Factors related to preoperative uncertainty among patients with breast cancer in Wenzhou, China: A cross-sectional study
PDF
XML

Keywords

breast neoplasms
uncertainty
anxiety
illness perception
social support
nurses
China

How to Cite

Shen, H., Masingboon, K., & Samartkit, N. (2023). Factors related to preoperative uncertainty among patients with breast cancer in Wenzhou, China: A cross-sectional study. Belitung Nursing Journal, 9(3), 236–243. https://doi.org/10.33546/bnj.2648
Crossref
Scopus
Google Scholar

Link to Google Scholar

Accepted for publication: 2023-06-02
Peer reviewed: Yes

Related articles in


Search Relations - Article by Author(s)

Share this article on:

Abstract

Background: One of the most prevalent psychological signs of breast cancer is uncertainty, which is more prevalent in Chinese patients during the preoperative period. Despite the numerous factors contributing to preoperative uncertainty, there is limited relevant research conducted in China.

Objective: This study aimed to describe the current state of preoperative uncertainty and to investigate the relationship between anxiety, illness perception, social support, and preoperative uncertainty in patients with breast cancer in Wenzhou, China.

Methods: This cross-sectional research used a simple random sampling technique to select 122 participants from a university hospital in Wenzhou, China, from July 2022 to December 2022, employing validated instruments. Descriptive statistics and Pearson’s correlation coefficient were utilized to analyze the data.

Results: The average preoperative uncertainty scores of the patients fell within a moderate range (M = 61.92, SD = 7.51). Significant correlations were found between anxiety (r = 0.638, p <0.01), illness perception (r = 0.704, p <0.01), social support (r = -0.481, p <0.01), and preoperative uncertainty.

Conclusions: The results can assist healthcare professionals, especially nurses, in recognizing the factors contributing to uncertainty before surgery in patients with breast cancer. This knowledge enables them to promptly address and minimize this issue, leading to improved outcomes.

https://doi.org/10.33546/bnj.2648
PDF
XML

Copyright

Copyright (c) 2023 Huaiyu Shen, Khemaradee Masingboon, Niphawan Samartkit

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 379 [Abstract: 182 | PDF: 183 | XML: 14 ]

Downloads

Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

All authors declared no potential conflict of interest in this study.

Acknowledgment

The authors acknowledge Burapha University, Thailand, and the First Affiliated Hospital of Wenzhou Medical University, China, for supporting this study. Our sincere gratitude also goes to the participants of this study for their kind cooperation.

Authors’ Contributions

All authors contributed substantially to the conception and design of the study, acquisition of data, and analysis and interpretation of data. Additionally, all authors drafted or revised the manuscript critically for important intellectual content and approved the final version.

Data Availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


References

Ahadzadeh, A. S., & Sharif, S. P. (2018). Uncertainty and quality of life in women with breast cancer: Moderating role of coping styles. Cancer Nursing, 41(6), 484-490. https://doi.org/10.1097/NCC.0000000000000552

Ahn, S. K., Oh, S., Kim, J., Choi, J.-S., & Hwang, K.-T. (2022). Psychological impact of type of breast cancer surgery: A national cohort study. World Journal of Surgery, 46(9), 2224-2233. https://doi.org/10.1007/s00268-022-06585-y

Akoglu, H. (2018). User's guide to correlation coefficients. Turkish Journal of Emergency Medicine, 18(3), 91-93. https://doi.org/10.1016/j.tjem.2018.08.001

American Psychological Association. (n.d.). Anxiety. https://www.apa.org/topics/anxiety

Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52(2), 69-77. https://doi.org/10.1016/S0022-3999(01)00296-3

Blackman, I., Henderson, J., Willis, E., Hamilton, P., Toffoli, L., Verrall, C., Abery, E., & Harvey, C. (2015). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. https://doi.org/10.1111/jocn.12688

Boehmke, M. M., & Dickerson, S. S. (2006). The diagnosis of breast cancer: Transition from health to illness. Oncology Nursing Forum,, 33(6), 1121-1127. https://doi.org/10.1188/06.ONF.1121-1127

Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research, 60(6), 631-637. https://doi.org/10.1016/j.jpsychores.2005.10.020

Bujang, M. A., & Baharum, N. (2017). A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: A review. Archives of Orofacial Science, 12(1), 1-11.

