The relationship between resilience, quality of life, and body image in women with breast cancer undergoing chemotherapy

Document Type : Original Article

Authors

Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The diagnosis and treatment of breast cancer put women at risk of altered body image and quality of life (QOL).
Objectives: This study aimed to investigate the relationship between resilience, QOL, and body image in women with breast cancer undergoing chemotherapy.
Methods: This cross-sectional study was conducted in 2022 on 172 women with breast cancer referring to the chemotherapy department of Omid Hospital in Isfahan, Iran. Data were collected using a demographic data form, the Connor-Davidson Resilience Scale, the World Health Organization Quality of Life questionnaire (WHOQOL-BREF), and the Hopwood Body Image Scale (HBIS). The data were analysed using one-way analysis of variance, Pearson’s correlation, Spearman’s correlation, and multiple linear regression analysis.
Results: The mean total QOL score was 53.70±18.94. In addition, the mean resilience score was 69.83±14.52. The mean body image score was 8.23±6.65. Resilience was directly correlated with QOL (r=0.491, P<0.001). The psychological-spiritual dimension of QOL was a significant predictor for resilience (P<0.001). Resilience was inversely correlated with body image (r=-0.37, P<0.05).
Conclusion: The psychological-spiritual dimension of QOL was a significant predictor for resilience. Improving women’s resilience during chemotherapy can reduce their psychological symptoms and improve the QOL and body image of these patients.

Highlights

Elaheh Ashouri [Pubmed] [Google Scholar]

