The Status And Influencing Factors Of Family Resilience In Breast Cancer Patients

Objective:To understand the current status of family resilience of breast cancer patients through quantitative research,explore the correlation between family resilience of breast cancer patients and coping style,self-efficacy,family intimacy and adaptability,and social support,and analyze the family resilience of breast cancer patients influencing factors of breast cancer;further analyze the protective factors and risk factors of family resilience of breast cancer patients through qualitative research,verify and supplement the conclusions of quantitative research,so as to provide effective reference and scientific basis for the improvement of family resilience of breast cancer patients and the development of practical nursing interventions in clinical work.Methods:1.Quantitative research:The convenience sampling method was used to select 308inpatients with breast cancer who met the research standards from July 2019 to September2020 in a three-level general hospital in Guizhou Province.To general data Questionnaire,Family resilience rating scale,Medical Coping Modes Questionnaire（MCMQ）,Strategies Used by People to Promote Health（SUPPH）,Family Adaptability and Cohesion Evaluation Scales-Ⅱ（FACESII-CV）and Social Support Rating Scale（SSRS）as the research tools for patients with questionnaire survey.Used Excel software for data entry and SPSS18.0 statistical software for statistical analysis of data.The statistical methods involved included statistical description,nonparametric test,Spearman correlation analysis and multiple linear regression analysis.2.Qualitative research:Purpose sampling method was used to select 16 inpatient breast cancer patients who met the research standards in a two tertiary general hospital in Guizhou Province from October 2020 to December 2020 as interview subjects.Based on the principle of data saturation,semi-structured interviews were conducted,and the interview data were sorted and analyzed.The Colaizzi 7-step analysis method was used to analyze the protective factors and risk factors of family resilience of breast cancer patients.Results:1.Quantitative research results:（1）The median（quartile）of the total family resilience score of breast cancer patients,namely M(P₂₅～P₇₅),was 186（159～202）,and the ten dimensions of score indicators from high to low were as follows:Dilemma interpretation（77.43%）,intimacy and harmony（77.13%）,forward looking（75.77%）,problem solving（74.66%）,cooperation and coordination（74.08%）,orderly（72.75%）,clear communication（72.34%）,emotional sharing（71.41%）,social support（70.63%）,and life excellence（68.47%）.（2）Among the coping styles of breast cancer patients,the M(P₂₅～P₇₅)scores of confrontation,avoidant,and surrender were 19（16～21）,17（15～19）,and 11（9.25～13）,respectively.The score index of each dimension from high to low was:avoidant coping style（59.81%）,confrontation coping style（57.93%）,and surrender coping style（54.89%）.（3）The total score M(P₂₅～P₇₅)of breast cancer patients’self-efficacy was 82（73～100）,and the scores of each dimension were in descending order:self-decompression（63.31%）,self-decision-making（63.23%）,positive attitude（59.84%）.（4）The M(P₂₅～P₇₅)scores of family intimacy and family adaptability of breast cancer patients were 68（63～72）and 47（42～51.75）respectively.（5）The total score of M(P₂₅～P₇₅)of social support for breast cancer patients was 40（36.25～45）.（6）Results of single factor analysis:The differences in the total scores of family resilience among breast cancer patients’religious beliefs,medical insurance type,education level,family type,and disease diagnosis time were statistically significant（P<0.05）.（7）Correlation analysis results:confrontation coping style,total scores of self-efficacy,positive attitudes,self-decompression,family intimacy,family adaptability,total scores of social support and scores of various dimensions of breast cancer patients were all compared with the total scores of family resilience and two the scores of each subscale were positively correlated（r=0.261～0.620,P<0.01）,and the avoidant coping style was negatively correlated with the total family resilience score and the scores of the two subscales（r=-0.373～-0.402,P<0.01）.（8）Results of multiple linear regression analysis:A total of 8 variables entered the regression equation,including family intimacy,family adaptability,confrontation coping style,avoidant coping style,objective support,total score of self-efficacy,religious belief,The diagnosis time of the disease was≥12 months.These variables can explain 65.1%of the total variation in family resilience of breast cancer patients.2.Qualitative research results:（1）In terms of protective factors for family resilience of breast cancer patients,a total of 4themes and 15 sub-themes were extracted,of which four themes were:personal factors,family factors,social support and disease management.Among them,personal factors included optimism,life expectancy,and family factors included acceptance of illness,intimacy,flexibility,active communication,family experience,family responsibility,social support included support from relatives and friends,support from medical staff,support from patients,and other social support,disease management included control side effects of treatment,return to the hospital on time for treatment,review regularly.（2）In terms of risk factors for family resilience of breast cancer patients,5 themes were extracted:negative emotions,Family disharmony,lack of communication,family burden,disease trouble.Conclusion:1.The family resilience of breast cancer patients is at the upper-middle level.Among them,the dilemma interpretation score is the highest and the life excellence score is the lowest.2.The family resilience of breast cancer patients is mainly affected by family intimacy,family adaptability,confrontation coping style,avoidant coping style,objective support,total score of self-efficacy,religious belief,and time of diagnosis of the disease.From the standardized regression coefficients,it can be seen that family intimacy,family adaptability,and confrontation coping style have the greatest impact on the family resilience of breast cancer patients,that is,the better the family intimacy,the stronger the family adaptability,and the more the coping style to the disease,the higher the family resilience.3.Medical staff should identify the protective factors and risk factors for family resilience of breast cancer patients,and formulate intervention measures at the individual level,family level,social level,and disease treatment level to improve the family’s adaptability to the disease and the ability to cope with the disease.