Carr, T., Teucher, U., & Casson, A. G. (2017). Waiting for scheduled surgery: A complex patient experience. Journal of Health Psychology, 22(3), 290-301. https://doi.org/10.1177/1359105315603464

Chen, L.-W., Chou, H.-H., Wang, S.-Y., & Shih, W.-M. (2022). Unmet care needs and uncertainty in patients newly diagnosed with breast cancer. Healthcare, 10(11), 2148. https://doi.org/10.3390/healthcare10112148

Chen, T.-Y., Kao, C.-W., Cheng, S.-M., & Chang, Y.-C. (2018). Uncertainty and depressive symptoms as mediators of quality of life in patients with heart failure. PloS One, 13(11), e0205953. https://doi.org/10.1371/journal.pone.0205953

Cheng, J. Y. J., Wong, B. W. Z., Chin, Y. H., Ong, Z. H., Ng, C. H., Tham, H. Y., Samarasekera, D. D., Devi, K. M., & Chong, C. S. (2021). Preoperative concerns of patients undergoing general surgery. Patient Education and Counseling, 104(6), 1467-1473. https://doi.org/10.1016/j.pec.2020.11.010

Cohen, M., Yagil, D., Aviv, A., Soffer, M., & Bar-Sela, G. (2022). Cancer patients attending treatment during COVID-19: Intolerance of uncertainty and psychological distress. Journal of Cancer Survivorship, 16(6), 1478-1488. https://doi.org/10.1007/s11764-021-01126-3

Drageset, S., Lindstrøm, T. C., Giske, T., & Underlid, K. (2011). Being in suspense: Women’s experiences awaiting breast cancer surgery. Journal of Advanced Nursing, 67(9), 1941-1951. https://doi.org/10.1111/j.1365-2648.2011.05638.x

Global Cancer Observatory. (2022). Cancer today. https://gco.iarc.fr/today/

Guan, N. C., Seng, L. H., Hway Ann, A. Y., & Hui, K. O. (2015). Factorial validity and reliability of the Malaysian Simplified Chinese Version of Multidimensional Scale of Perceived Social Support (MSPSS-SCV) among a group of university students. Asia Pacific Journal of Public Health, 27(2), 225-231. https://doi.org/10.1177/1010539513477684

Guan, T., Santacroce, S. J., Chen, D. G., & Song, L. (2020). Illness uncertainty, coping, and quality of life among patients with prostate cancer. Psycho‐Oncology, 29(6), 1019-1025. https://doi.org/10.1002/pon.5372

Hawrot, K., Shulman, L. N., Bleiweiss, I. J., Wilkie, E. J., Frosch, Z. A. K., Jankowitz, R. C., & Laughlin, A. I. (2021). Time to treatment initiation for breast cancer during the 2020 COVID-19 pandemic. JCO Oncology Practice, 17(9), 534-540. https://doi.org/10.1200/OP.20.00807

Hernández-Cruz, R., Moreno-Monsiváis, M. G., Cheverría-Rivera, S., & Díaz-Oviedo, A. (2017). Factors influencing the missed nursing care in patients from a private hospital. Revista Latino-Americana de Enfermagem, 25. https://doi.org/10.1590/1518-8345.1227.2877

Inan, F. Ş., Günüşen, N. P., & Üstün, B. (2016). Experiences of newly diagnosed breast cancer patients in Turkey. Journal of Transcultural Nursing, 27(3), 262-269. https://doi.org/10.1177/1043659614550488

Ismail, Z., So, W. K.-w., & Li, P. W.-c. (2010). Preoperative uncertainty and anxiety among Chinese patients with gynecologic cancer. Oncology Nursing Forum, 37(1), E67-E74.