Keywords


  1. Gradishar WJ, Anderson BO, Abraham J, Aft R, Agnese D, Allison KH, et al. Breast Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020;18:452-78. doi:10.6004/jnccn.2020.0016 PMid:32259783
  2. Cancer Today. Global Cancer Observatory. Retrieved July 09, 2020, Available from: https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf [Last access date: December, 30 2022]
  3. Cancer Tomorrow. Global Cancer Observatory. Retrieved July 09, 2020, Available from:https://gco.iarc.fr/tomorrow/en/dataviz/isotype?cancers=20&single_unit=100000 [Last access date: December 30 2022]
  4. Alizadeh M, Ghojazadeh M, Piri R, Mirza-Aghazadeh-Attari M, Mohammadi S, Naghavi-Behzad M. Age at Diagnosis of Breast Cancer in Iran: A Systematic Review and Meta-Analysis. Iran J Public Health 2021;50:1564-76. doi: 10.18502/ijph.v50i8.6802PMid:34917527 PMCid:PMC8643522
  5. Iran, Islamic Republic of Fact Sheets. Global Cancer Observatory. Retrieved July 10, 2020, Available from:https://gco.iarc.fr/today/data/factsheets/populations/364-iran-islamic-republic-of-fact-sheets.pdf [Last access date: December, 30 2022]
  6. Matzo M, SHerman DW. Palliative Care Nursing: Quality Care to the End of Life. 5th ed: Springer Publishing Company; 2019. doi: 10.1891/9780826127198
  7. Wilkes GM, Barton-Burke M. 2020-2021 Oncology Nursing Drug Handbook. 23rd ed: Jones & Bartlett Learning; 2020.
  8. Hinkle JL, H.Cheever K, Overbaugh K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. 15th ed: LWW; 2022.
  9. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995;41:1403-9. doi:10.1016/0277-9536(95)00112-K PMid:8560308
  10. van Leeuwen M, Husson O, Alberti P, Arraras JI, Chinot OL, Costantini A, et al. Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire. Health Qual Life Outcomes 2018;16:114. doi:10.1186/s12955-018-0920-0 PMid:29866185 PMCid:PMC5987570
  11. Berman A, Snyder S, Frandsen G. Kozier & Erb's Fundamentals of Nursing Concepts, Process, and Practice. 11th ed: Pearson 2022.
  12. Pereira M, Moreira CS, Nogueira-Silva C, Izdebski P, Pereira MG. Breast cancer post-surgical impact on women's quality of life during chemotherapy treatment: A structural equation modelling approach. Eur J Cancer Care (Engl) 2021;30:e13349. doi:10.1111/ecc.13349
  13. Phoosuwan N, Lundberg PC. Psychological distress and health-related quality of life among women with breast cancer: a descriptive cross-sectional study. Support Care Cancer 2022;30:3177-86. doi:10.1007/s00520-021-06763-z PMid:34950961 PMCid:PMC8857009
  14. Ettridge K, Scharling-Gamba K, Miller C, Roder D, Prichard I. Body image and quality of life in women with breast cancer: Appreciating the body and its functionality. Body Image 2022;40:92-102. doi:10.1016/j.bodyim.2021.11.001 PMid:34902783
  15. Babić R, Babić M, Rastović P, Ćurlin M, Šimić J, Mandić K, et al. Resilience in Health and Illness. Psychiatr Danub 2020;32:226-32.
  16. Sisto A, Vicinanza F, Campanozzi LL, Ricci G, Tartaglini D, Tambone V. Towards a Transversal Definition of Psychological Resilience: A Literature Review. Medicina (Kaunas) 2019;55:745. doi:10.3390/medicina55110745 PMid:31744109 PMCid:PMC6915594
  17. Zhou K, Ning F, Wang X, Wang W, Han D, Li X. Perceived social support and coping style as mediators between resilience and health-related quality of life in women newly diagnosed with breast cancer: a cross-sectional study. BMC Womens Health 2022; 22:198. doi:10.1186/s12905-022-01783-1 PMid:35643446 PMCid:PMC9148478
  18. Boškailo E, Franjić D, Jurić I, Kiseljaković E, Marijanović I, Babić D. Resilience and Quality of Life of Patients with Breast Cancer. Psychiatr Danub 2021;33:572-9.
  19. Ristevska-Dimitrovska G, Filov I, Rajchanovska D, Stefanovski P, Dejanova B. Resilience and Quality of Life in Breast Cancer Patients. Open Access Maced J Med Sci 2015;3:727-31. doi:10.3889/oamjms.2015.128 PMid:27275317 PMCid:PMC4877917
  20. Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychol Med 1998;28:8-551. doi:10.1017/S0033291798006667 PMid:9626712
  21. Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh SR. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. J School of Public Health and Institute Public Health Res 2006;4:1-12.
  22. Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer 2001;37:189-97. doi:10.1016/S0959-8049(00)00353-1 PMid:11166145
  23. Rajabi G, Kaveh Farsani Z, Fadaei Dehcheshmeh H, Jelodari A. Psychometric Properties of the Persian version Scale of Body Image among Patients with Breast Cancer. Iran Breast Dis Q 2015; 8:66-74 .
  24. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003;18:76-82. doi:10.1002/da.10113 PMid:12964174
  25. Amini F. The relationship between resilience and burnout of nurses. J Res Dev Nurs Midw 2013;10:94-102.
  26. Schröder ML, Stöckigt B, Binting S, Tissen-Diabaté T, Bangemann N, Goerling U, et al. Feasibility and Possible Effects of Mindful Walking and Moderate Walking in Breast Cancer Survivors: A Randomized Controlled Pilot Study With a Nested Qualitative Study Part. Integr Cancer Ther 2022;21:15347354211066067. doi:10.1177/15347354211066067 PMid:35045736 PMCid:PMC8777370
  27. Gangane N, Khairkar P, Hurtig AK, San Sebastián M. Quality of Life Determinants in Breast Cancer Patients in Central Rural India. Asian Pac J Cancer Prev 2017;18:3325-32.
  28. Farahbakhshbeh S, Nejad SAM, Moazedian A. Predicting Self-Efficacy of Women with Breast Cancer based on Quality of Life, Religious Orientation, Resilience, Death Anxiety, Psychological Hardiness and Perceived Social Support. Iran J Health Psychol 2019;2:65-78.
  29. Taheri A, Falavarjani MF. Hope, self-efficacy, and perceived stress among Iranian women with breast cancer: Examining the mediating role of resilience. Middle East J Posit Psychol 2019;5:82-96
  30. Kiaei T, Makvandi B, Manesh FM, Hafezi F. The causal relationship between perceived stress, perceived social support, and resilience with emotional adaptation mediated by bodyimage of breast cancer patients. Razavi Int J Med 2021;9:81-6.
  31. Tu PC, Yeh DC, Hsieh HC. Positive psychological changes after breast cancer diagnosis and treatment: The role of trait resilience and coping styles. J Psychosoc Oncol 2020;38:156-70. doi:10.1080/07347332.2019.1649337 PMid:31625826
  32. Zhou K, Ning F, Wang W, Li X. The mediator role of resilience between psychological predictors and health-related quality of life in breast cancer survivors: a cross-sectional study. BMC Cancer 2022;22:57. doi:10.1186/s12885-022-09177-0 PMid:35022019 PMCid:PMC8756657
  33. Hsu H-T, Juan C-H, Chen J-L, Hsieh H-F. Mediator Roles of Social Support and Hope in the Relationship Between Body Image Distress and Resilience in Breast Cancer Patients Undergoing Treatment: A Modeling Analysis. Front Psychol 2021;12:695682. doi:10.3389/fpsyg.2021.695682 PMid:34630208 PMCid:PMC8498031
  34. Plitzko L, Mehnert-Theuerkauf A, Götze H. Resilience in Long-Term Cancer Survivors - Associations with Psychological Distress and Sociodemographic Characteristics. Psychother Psychosom Med Psychol 2020;70:182-9. doi:10.1055/a-0927-6782 PMid:31315142
  35. Bazzi AR, Clark MA, Winter MR, Ozonoff A, Boehmer U. Resilience Among Breast Cancer Survivors of Different Sexual Orientations. LGBT Health 2018;5:295-302. doi:10.1089/lgbt.2018.0019 PMid:29878863 PMCid:PMC6913098
  36. Wu TY, Chang TW, Chang SM, Lin YY, Wang J, Kuo YL. Dynamic Changes of Body Image and Quality of Life in Breast Cancer Patients. Cancer Manag Res 2019;11:10563-10571 doi:10.2147/CMAR.S223314 PMid:31908528 PMCid:PMC6925559