also observed for the main domains of quality of life i.e. Global Health Status, Physical Functioning, Role Functioning, Emotional Functioning and Social Functioning, sexuality (body image and attractiveness), as well as their interpersonal relationship aspects (Perceived Husband Support, Level of Disclosure, Empathy, Criticism and Withdrawal). The regression model indicated that women’s depression was predictive of their global health status. Women’s sexual attractiveness was predicted by their body image and anxiety; as well as their husbands’ view on their sexual attractiveness and body image. Meanwhile, women’s relationship satisfaction was predicted by their depression, perceived husband’s support, empathy, helpfulness of disclosure, husbands’ relationship satisfaction and husbands’ perceived providing support. Women’s age and their perceived husband’s support are predictive of their problemfocused strategy. In conclusions, the treatment phases of chemotherapy, following breast cancer surgery, were revealed to have significant impacts on the quality of life, interpersonal relationship and coping strategies of women with breast cancer and their husbands, with the similar patterns over the time. Bio/socio-demographic factors such as menopausal status and ethnicity are important determinants in these psychosocial aspects of breast cancer. Healthcare organizations should implement broaden breast health-related programmes targeting the family of women with breast cancer.

Item Type: Thesis (PhD)
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine, Health and Life Sciences > School of Medicine
Date Deposited: 23 Jul 2013 06:24
Last Modified: 23 Jul 2013 06:24
URI: http://repository.um.edu.my/id/eprint/1021

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