Kagan, I., & Bar‐Tal, Y. (2008). The effect of preoperative uncertainty and anxiety on short‐term recovery after elective arthroplasty. Journal of Clinical Nursing, 17(5), 576-583. https://doi.org/10.1111/j.1365-2702.2007.01968.x

Kaptein, A. A., Schoones, J. W., Fischer, M. J., Thong, M. S. Y., Kroep, J. R., & van der Hoeven, K. J. M. (2015). Illness perceptions in women with breast cancer—a systematic literature review. Current Breast Cancer Reports, 7, 117-126. https://doi.org/10.1007/s12609-015-0187-y

Karabulutlu, E. Y., Avcı, İ. A., Karayurt, Ö., Gürsoy, A., Köşgeroğlu, N., Tuna, A., Ersin, F., Arıkan, F., & Karaman, S. (2019). Evaluation of illness perception of women with breast cancer in Turkey. European Journal of Breast Health, 15(2), 98-104. https://doi.org/10.5152/ejbh.2019.4317

Katsohiraki, M., Poulopoulou, S., Fyrfiris, N., Koutelekos, I., Tsiotinou, P., Adam, O., Vasilopoulou, E., & Kapritsou, M. (2020). Evaluating preoperative anxiety levels in patients undergoing breast cancer surgery. Asia-Pacific Journal of Oncology Nursing, 7(4), 361-364. https://doi.org/10.4103/apjon.apjon_31_20

Kim, J., Cho, J., Lee, S. K., Choi, E.-K., Kim, I.-R., Lee, J. E., Kim, S. W., & Nam, S.-J. (2020). Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study. Annals of Surgical Treatment and Research, 98(5), 215-223. https://doi.org/10.4174/astr.2020.98.5.215

Kim, S. H., Lee, R., & Lee, K. S. (2012). Symptoms and uncertainty in breast cancer survivors in Korea: Differences by treatment trajectory. Journal of Clinical Nursing, 21(7‐8), 1014-1023. https://doi.org/10.1111/j.1365-2702.2011.03896.x

Knight, L. K., & Depue, B. E. (2019). New frontiers in anxiety research: The translational potential of the bed nucleus of the stria terminalis. Frontiers in Psychiatry, 10, 510. https://doi.org/10.3389/fpsyt.2019.00510

Lee, I., & Park, C. (2020). The mediating effect of social support on uncertainty in illness and quality of life of female cancer survivors: A cross-sectional study. Health and Quality of Life Outcomes, 18(1), 143. https://doi.org/10.1186/s12955-020-01392-2

Lee, S. H., Kim, Y.-S., Han, W., Ryu, H. S., Chang, J. M., Cho, N., & Moon, W. K. (2016). Tumor growth rate of invasive breast cancers during wait times for surgery assessed by ultrasonography. Medicine, 95(37), e4874. https://doi.org/10.1097%2FMD.0000000000004874

Leonhart, R., Tang, L., Pang, Y., Li, J., Song, L., Fischer, I., Koch, M., Wuensch, A., Fritzsche, K., & Schaefert, R. (2017). Physical and psychological correlates of high somatic symptom severity in Chinese breast cancer patients. Psycho‐Oncology, 26(5), 656-663. https://doi.org/10.1002/pon.4203

Liao, M.-N., Chen, M.-F., Chen, S.-C., & Chen, P.-L. (2008). Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer. Cancer Nursing, 31(4), 274-283. https://doi.org/10.1097/01.NCC.0000305744.64452.fe

Lien, C. Y., Lin, H. R., Kuo, I. T., & Chen, M. L. (2009). Perceived uncertainty, social support and psychological adjustment in older patients with cancer being treated with surgery. Journal of Clinical Nursing, 18(16), 2311-2319. https://doi.org/10.1111/j.1365-2702.2008.02549.x

Liu, G. X., Zhang, H., & Meng, Y. (2019). Relation of self-perceived burden to disease perception, uncertainty in illness and resilience in patients with lung cancer during chemotherapy. Chinese Mental Health Journal, 33(11), 816-821.

