PSYCHOLOGICAL ADJUSTMENT TO CANCER: THE RELEVANCE OF SOCIAL SUPPORT AND FAMILY STRUCTURE

Abstract

This study was designed to investigate psychological adjustment to breast cancer in relation to social support, and family cohesion and adaptability. A sample of forty one women, admitted to hospital with breast cancer for surgery, were given an assessment package six to eight weeks after hospital discharge. The package consisted of the Mental Adjustment to Cancer Scale (MAC), the Family Adaptability and Cohesion Evaluation Scales(FACES) and the Michigan Social Support Scale for breast cancer patients. An identical package was posted to the patients after six months. Three models were tested corresponding to different levels of consistency with a causal interpretation of a relationship between social support and psychological adjustment. The results indicated that psychological morbidity was high at both ti me points. Social support from a doctor, nurse specialist, friend, and spouse were each found to be correlated with at least one psychological adjustment sub- scale at time one. The strongest relationship emerged for social support from the nurse specialist and the ''fighting spirit" sub- scale of the MAC. None of the family scales were found to be related to psychological adjustment or social support. Discriminant function analysis was performed to investigate variables which discriminated caseness at time one and time two. Social support from a doctor emerged as the most significant variable discriminating cases from non-cases at time one . At time two negative support was the most significant variable. The results were discussed in relation to previous research and a service development emerging from the study was described.