Treatment and Predicting Life Expectancy for Women with Breast Cancer Based on Perception of the Disease, Perceived Social Support, and Coping Styles

Today, cancer is a growing phenomenon that is recognized as one of the major problems for contemporary human health. Breast cancer is still the most common cancer among women in the world. Living with breast cancer presents women with significant challenges that interfere with their physical, social, psychological, economic and spiritual life of patients. These challenges are major factors that reduce the quality of life of women with breast cancer. One of the psychological components that plays a key role in the lives of these patients and their families is hope. Hope is a vital factor in predicting the adaptation of cancer patients to the nature of the disease and its treatment, especially when faced with the prospect of chronic pain. Low or no hope can threaten the patient's physical and mental health. Another important psychological component in coping with the disease is the perception of the disease. Perception of disease means the belief or image that patients have of their disease, which affects their adaptation to the disease and their psychological state. Understanding the causes of breast cancer can affect patients' ability to seek medical treatment; Because misconceptions may lead to search for alternative health care from unapproved sources. Another psychological factor related to life expectancy in patients is the availability and perception of social support. The availability of social support is considered a important source of coping that can help the patient to cope with life with cancer. Evidence from the research literature shows that social support from family, friends, and other important individuals is associated with reduced mental health problems such as depression, anxiety, and suicidal behaviors, and improved quality of life in women with breast cancer. Another important psychological component that people use when facing problems is coping styles. These styles that developed to reduce stress are important both in acute periods of stress (such as natural disasters) and in patients suffering from chronic illnesses such as depression, breast cancer, and HIV / AIDS. One of the most common styles for managing a challenging situation is trying to deal with and change the stressful stimulus; This strategy is called problem-oriented coping. Most research shows that people who use this style are more adaptable. On the other hand, research shows that people who use emotion-oriented and avoidance strategies experience higher stress and lower quality of life. Thus, the aim of this study was to determine the role of perception of disease, perceived social support and coping style in the life expectancy in women with breast cancer.

The method of the present study is descriptive-correlational. The statistical population is all patients with breast cancer in Ahvaz in 1398 that 60 patients volunteered to participate in the study by available sampling method. Inclusion criteria include 1- ability to read and write, 2- being between 31 to 70 years old, 3- having 2 to 3 years of illness, 4- undergoing chemotherapy without or before mastectomy, 5- Not having a history of psychiatric illness and being hospitalized in psychiatric wards and 6- Willingness to participate in research. In order to conduct the research, after obtaining the necessary permits and coordination with the relevant authorities from the two public hospitals of Baqaei and Golestan in an available method, 70 patients who met the research criteria were asked to complete the research tools. Due to the decrease in patients staying in the hospital during corona disease and the lack of cooperation of patients, the sample of this study was reduced from 70 volunteers to 60 patients. The tools used in this study included questionnaires of disease perception (Bradbent, 2006), multidimensional perceived social support (Zimt et al., 1998), coping styles in special situations (Billings & Moss, 1981) and  life expectancy (Schneider, 1991). In this study, multivariate regression was used to analyze the data.

The results showed that there is a negative and significant relationship between perception of disease and life expectancy (-0.78). Also, there is a significant relationship between predictor variables including social support, problem-oriented coping styles and emotion-oriented coping style with participants' life expectancy (0.80, 0.47 and -0.52, respectively). On the other hand, the relationship between avoidant coping style and participants' life expectancy was not significant (0.06 and 0.06, respectively). Also, the results of stepwise regression analysis indicate that the variables of social support and disease perception are the best predictors of life expectancy in patients with breast cancer, respectively.

The findings of this study showed that there is a positive and significant relationship between social support and life expectancy of breast cancer patients. Sun et al. Also found in their research that people who benefit from the social support of their relatives when faced with problems are more satisfied with life. Perceived social support affects patients' life expectancy in two ways. First, it can vaccinate a person before experiencing stress, thus reducing the harmful effects of stress. Second, it acts as a shield against the stress of the disease and makes the patient more satisfied with his life and hopes for positive consequences such as health and reducing the risk of disease. Also, this study showed that there is a significant positive relationship between problem-oriented coping style and life expectancy of breast cancer patients. When people believe that they have the ability to cope with stressful events such as illness, their anxiety is reduced and they can choose more effective coping strategies. Also, this study showed that the perception of the disease has a negative and significant relationship with life expectancy of women with breast cancer. Therefore, when patients have negative beliefs and perceptions of their disease and its various aspects, they experience physical and mental problems that can increase the burden of the disease for them and reduce their quality of life. Considering the importance of hope in the life and treatment of cancer patients, it is recommended that medical staff and psychologists pay attention to the role of life expectancy in their interventions and treatment protocol, especially in breast cancer patients.