The Relationship among Inner Strength, Depression, and Time since Diagnosis to Quality of Life and Health Promoting Behaviors in Female Cancer Survivor

Background.;The evolving focus of cancer survivorship research includes the physical, psychosocial, and emotional issues of cancer from diagnosis through the end of life and the promotion of health within cancer as a chronic illness. The primary goal of survivorship care is to provide individuals the best chance for healthy living by identifying ways to prevent suffering and improve strategies to increase overall well-being and quality of life (QOL). There is increasing interest in cancer survivors' QOL and the improvement in long-term effects of cancer and its treatment. This study intended to explain the relationship of the independent variables inner strength, depression, and time since diagnosis with the dependent variables QOL, and health promotion activities in female cancer survivors. This relationship was explored utilizing the guiding framework of the Theory of Inner Strength.;Methods.;Eligibility requirements for this non-experimental, descriptive study included adult females with cancer who were more than six months and less than five years since treatment. Recruitment for subjects included in-person and online efforts using local and national organizations as well as snowball sampling. This study utilized the survey collection platform Survey MonkeyRTM for data collection and storage. Data collection instruments included a demographic survey as well as the Inner Strength Questionnaire, Quality of Life-Cancer Survivor, Center for Epidemiologic Studies of Depression -- Revised, and Health Promoting Lifestyle Profile-II. Following the collection of data, data analysis consisted of descriptive, correlational, and multiple regression analyses.;Results.;Findings indicated high levels of inner strength, moderate levels of health promotion activities and quality of life, and low levels of depression in this study sample of 118 women who met the eligibility criteria. The relationships among inner strength (r = .44, p < 0.001), depression (r = 0.47, p < 0.001), and time since diagnosis (r = -0.26, p < 0.01) to QOL were all found to be significant, both separately and together (r = 0.68, p < 0.001). Although the relationships between time since diagnosis and QOL were statistically significant, the strength of this relationship was weak. The relationships among inner strength (r = .55, p < 0.001) and depression (r = 0.39, p < 0.001) to health promoting activities were found to be significant, both separately and together (r = .66, p < 0.001). The relationship of time since diagnosis to health promoting activities was not found to be significant and the relationship between QOL and health promotion were also not found to be significant.;Demographic data was described in this chapter and demonstrated that subjects from this study were not representative of the United States population and included primarily college/graduate school educated Caucasian women with incomes over $75,000/year. This is consistent with the literature that has found enrollment in research studies in the United States to inadequately represent minorities and socioeconomically disadvantaged population. Research has demonstrated that socially advantaged individuals experience higher levels of health and well-being, suggesting that this subject sample may be experiencing improved emotional health related to their advantaged socioeconomic status. Given the homogenous nature of the sample, the findings of this sample need to be interpreted with caution.;Implications.;The results of this study support the premise that women who experience inner strength have enhanced QOL and health promoting behaviors. Approaching female cancer survivors from an assumption of strength rather than a focus on weakness can help nurses to positively affect the outcome of maximal QOL and wellness beyond treatment for cancer. Nurses are ideally situated to assess the motivational and emotional factors related to survivor engagement in maximizing QOL through health promotion activities. Understanding the role of inner strength is likely to assist nurses and other healthcare providers in identifying and facilitating positive coping styles and strategies for women with cancer. Understanding ways to facilitate inner strength may be valuable for women as they move through the survivorship process. This study contributes to the body of knowledge on inner strength in female cancer survivors and it is hoped that this will result in improved health and QOL in this population.