J Breast Cancer.  2010 Jun;13(2):219-226. 10.4048/jbc.2010.13.2.219.

Biopsychosocial Predictors of the Quality of Life in Breast Cancer Patients

• Ha EH
• Lee SH
• Jeong J
• Lee HD
• Lee JE
• Nam SJ
• Yang JH

• KMID: 2286549
• DOI: http://doi.org/10.4048/jbc.2010.13.2.219

Abstract

PURPOSE
The purpose of this study was to identify biopsychosocial predictors of the quality of life in breast cancer patients. Disease factors (disease stage, type of surgery, type of treatment, family history), personal factors (age, education level, income), and psychosocial factors (psychological symptoms, optimism, self-esteem, husband's support, cancer coping) were included in biopsychosocial predictors.
METHODS
A total of 128 breast cancer patients were recruited. Subjects were assessed by the Optimism Scale, the Selfesteem Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-BR23), the Symptom Checklist-90-Revision (SCL-90-R), and the Korean Cancer Coping Questionnaire (KCCQ).
RESULTS
Disease factors and personal factors were not different between the high and low quality of life group. But the psychosocial factors were significantly different. Somatization, anxiety, depression, interpersonal sensitivity, hostility, and phobic anxiety showed significantly lower scores in the high quality of life group than the low group. Optimism, self-esteem and husband's support showed significantly higher score in the high quality of life group than the low group. In a stepwise multiple regression analysis, not disease factors and personal factors but the psychosocial factors significantly predicted the quality of life in breast cancer patients. Especially, somatization and depression significantly predicted the quality of life.
CONCLUSION
Among psychosocial factors, somatization and depression were the most significant predictors of the quality of life in breast cancer patients. These results supported psychosocial intervention should be needed to breast cancer patients, in order to improve the quality of life.

Keyword

Breast neoplasms; Depression; Quality of life; Somatoform disorders

MeSH Terms

Anxiety
Breast
Breast Neoplasms
Depression
Hostility
Humans
Quality of Life
Somatoform Disorders
Surveys and Questionnaires

Reference

1. Fann JR, Thomas-Rich AM, Katon WJ, Cowley D, Pepping M, McGregor BA, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry. 2008. 30:112–126.

2. Korean Institute for Health and Social Affairs. Korea Regional Center for Health and Social Policy. 2006. Seoul: Korean Institute for Health and Social Affairs.

3. Wildes KA, Miller AR, de Majors SS, Ramirez AG. The religiosity/spirituality of Latina breast cancer survivors and influence on health-related quality of life. Psychooncology. 2009. 18:831–840.

4. Institute of Medicine. From Cancer Patients to Cancer Survivor: Lost in Transition. 2006. Washington, DC: Institute of Medicine and the National Research Council, National Academics Press.

5. Knobf MT. Psychosocial responses in breast cancer survivors. Semin Oncol Nurs. 2007. 23:71–83.

6. Suh YO. Predictors of quality of life in women with breast cancer. J Korean Acad Nurs. 2007. 37:459–466.

7. Jo KH. The relationship among personality, hope and quality of life of breast cancer patients. J Korean Acad Soc Nurs Educ. 2004. 10:115–124.

8. Shim JH, Park KS. A study on quality of life of those who have breast cancer patients taking chemotherapy. J Korean Acad Adult Nurs. 2004. 16:49–59.

9. Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol. 2005. 23:3322–3330.

10. So WK, Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, et al. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs. 2010. 14:17–22.

11. Arndt V, Stegmaier C, Ziegler H, Brenner H. Quality of life over 5 years in women with breast cancer after breast-conserving therapy versus mastectomy: a population-based study. J Cancer Res Clin Oncol. 2008. 134:1311–1318.

12. Whelan TJ, Levine M, Julian J, Kirkbride P, Skingley P. The effects of radiation therapy on quality of life of women with breast carcinoma: result of a randomized trial. Ontario Clinical Oncology Group. Cancer. 2000. 88:2260–2266.

13. Andritsch E, Dietmaier G, Hofmann G, Zloklikovits S, Samonigg H. Global quality of life and its potential predictors in breast cancer patients: an exploratory study. Support Care Cancer. 2007. 15:21–30.

14. Shapiro SL, Lopez AM, Schwartz GE, Bootzin R, Figueredo AJ, Braden CJ, et al. Quality of life and breast cancer: relationship to psychosocial variables. J Clin Psychol. 2001. 57:501–519.

15. Pedro LW. Quality of life for long-term survivors of cancer: influencing variables. Cancer Nurs. 2001. 24:1–11.

16. Carver CS, Smith RG, Petronis VM, Antoni MH. Quality of life among long-term survivors of breast cancer: different types of antecedents predict different classes of outcomes. Psychooncology. 2006. 15:749–758.

17. Yoo YS, Cho OH. Spouse support, sexual satisfaction and marital intimacy of post-mastectomy patients. J Korea Community Health Nurs Acad Soc. 2001. 15:148–156.

18. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977. 196:129–136.

19. Yun YH, Park Ys, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res. 2004. 13:863–868.

20. EORTC. EORTC-C30 Scoring Manual. 2001. 3rd ed. Brussels: EORTC.

21. Derogatis LR. SCL-90-R Manual I. 1977. Baltimore: Clinical Psychometrics Research Unit.

22. Kim KI, Kim JH, Won HT. Korean Manual of Symptom Checklist-90-Revision. 1984. Seoul: Chung Ang Aptitude Publishing Co..

23. Scheier MF, Carver CS. Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol. 1985. 4:219–247.

24. Park HS, Son JT. A study on the relationship between optimism and depression in chronic low-back pain patients. J Korean Acad Psychiatr Ment Health Nurs. 2001. 10:125–136.

25. Rosenberg M. Society and the Adolescent Self-Image. 1965. Princeton: Princeton University Press.

26. Jeon BJ. Self-esteem: a test of its measurability. Yonsei Nonchong. 1974. 11:109–129.

27. House JS. Work Stress and Social Support. 1981. Massachusette: Addison-Wesley.

28. Kim JN, Kwon JH. The efficacy of group psychotherapy for breast cancer patients: a preliminary study. Korean J Clin Psychol. 2005. 24:1–17.

29. Moorey S, Frampton M, Greer S. The Cancer Coping Questionnaire: a self-rating scale for measuring the impact of adjuvant psychological therapy on coping behavior. Psychooncology. 2003. 12:331–344.

30. Kim JN, Kwon JH, Kim SY, Yu BH, Hur JW. Validation of Korean Cancer Coping Questionnaire (K-CCQ). Korean J Health Psychol. 2004. 9:395–414.