Psychosocial Adjustment between Younger and Older Breast Cancer Survivors

A hermeneutic phenomenological study on the disease experience among young women with breast cancer

Objective

Women diagnosed with breast cancer under the age of 40 face distinctive physical and psychosocial challenges resulting from the disease's pathological features and the developmental aspects associated with their youth. This study aims to investigate the lived experience of breast cancer among this group of young women.

Methods

Participants were purposefully selected from online communities and chat rooms in South Korea. A total of 15 young women with breast cancer were included in this study, and data were gathered through three focus group interviews. The interviews were transcribed verbatim and analyzed using the hermeneutic phenomenology method.

Results

Four essential themes emerged based on four lifeworld existentials: lived body, lived time, lived space, and lived others. These four essential themes were: a wounded and sick body, life robbed of youth and elderly years, crossroads of growth discovered at life's extremes, and a steadfast companion on a solitary journey.

Conclusions

Young women with breast cancer face unique challenges due to the intersection of a severe illness and its impact during their formative years. This study offers valuable insights for crafting customized interventions that directly target the physical and psychosocial requirements of young breast cancer survivors, ultimately enhancing their quality of life.

[The Experience of Gynecologic Cancer in Young Women: A Qualitative Study]

PURPOSE

This study aimed to understand the experiences of women under 40 years of age with gynecologic cancer.

METHODS

Semi-structured individual in-depth interviews were conducted with 14 Korean female patients aged 21~39 years with gynecologic cancer. The data were analyzed using Corbin and Strauss' grounded theory approach, including open coding, context analysis, and integrating categories.

RESULTS

Grounded theory analysis revealed nine categories and a core category of 'the journey to find my life after losing the life as a typical woman.' The categories that emerged as the conditions are 'Unwelcomed guest, cancer,' 'Completely devastated life as an ordinary woman,' 'Uncertain future,' 'Losing my physical characteristics as a woman,' and 'Life tied with treatments.' The actions/interactions were'Decrease of interpersonal relationships,' 'A lonely battle to overcome alone,' and 'The power to overcome hardships.' The consequence was 'Live my own life.'

CONCLUSION

This study contributes to the development of a substantive theory of the experience of gynecologic cancer in young women, which has been on the rise in recent years. The study's results are expected to be used as a basis for providing nursing care to help young women with gynecologic cancer adapt to their disease.

Convalescent Hospital Use among Young and Older Female Cancer Survivors

This study analyzed national health data to assess convalescent hospital use among female cancer survivors according to age group. This retrospective study collected data from women recovering from breast, colon, and stomach cancer, based on health insurance claim data over 5 years (2013-2017), from the Korea Health Insurance Review and Assessment Service (KHIRA). Interestingly, the number of young and older women who were treated in convalescent hospitals increased every year. In addition, total medical expenses increased in both groups. The annual rate of convalescent hospitalization was higher in older women (8.29~16.39%) than in younger women (4.01~7.46%). The total yearly medical expenses of cancer survivors in convalescent hospitals increased in both age groups and all cancer types, and the range of increase rate was from 7.7% in young breast cancer survivors to 32.2% in young colon cancer survivors. Visit days and days of medication increased noticeably in young colon cancer survivors. Taken together, these data have confirmed the importance of developing standard guidelines for inpatient management in convalescent hospitals and the health management of women cancer survivors by cancer type. This includes establishing a health management system and medical policies.

Stress, Social Support, and Sexual Adjustment in Married Female Patients with Breast Cancer in Korea

OBJECTIVE

This study identified the level of stress, social support, and sexual adjustment in married women with breast cancer in Korea.

METHODS

This study used a subgroup analysis, prospective, cross-sectional, and descriptive correlation design. Data were obtained using the perceived stress scale, multidimensional scale of perceived social support, and sexual adjustment subscale of the Korean version of the psychosocial adjustment to illness scale. From May 2015 to April 2016, 272 married female patients who had been diagnosed with breast cancer were recruited at a university hospital in Korea. Data were analyzed using SPSS Win 21.0.

RESULTS

The mean score of stress level was 17.53 ± 4.13, social support was 5.37 ± 1.07, and sexual adjustment was 6.36 ± 3.29. A significant positive correlation emerged between sexual adjustment and stress (r = 0.161, P = 0.008). Significant negative correlations were observed among sexual adjustment and family support (r = -0.177, P = 0.003) and friends' support (r = -0.205, P = 0.001).

CONCLUSIONS

The assessment of stress level and social support may be used in planning sexual-adjustment interventions appropriate for married female breast cancer patients in Korea.

Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor

PURPOSE

To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor.

METHODS

With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression.

RESULTS

The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were 1.57±0.51, 0.37±0.64, 3.62±0.67, and 4.00±0.45, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment.

CONCLUSION

In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.