OJN  Vol.4 No.3 , March 2014
The Predictors of Psychological Status among Primary Breast Cancer Patients in Japan
ABSTRACT

This study examined the psychological status of Japanese ambulatory patients with primary breast cancer, with a focus on evaluating the impact of the patients’ self-repressive trait and the role of previously identified associated factors, including social support, attributes, and disease-related variables. The subjects included 112 women [mean (SD) age: 58.3 (12.7)] in Japan with postoperative primary breast cancer. The results showed that around 40% of the subjects were in a psychologically vulnerable situation. In addition, the self-repressive trait and support from family were significant predictors of both anxiety [self-repressive trait (β = 0.30, p = 0.000) and family support (β = -0.37, p = 0.001)] and depression [self-repressive trait (β = 0.26, p = 0.002) and family support (β = -0.42, p = 0.000)], whereas attributes and disease-related variables were not. Health care providers need to recognize that self-repressive patients may seem to be well-adjusted when, in fact, they are suffering. Careful assessment of self-repression and psychological status is needed. Family support can contribute to a better psychological status of patients. Nurses need to encourage and provide support for not only the patients but also the family members so that family members can also effectively care for the patients’ needs.


Cite this paper
Maeda, T. , Morishima, I. , Ueno, E. , Umemoto, T. and Sasaki, K. (2014) The Predictors of Psychological Status among Primary Breast Cancer Patients in Japan. Open Journal of Nursing, 4, 169-180. doi: 10.4236/ojn.2014.43022.
References
[1]   Ministry of Health Labour and Welfare. (2013) Vital Statistics Japan.
http://ganjoho.jp/professional/statistics/statistics.html

[2]   Matsuda, A., Matsuda, T., Shibata, A., and the Japan Cancer Surveillance Research Group (2013) Cancer Incidence and Incidence Rates in Japan in 2007: A Study of 21 Population-Based Cancer Registries for the Monitoring of Cancer Incidence in Japan (MCIJ) Project. Japanese Journal of Clinical Oncology, 43, 328-336.
http://dx.doi.org/10.1093/jjco/hys233

[3]   Kornblith, A.B. and Ligibel, J. (2003) Psychosocial and Sexual Functioning of Survivors of Breast Cancer. Seminars in Oncology, 30,799-813.
http://dx.doi.org/10.1053/j.seminoncol.2003.08.025

[4]   Kugaya, A., Akechi, T., Okuyama, T., et al. (1998) Screening for Psychological Distress in Japanese Cancer Patients. Japanese Journal of Clinical Oncology, 28, 333-338. http://dx.doi.org/10.1093/jjco/28.5.333

[5]   Vahdaninia, M., Omidvari, S. and Montazeri, A. (2010) What Do Predict Anxiety and Depression in Breast Cancer Patients? A Follow-Up Study. Social Psychiatry and Psychiatric Epidemiology, 45, 355-361.
http://dx.doi.org/10.1007/s00127-009-0068-7

[6]   Andreu, Y., Galdón, M.J., Durá, E., et al. (2012) A Longitudinal Study of Psychosocial Distress in Breast Cancer: Prevalence and Risk Factors. Psychology Health, 27, 72-87. http://dx.doi.org/10.1080/08870446.2010.542814

[7]   Akechi, T., Okuyama, T., Imoto, S., et al. (2001) Biomedical and Psychosocial Determinants of Psychiatric Morbidity among Postoperative Ambulatory Breast Cancer Patients. Breast Cancer Res Treat, 65, 195-202.
http://dx.doi.org/10.1023/A:1010661530585

[8]   Watson, M., Greer, S., Rowden, L., et al. (1991) Relationships between Emotional Control, Adjustment to Cancer and Depression and Anxiety in Breast Cancer Patients. Psychological Medicine, 21, 51-57.
http://dx.doi.org/10.1017/S0033291700014641

[9]   Iwamitsu, Y., Shimoda, K., Abe, H., et al. (2005) Anxiety, Emotional Suppression, and Psychological Distress before and after Breast Cancer Diagnosis. Psychosomatics, 46, 19-24.
http://dx.doi.org/10.1176/appi.psy.46.1.19

