An investigation of psychological stress, coping styles/strategies and psychological adjustments in a sample of Indian South African women with breast cancer in different developmental stages of the life-cycle.

Abstract

The purpose of this research was to examine some major themes of stress, coping styles/strategies, and psychological adjustment to breast cancer, of 116 English speaking, low socioeconomic status Indian South African women at different developmental stages of the life-cycle. The sample was drawn from a population of hospital outpatients receiving treatment for breast cancer at three academic hospitals in Durban, South Africa. Convenience sampling was employed, and a battery of six questionnaires was completed in addition to the collection of demographic data. Descriptive statistics, correlational analysis, multivariate analysis and regression analysis was used to analyse the data. The results suggested both similarities and differences between the younger and older groups of patients with regard to the disruption of life-tasks by breast cancer. However, the younger group, on average, experienced significantly greater disruption with regard to the following ‘themes of stress’: interpersonal relationships, achievement-oriented goals/activities, body or sexual image and integrity, and existential issues. In addition, the younger patients, on average, experienced a greater degree of overall disruption to life-tasks. The disruption of life-tasks was only associated with psychological morbidity in the younger patients, and the overall extent of disruption to life-tasks was shown to directly contribute to the younger patients’ depressive symptomatology. Both groups demonstrated elevated stress reactions and psychological symptoms in comparison to norms generally, however the younger patients demonstrated higher levels of ‘psychological’ stress and depressive symptomatology. With regard to coping styles, the younger group, on average, demonstrated a greater prevalence of ‘fighting spirit’ and ‘anxious preoccupation’, while the older group contained a significantly greater percentage of patients demonstrating a problematic combination of coping styles. The coping style ‘helpless or hopeless’ was associated with various stress reactions and psychological symptoms for both groups, although this association was less prevalent for the older group. The coping strategy ‘escape-avoidance’ was associated with overall psychological distress only for the younger group. The results suggested that there may be other, more significant predictor variables for psychological distress in older breast cancer patients – a potential area for future research.