Psychological Morbidity And Posttraumatic Growth Among Women With Breast Cancer In Nepal

Background and purpose:Struggle with highly adverse experiences like breast cancer has both negative and positive consequences. The purpose of this study is to investigate the prevalence of anxiety, depression and posttraumatic growth. And identify correlates and predictors of depression and posttraumatic growth among breast cancer patients in Nepal.Method:A cross-sectional descriptive design was used. Structured form for socio-demographic and disease related information of the participants, Hospital Anxiety and Depression Scale (HADS), Posttraumatic Growth Inventory (PTGI) were used to collect information from120participants. Study was carried out in various departments:out-patient department, chemo therapy department, radiation department, surgical department and palliative department of Bhaktapur cancer hospital, Nepal from May2013to August2013. Data were analyzed using a Statistical Package for Social Sciences (SPSS)16.Result:The mean age of respondents was51.92(S.D=10.1783). The mean depression score was11.266(S.D=2.782) and mean anxiety score was11.81(S.D=3.47).4.2%had severe depression,60%had moderated depression and29.2%respondents had mild levels of depression.15.8%of respondents had severe anxiety followed by48.3%of respondents having moderate anxiety and25%had mild form of anxiety. Depression was found to be negatively correlated with educational status of respondents (r=-0.226, P=0.013) and positively correlated with anxiety level of respondents (r=0.450, P=0.000). Educational status (P=0.008, B=-0.466and Beta=-0.212) along with anxiety level of respondents (P=0.000, B=0.369and Beta=0.461) accounts for30.4%of variance in depression level of respondents (F=25.494and R2=0.304).Mean PTG score was54.62(S.D=13.66).19.20%of respondents had no or low level of PTG and80.80%had moderate to high levels of PTG. Among the factors of PTG, majority of respondents (85.00%) shown growth in relating to others, followed by appreciation of life (74.20%), spiritual change (67.50%), personal strength (63.30%), and new possibilities (45.80%). Post traumatic growth was found to be positively correlated with educational status of respondents (r=0.220, P=0.016) and negatively correlated with year since diagnosis (r=-0.253, P=0.005), anxiety level of respondents (r=-0.286, P=0.002), depression level of respondents (r=-0.200, P=0.029) and age of respondents (r=-0.210, P=0.021). Age of respondents (P=0.003, B=-0.331and Beta=-0.247) and depression level of respondents (P=0.000, B=-1.968and Beta=-0.401) accounts for25.1%of variance in post traumatic growth of respondents.Series of regression analysis found that depression level, occupation and age of respondents accounted for23.00%of variance in growth in relating to others and23.10%in appreciation of life. Depression level and age accounted for22.30%of variance in growth in new possibilities,18.50%in personal strength.Conclusion:Screening for psychological morbidities in oncology patients is very important. Finding suggests negative correlation between anxiety and depression with PTG. Thus for the holistic treatment plan of cancer patient prompt screening along with psychological rehabilitation is required.