| Summary: | 博士 === 國立台北護理學院 === 護理研究所 === 97 === The growing prevalence rate of breast cancer is alarming. The susceptible age of breast cancer was changed more and more young. Many risk factors are involved with breast cancer, whereas psychological impact of cancer is still a controversial factor to breast cancer. To study the relationship between psychological factors and breast cancer development was faced methodological handicap as lack of standard measurements, few sample or confounders of cases suspicious of their breast cancer diagnosis before research. To overcome a number of research methodological issues, this study aimed to explore the psychological factors associated with breast cancer development, conduct the qualitative research with new diagnosed breast cancer women of their stress experience, and then to develop a stress scale.
In Phase I, a cross-sectional design was used to explore the relationship between breast cancer and stress development. Research participants were recruited from the outpatient department of a medical center. Stress, anxiety, and depression data were collected. The t test, Pearson correlation, multiple logistic regressions, odds ratio was used to analyze data. In Phase II, a qualitative method was used to interview newly diagnosed breast cancer women to understand their stress experiences and then develop a questionnaire. Research participants were recruited from the breast surgical ward of a medical center. Before operation, in-depth interview were administered under a semi-structured questionnaire. Content analysis was use to analyze data. In Phase III, a methodological design was used to test reliability and validity of developed questionnaire. The newly diagnosed breast cancer women were recruited from the breast surgical ward of a medical center. Internal consistency reliability, content validity, expert validity, and exploratory factor analysis were test to establish reliability and validity.
Cases were sampled form Oct 2008. to April 2009, including 1160 mammography screening women, 20 newly diagnosed breast cancer women interviewed, and 125 newly diagnosed breast cancer women tested by the new questionnaire. Results were: 1) Relationship existed between breast cancer risk and educational levels. 2) After adjusting education, psychological factors served as breast cancer predictors. 3) Newly diagnosed breast cancer women experienced suffering from cancer, adjusting life, facing challenge, being afraid of cancer, negative moods, insomnia, impact on the attractiveness and socialization, life change, and worrying about treatment, families, jobs, and future. To collect information and to choose good reputation hospitals/physicians to build up confidence were also involved. 4) The new stress questionnaire (Stress of Newly Diagnosed Breast Cancer Scale, SNDBCS) was categorized four factors: unpredictable feelings, uncontrollable feelings, overloaded feelings, and challenged feelings. Internal consistency reliability showed Cronbach’s α=0.84, criterion validity showed r=0.46 (p<0.001) with a SPSS-10 stress scale, and r=0.57 (p<0.001) with HADS-14 anxiety, r= 0.35 (p<0.001) with depression scale.
This study recommends that psychological health of women should be strengthened. As to women in newly diagnosed breast cancer, professionals should provide adequate interventions depending on the finding of woman’s stress perception and experience. For measuring breast cancer women stress, the SNDBCS with reliability and validity can effectively facilitate the professionals assess reference to breast cancer.
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