[10]   Bardwell, W.A., Natarajan, L., Dimsdale, J.E., et al. (2006) Objective Cancer-Related Variables Are Not Associated with Depressive Symptoms in Women Treated for Early-Stage Breast Cancer. Journal of Clinical Oncology, 24, 2420-2427. http://dx.doi.org/10.1200/JCO.2005.02.0081

[11]   Nakatani, Y., Iwamitsu, Y., Kuranami, M., et al. (2012) Emotional Suppression and Psychological Responses to a Diagnosis of Breast Cancer. Shinrigaku Kenkyu, 83, 126-134.
http://dx.doi.org/10.4992/jjpsy.83.126

[12]   Schlatter, M.C. and Cameron, L.D. (2010) Emotional Suppression Tendencies as Predictors of Symptoms, Mood, and Coping Appraisals during AC Chemotherapy for Breast Cancer Treatment. Annals of Behavioral Medicine, 40, 15-29.
http://dx.doi.org/10.1007/s12160-010-9204-6

[13]   Munakata, T. (1996) Koudoukagaku kara mita kennkou to byouki [Health and Disease from the Perspective of Behavioral Science]. 2nd Edition, Medical-Friend Co, Tokyo.

[14]   Munakata, T. (1993) Perceived Stressor and Coping Behavior-Self-Growth Growth from “Iiko” Behavior. Journal of Mental Health, 39, 29-40.

[15]   Yoshida, M., Endo, K., Morita, M., et al. (2004) A Study on the Effects of a Support Group Program for Cancer Patients Open to Local Communities. Japanese Journal of Psychosomatic Medicine, 44, 133-140.

[16]   Fukui, S., Kugaya, A., Okamura, H., et al. (2000) A Psychosocial Group Intervention for Japanese Women with Primary Breast Cartinoma. Cancer, 89, 1026-1036.
http://dx.doi.org/10.1002/1097-0142(20000901)89:5<1026::AID-CNCR12>3.0.CO;2-5

[17]   Fukui, S., et al. (2003) The Effect of a Psychosocial Group Intervention on Loneliness and Social Support for Japanese Women with Primary Breast Cancer. Oncology Nursing Forum, 30, 823-830.
http://dx.doi.org/10.1188/03.ONF.823-830

[18]   Spiegel, D. and Classen, C. (2000) Group Therapy for Cancer Patients: A Research-Based Handbook of Psychosocial Care. Basic Books, United States.

[19]   Baucom, D.H., Porter, L.S., Kirby, J.S., et al. (2005-2006) Psychosocial Issues Confronting Young Women with Breast Cancer. Breast Disease, 23, 103-113.

[20]   Wenzel, L.B., Fairclough, D.L., Brady, M.J., et al. (1999) Age-Related Differences in the Quality of Life of Breast Carcinoma Patients after Treatment. Cancer, 86, 1768-1774.
http://dx.doi.org/10.1002/(SICI)1097-0142(19991101)86:9<1768::AID-CNCR19>3.0.CO;2-O

[21]   Kissane, D.W., Grabsch, B., Love, A., et al. (2004) Psychiatric Disorder in Women with Early Stage and Advanced Breast Cancer: A Comparative Analysis. Australian & New Zealand Journal of Psychiatry, 38, 320-326.
http://dx.doi.org/10.1080/j.1440-1614.2004.01358.x

[22]   Aapro, M. and Cull, A. (1999) Depression in Breast Cancer Patients: The Need for Treatment. Annals of Oncology, 10, 627-636. http://dx.doi.org/10.1023/A:1008328005050

[23]   Cohen, L., Hack, T.F., de Moor, C., et al. (2000) The Effects of Type of Surgery and Time on Psychological Adjustment in Women after Breast Cancer Treatment. Annals of Surgical Oncology, 7, 427-434.
http://dx.doi.org/10.1007/s10434-000-0427-9