Man, M. A., Toma, C., Motoc, N. S., Necrelescu, O. L., Bondor, C. I., Chis, A. F., Lesan, A., Pop, C. M., Todea, D. A., Dantes, E., Puiu, R., & Rajnoveanu, R.-M. (2020). Disease perception and coping with emotional distress during COVID-19 pandemic: A survey among medical staff. International Journal of Environmental Research and Public Health, 17(13), 4899. https://doi.org/10.3390/ijerph17134899

Mei, Y. Q., Li, H. P., Yang, Y. J., Su, D., Ma, L., Zhang, T., & Dou, W. (2015). Reliability and validity of Chinese version of the brief illness perception questionnaire in patients with breast cancer. Journal of Nursing, 22, 11-14.

Mishel, M. H. (1983). Adjusting the fit: Development of uncertainty scales for specific clinical populations. Western Journal of Nursing Research, 5(4), 355-370. https://doi.org/10.1177/019394598300500408

Mishel, M. H. (1988). Uncertainty in Illness. Image: The Journal of Nursing Scholarship, 20(4), 225-232. https://doi.org/10.1111/j.1547-5069.1988.tb00082.x

Mishel, M. H. (1990). Reconceptualization of the Uncertainty in Illness Theory. Image: The Journal of Nursing Scholarship, 22(4), 256-262. https://doi.org/10.1111/j.1547-5069.1990.tb00225.x

Mitchell, M. (2017). Day surgery nurses' selection of patient preoperative information. Journal of Clinical Nursing, 26(1-2), 225-237. https://doi.org/10.1111/jocn.13375

Moreland, P., & Santacroce, S. J. (2018). Illness uncertainty and posttraumatic stress in young adults with congenital heart disease. The Journal of Cardiovascular Nursing, 33(4), 356-362. https://doi.org/10.1097%2FJCN.0000000000000471

National Cancer Institute. (2022). NCI Dictionaires: Social support. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/social-support

Osmialowska, E., Stas, J., Chabowski, M., & Jankowska-Polanska, B. (2022). Illness perception and quality of life in patients with breast cancer. Cancers, 14(5), 1214. https://doi.org/10.3390/cancers14051214

Park, S. K., Min, Y. H., & Lee, S. B. (2021). Longitudinal trends in illness perception and depression during adjuvant breast cancer endocrine therapy: A prospective observational study. Healthcare, 9(9), 1223. https://doi.org/10.3390/healthcare9091223

Safdari, A., Rassouli, M., Elahikhah, M., Ashrafizadeh, H., Barasteh, S., Jafarizadeh, R., & Khademi, F. (2023). Explanation of factors forming missed nursing care during the COVID-19 pandemic: A qualitative study. Frontiers in Public Health, 11, 989458. https://doi.org/10.3389%2Ffpubh.2023.989458

Salakari, M., Pylkkänen, L., Sillanmäki, L., Nurminen, R., Rautava, P., Koskenvuo, M., & Suominen, S. (2017). Social support and breast cancer: A comparatory study of breast cancer survivors, women with mental depression, women with hypertension and healthy female controls. The Breast, 35, 85-90. https://doi.org/10.1016/j.breast.2017.06.017

Scott, J. (2022). Breast Cancer Surgery Options: Several factors go into determining which one is most appropriate. Verywell Health. https://www.verywellhealth.com/breast-cancer-surgery-options-430561

Shabrina, A., & Iskandarsyah, A. (2018, 2018). Case study on illness perception and treatment belief in breast cancer patient who undergo a traditional treatment. Proceedings of the Universitas Indonesia International Psychology Symposium for Undergraduate Research (UIPSUR 2017), Jakarta.

