Psychosocial Adaptation and Quality of Life of Female Breast Cancer Survivors
DOI:
https://doi.org/10.47152/ziksi2026012Keywords:
breast cancer, resilience, psychosocial adjustment, family support, quality of lifeAbstract
Women with breast cancer face numerous challenges not only in the domain of physical health but also in mental well-being. Their psychosocial adjustment occurs under continuous health-related, psycho-emotional, and social burdens. The aim of this study was to examine psychosocial adaptation and resilience in a sample of women with breast cancer using the Psychosocial Adjustment to Illness Scale (PAIS-SR) and the Resilience Scale (RS). The sample consisted of 33 women aged 40–76 years (M = 55.82, SD = 8.35). Data were analysed using descriptive and multivariate statistical methods. The findings indicate generally adaptive psychosocial adjustment alongside moderate to high levels of resilience. Higher resilience was positively associated with better personal health care orientation, more positive emotional responses, greater understanding of treatment, stronger social and family support, and higher satisfaction with medical services. These findings underscore the need for holistic approaches that integrate psychosocial support with medical care. Future research should build upon these findings by employing larger samples, longitudinal designs, and mixed-method approaches to inform the development of individualized support models and tailored intervention strategies.
References
Abdelsalam, A.E., & Bayomi, M.A. (2022). Assessment of supportive care needs, satisfaction and quality of life among breast cancer survivors. The Egyptian Family Medicine Journal, 6, 3–18.
Anguiano, L., Mayer, D., Piven, M. L., & Rosenstein, D. (2012). A Literature Review of Suicide in Cancer Patients. Cancer Nursing, 35(4), 14–26.
Annunziata, M.A., Muzzatti, B., Flaiban, C., Gipponi, K., Carnaghi, C., Tralongo, P., Caruso, M., Cavina, R. & Tirelli, U. (2018). Long-term quality of life profile in oncology: a comparison between cancer survivors and the general population. Support Care Cancer, 26, 651–656.
Arnold, M., Morgan, E., Rumgay, H., Mafra, A., Singh, D., Laversanne, M., Vignat, J., Gralow, J.R., Cardoso, F., Siesling, S. & Soerjomataram, I. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast, 66, 15–23.
Batrićević, A., & Kubiček, A. (2021). The right to life and quality of living of women suffering and recovered from breast cancer in Serbia. In Z. Pavlović (Ed.), Yearbook No. 4: Human rights protection: Right to life (pp. 631–651). Provincial Protector of Citizens – Ombudsman; Institute of Criminological and Sociological Research.
Bellur, Z., Aydın, A., & Alpay, E. H. (2018). Mediating role of coping styles in personal, environmental and event related factors and posttraumatic growth relationships in women with breast cancer. Klinik Psikiyatri Dergisi, 21(1).
Boland, V., Brady, A. M., & Drury, A. (2020). The physical, psychological and social experiences of alopecia among women receiving chemotherapy: An integrative literature review. European Journal of Oncology Nursing, 49.
Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R., Soerjomataram, I. & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 74(3), 229–263.
Capewell, C., Ralph, S. & Symonds, M. (2020). Listening to Women’s Voices: Using an Adapted Photovoice Methodology to Access Their Emotional Responses to Diagnosis and Treatment of Breast Cancer. Journal of Patient Experience, 7(6), 1316–1323.
Cella, F. (1994). Quality of Life: Concepts and Definition. Journal of Pain and Symptom Mallagement, 9(3), 186–192.
Cohler, B. J. (1987). Adversity, resilience, and the study of lives. In E. J. Anthony & B. J. Cohler (Eds.), The invulnerable child (pp. 363–424). The Guilford Press.
Derogatis, L. R. (1986). The Psychosocial Adjustment to Illness Scale (PAIS). Journal of Psychosomatic Research, 30(1), 77–91.
Dooley, L., Slavich, G., Moreno, P. & Bower, J. (2017). Strength through adversity: Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress Health, 33(5), 549–57.
Dutta-Bergman, M. J. (2005). Developing a profile of consumer intention to seek out additional information beyond a doctor: the role of communicative and motivation variables. Health Communication, 17(1), 1–16.
