Social adjustment in Chinese women following breast cancer surgery

Abstract

PURPOSE: To describe the course of social adjustment among Chinese women following breast cancer surgery and to identify factors predicting the adjustment. METHODS: Prospective study of 405 Chinese women assessed at 3 days, one-month, four-months, and eight-months following breast surgery on measures of treatment decision making difficulty (TDMD), self-efficacy (GeS), optimism (C-LOT-R), consultation satisfaction (C-MISS-R), expectancy-outcome incongruence (E-OI), social adjustment (SAS) physical (PD) and psychological distress (CHQ-12). RESULTS: 303 women completed all data collection. With the exception of the subscale measuring Attractiveness & Sexuality (AS), the subscales of SAS - Family Relationship, Self-image, Relationships with Friends, and Social Enjoyment showed significant changes over time. Self-image (F = 3:58; df 2, p = 0:029) and Social Enjoyment (F = 26:89; df 2, p < 0.001) improved whereas Family Relationship (F = 26:19; df 2, p < 0.001) and Relationships with Friends (F = 3:61; df 2, p = 0:028) declined significantly over the illness trajectory. One-month social adjustment (Adjusted R2 = 0:23) was predicted by baseline psychological distress, self-efficacy, consultation satisfaction, and optimism; four-months social adjustment (Adjusted R2 = 0:27) was predicted by psychological distress, self-efficacy, consultation satisfaction, optimism, and E-OI; eight-months social adjustment (Adjusted R2 = 0:17) was predicted by psychological distress, self-efficacy, physical symptom distress, and TDM difficulties. CONCLUSION: Self-image and enjoyment of social activity improves over the 8 months post-surgery. Social relationship however declines over time, probably from a peak around the time of diagnosis. Women distressed at Baseline are at increased risk of poor social adjustment following breast cancer surgery for up to 8 months thereafter.