Shahnawaz, M., Nabi, W., Nabi, S., Afaq, M., Paul, M. A., War, F. A., & Shah, N. N. (2022). Relationship between intolerance of uncertainty and symptom severity in Covid-19 patients: The mediating role of illness perception and Covid-19 fear. Current Psychology. https://doi.org/10.1007/s12144-022-03577-y

Sharma, S., & Gharti, K. (2019). Preoperative anxiety and social support among patients undergoing surgery. Janapriya Journal of Interdisciplinary Studies, 8, 149-159. https://doi.org/10.3126/jjis.v8i0.27314

Stern, A. F. (2014). The hospital anxiety and depression scale. Occupational Medicine, 64(5), 393-394. https://doi.org/10.1093/occmed/kqu024

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209-249. https://doi.org/10.3322/caac.21660

Supriati, L., Sudiana, I. K., Nihayati, H. E., Ahsan, Rodli, M., & Kapti, R. E. (2022). Perspective of uncertainty and emotional responses in breast cancer patients during the COVID-19 pandemic. SAGE Open Nursing, 8, 23779608221124294. https://doi.org/10.1177/23779608221124294

Szulczewski, L., Mullins, L. L., Bidwell, S. L., Eddington, A. R., & Pai, A. L. H. (2017). Meta-analysis: Caregiver and youth uncertainty in pediatric chronic illness. Journal of Pediatric Psychology, 42(4), 395-421. https://doi.org/10.1093/jpepsy/jsw097

Vanni, G., Materazzo, M., Pellicciaro, M., Ingallinella, S., Rho, M., Santori, F., Cotesta, M., Caspi, J., Makarova, A., & Pistolese, C. A. (2020). Breast cancer and COVID-19: The effect of fear on patients' decision-making process. In Vivo, 34(3 suppl), 1651-1659. https://doi.org/10.21873/invivo.11957

Wang, X., Xie, J., Wang, G. Q., Liu, A. L., Zhu, G. H., & Lei, S. Y. (2021). Analysis of the correlation between preoperative illness perception and postoperative short term quality of life in patients with cervical cancer. Clinical Medicine Research and Practice, 6(3), 12-15.

Wei, X., Zhang, X., Zheng, X., & Zhou, L. (2019). Analysis of illness uncertainty and the related factors in patients undergoing heart valve surgeries during the perioperative period. International Journal of Clinical and Experimental Medicine, 12(9), 11520-11528.

Winstead, E. (2021). Breast cancer surgery choice may affect young survivors’ quality of life. National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2021/breast-cancer-mastectomy-quality-of-life

Xie, W., Kong, S., He, H., Xiong, H., Zhu, Q., & Huang, P. (2022). A mixed-methods study of emotional support for families of organ donors in Hunan Province, China. Frontiers in Psychology, 13, 952524. https://doi.org/10.3389%2Ffpsyg.2022.952524

Ye, Z. J., She, Y., Liang, M. Z., Knobf, T., Dixon, J., Hu, Q., Zeng, Z., Hu, G. Y., Zhu, Y. F., & Qiu, H. Z. (2018). Revised Chinese version of Mishel Uncertainty in Illness Scale: Development, reliability and validity. Chinese General Practice, 21(9), 1091-1097. https://doi.org/10.3969/j.issn.1007-9572.2018.00.068

Youn, K., & Lee, J. (2018). Preoperative uncertainty, meaning of life, and anxiety in cancer patients. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 27(3), 208-215. https://doi.org/10.12934/jkpmhn.2018.27.3.208

Zhang, H., Xiao, L., & Ren, G. (2018). Experiences of social support among Chinese women with breast cancer: A qualitative analysis using a framework approach. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 24, 574-581. https://doi.org/10.12659%2FMSM.908458

Zhang, N., Fielding, R., Soong, I., Chan, K. K. K., Tsang, J., Lee, V., Lee, C., Ng, A., Sze, W. K., Tin, P., & Lam, W. W. T. (2016). Illness perceptions among cancer survivors. Supportive Care in Cancer, 24(3), 1295-1304. https://doi.org/10.1007/s00520-015-2914-3

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41. https://doi.org/10.1207/s15327752jpa5201_2


Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system