Erden, Y., Cecen Celik, H. & Karakurt, N. (2025). Women’s body image after mastectomy: a photovoice study. Supportive Care in Cancer, 33, 501.
Falagas, M., Zarkadoulia1, E., Ioannidou1, E., Peppas, G., Christodoulou, C. & Rafailidis, P. (2007). The effect of psychosocial factors on breast cancer outcome: A systematic review. Breast Cancer Research, 9(R44).
Fletcher, D., & Sarkar, M. (2013). Psychological resilience: A review and critique of definitions, concepts and theory. European Psychologist, 18(1), 12–23.
Gaspar, T., Ferreira, J., & Coelho, A. (2025). Survivors of Oncological Disease: Experience and Satisfaction with National Health Care and Service. Healthcare, 13(18), 2330.
Herrman, H., Stewart, D. E., Diaz-Granados, N., Berger, E. L., Jackson, B., & Yuen, T. (2011). What is resilience?. The Canadian Journal of Psychiatry, 56(5), 258–265.
IARC- International Agency for Research on Cancer – World Health Organization. (2025, February 24). Breast cancer cases and deaths are projected to rise globally Press Release No. 361. https://www.iarc.who.int/wp-content/uploads/2025/02/pr361_E.pdf
Jin, Y., Bhattarai, M., Kuo, W.C. & Bratzke, L. (2022). Relationship between resilience and self‐care in people with chronic conditions: A systematic review and meta‐analysis. Journal of Clinical Nursing, 32(9–10), 2041–2055.
Kim, J., Harper, A., McCormack,V., Sung, H., Houssami, N., Morgan, E., Mutebi, M., Garvey, G., Soerjomataram, I. & Fidler-Benaoudia, M. M. (2025). Global patterns and trends in breast cancer incidence and mortality across 185 countries. Nature Medicine, 31, 1154–1162.
Lee, E. S., Lee, M. K., Kim, S. H., Ro, J. S., Kang, H. S., Kim, S. W., Lee, K. S. & Yun, Y. H. (2011). Health-related quality of life in survivors with breast cancer 1 year after diagnosis compared with the general population: a prospective cohort study. Annals of Surgery, 253(1), 101–108.
Lee, S. H., Min, Y. S., Park, H. Y. & Jung, T. D. (2012). Health-related quality of life in breast cancer patients with lymphedema who survived more than one year after surgery. Journal of Breast Cancer, 15(4), 449–453.
Lee, S. T., Dutta, M. J., Luk, P., Kaur-Gill, S., & Lin, J. (2023). Health Orientation as a Psychographic Framework for Understanding Physical Exercise Behavior. Health Communication, 38(3), 460–467.
Liu, Y., Li, Y., Chen, L., Li, Y., Qi, W. & Yu, L. (2018). Relationships between family resilience and posttraumatic growth in breast cancer survivors and caregiver burden. Psycho-Oncology, 27(4), 1284–1290.
Napoles, A. M., Gregorich, S.E., Santoyo-Olsson, J., O'Brien, H. & Stewart, A. L. (2009). Interpersonal processes of care and patient satisfaction: do associations differ by race, ethnicity, and language? Health Services Research, 44(4),1326–1344.
Owczarek, K. (2010). The Concept of Quality of Life. Acta Neuropsychologica, 8(3), 207-213.
Pieters, H. C. (2016). I’m still here: Resilience among older sur vivors of breast cancer. Cancer Nursing, 39(1), E20–E28.
Riegel, B., Jaarsma, T., & Strömberg, A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194–204.
Ristevska-Dimitrоvska, G., Filov, I., Rajchanovska, D., Stefanovski, P. & Dejanova, B. (2015). Resilience and Quality of Life in Breast Cancer Patients. Open Access Macedonian Journal of Medical Sciences, 3(4), 727–731.