[24]   Kornblith, A.B., Herndon, J.E., Zuckerman, E., et al. (2001) Social Support as a Buffer to the Psychological Impact of Stressful Life Events in Women with Breast Cancer. Cancer, 91, 443-454.
http://dx.doi.org/10.1002/1097-0142(20010115)91:2<443::AID-CNCR1020>3.0.CO;2-Z

[25]   Helgeson, V.S. and Cohen, S. (1996) Social Support and Adjustment to Cancer: Reconciling Descriptive, Correlational, and Intervention Research. Health Psychology, 15, 135-148. http://dx.doi.org/10.1037/0278-6133.15.2.135

[26]   Schroevers, M.J., Ranchor, A.V. and Sanderman, R. (2003) The Role of Social Support and Self-Esteem in the Presence and Course of Depressive Symptoms: A Comparison of Cancer Patients and Individuals from the General Population. Social Science & Medicine, 57, 375-385. http://dx.doi.org/10.1016/S0277-9536(02)00366-0

[27]   Lazarus, R. and Folkman, S. (1984) Stress, Appraisal, and Coping. Springer Publishing Co., New York.

[28]   Kitamura, T. (1993) Hospital Anxiety and Depression Scale. Seishinka Shindangaku, 4, 371-372.

[29]   Zimet, G.D., Dahlem, N.W., Zimet, S.G. and Farley, G.K. (1988) The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30-41. http://dx.doi.org/10.1207/s15327752jpa5201_2

[30]   Iwasa, H., Gondo, Y., Mausi, Y., et al. (2007) Reliability and Validity of the Japanese Version of the Multidimensional Scale of Perceived Social Support among Middle-Aged and Elderly People Living in a Japanese Community. Journal of Health and Welfare Statistics, 54, 26-33.

[31]   Zigmond, A.S. and Snaith, R.P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand, 67, 361-370.
http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x

[32]   Moorey, S., Greer, S., Watson, M., et al. (1991) The Factor Structure and Factor Stability of the Hospital Anxiety and Depression Scale in Patients with Cancer. British Journal of Psychiatry, 158, 255-259.
http://dx.doi.org/10.1192/bjp.158.2.255

[33]   Maeda, T., Onuoha, F.N. and Munakata, T. (2006) The Effect of Postoperative Symptom Experience, and Personality and Psychosocial Factors on Depression among Postgastrectomy Patients in Japan. Gastroenterology Nursing, 29, 437-444. http://dx.doi.org/10.1097/00001610-200611000-00002

[34]   Mårtensson, G., Carlsson, M. and Lampic, C. (2010) Are Cancer Patients Whose Problems Are Overestimated by Nurses Less Satisfied with Their Care? European Journal of Cancer Care, 19, 382-392.
http://dx.doi.org/10.1111/j.1365-2354.2009.01070.x

[35]   Mårtensson, G., Carlsson, M. and Lampic, C. (2008) Do Nurses and Cancer Patients Agree on Cancer Patients’ Coping Resources, Emotional Distress and Quality of Life? European Journal of Cancer Care, 17, 350-360.
http://dx.doi.org/10.1111/j.1365-2354.2007.00866.x

[36]   den Heijer, M., Vos, J., Seynaevem, C., Vanheusden, K., et al. (2012) The Impact of Social and Personal Resources on Psychological Distress in Women at Risk for Hereditary Breast Cancer. Psychooncology, 21, 153-160.
http://dx.doi.org/10.1002/pon.1879

[37]   Schmid-Büchi, S., Halfens, R.J., Dassen, T. and van den Borne, B. (2011) Psychosocial Problems and Needs of Posttreatment Patients with Breast Cancer and Their Relatives. European Journal of Oncology Nursing, 15, 260-266.
http://dx.doi.org/10.1016/j.ejon.2009.11.001

[38]   Heidari Gorji, M.A., Bouzar, Z., Haghshenas, M., Kasaeeyan, A.A, Sadeghi, M.R. and Ardebil, M.D. (2012) Quality of Life and Depression in Caregivers of Patients with Breast Cancer. BMC Research Notes, 20, 310.

 
 
Top