Roine, E., Sintonen, H., Kellokumpu-Lehtinen, P. L., Penttinen, H., Utriainen, M., Vehmanen, L., Huovinen, R., Kautiainen, H., Nikander, R., Blomqvist, C., Hakamies-Blomqvist, L., & Saarto, T. (2021). Long-term health-related quality of life of breast cancer survivors remains impaired compared to the age-matched general population especially in young women. Results from the prospective controlled BREX exercise study. The Breast, 59, 110–116.
Segerstrom, S. C., Taylor, S. E., Kemeny, M. E., & Fahey, J. L. (1998). Optimism is associated with mood, coping, and immune change in response to stress. Journal of Personality and Social Psychology, 74(6), 1646–1655.
Schomberg, J., Teismann, T., Gerlach, A. L., & Cwik, J. (2025). Testing the predictions of the interpersonal-psychological theory of suicide in a sample of female cancer patients. Support Care Cancer, 33, 1157.
Schulze, T., Maercker, A., & Horn, A. B. (2014). Mental health and multimorbidity: psychosocial adjustment as an important process for quality of life. Gerontology, 60(3), 249– 254.
Simancas Fernández, M., Zapata Ruedab, C., & Galván Patrignania, G. (2023). Adaptation to the disease, resilience and optimism in woman with breast cancer. Revista Colombiana de Psiquiatría, 52(4), 280-286.
Stanton, A., & Bower, J. (2015). Psychological adjustment in breast cancer survivors. In A. Ganz (Ed.), Improving Outcomes for Breast Cancer Survivors: Perspectives on Research Challenges and Opportunities (pp. 231–242). Springer.
Stanton, A., Revenson, T. & Tennen, H. (2007). Health Psychology: Psychological Adjustment to Chronic Disease. Annual Review of Psychology, 58(1), 565–592.
Thind, A., Liu, Y. & Maly, R. C. (2011). Patient satisfaction with breast cancer follow-up care provided by family physicians. Journal of the American Board of Family Medicine, 24(6), 710–716.
Togas, C., & Parlalis, S. (2021). Translation and Psychometric Evaluation of the Health Orientation Scale in a Greek Speaking Sample (Greece-Cyprus). Health Psychology Research. 9(1).
Tu, P., Yeh, D., & Hsieh, H. (2020). Positive psychological changes after breast cancer diagnosis and treatment: The role of trait resilience and coping styles. Journal of Psychosocial Oncology, 38, 156–170.
Vella, S. L. C. & Pai, N. (2019). A Theoretical Review of Psychological Resilience: Defining Resilience and Resilience Research over the Decades. Archives of Medicine and Health Sciences 7(2), 233–239.
Veličković, K., Johnsson, P., Månsson, J., & Lundberg, T. (2024). “You Can’t Influence Illness, But You Can Influence Everything Else”: Women’s Diverse Experiences of Important Resilience Aspects in the Context of Breast Cancer. Sage Open, 14(4).
Vicko, F. (Ed.). (2025). Dijagnostikovanje i lečenje karcinoma dojke: nacionalni vodič dobre kliničke prakse. Ministarstvo zdravlja Republike Srbije.
Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.
World Health Organisation. (2025). Leading causes of death, Serbia, World Health Organization. https://data.who.int/countries/688
Waljee, J. F., Hu, E. S., Newman, L. A. & Alderman, A.K. (2008). Correlates of patient satisfaction and provider trust after breast-conserving surgery. Cancer, 112, 1679– 1687.
Wang, Y. F., Liu, A. K., Dai, J. Z., Zhang, J. P., Chen, H. H., Jiang, X. H., Tang, L., He, Y. Y., & Yang, Q. H. (2024). The effect of illness perception on psychosocial adjustment of patients with breast cancer and their spouses: actor–partner independence model. BMC Psychology, 12, 310.
Zhang, T., Li, H., Liu, A., Wang, H., Mei, Y., & Dou, W. (2018). Factors promoting resilience among breast cancer patients: A qualitative study. Contemporary Nurse, 54(3), 293–303.
Zhu, H., Yang, L., Yin, H., Yuan, X., Gu, J., & Yang, Y. (2024) The Influencing Factors of Psychosocial Adaptation of Cancer Patients: A Systematic Review and Meta-Analysis. Health Services Insights, 17.
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