Targets for psychosocial treatment: family and work after breast cancer — ASN Events

Targets for psychosocial treatment: family and work after breast cancer (#459)

Galina Kuznecova 1 , Sergejs Kuznecovs 1 , Ivans Kuznecovs 1
  1. Preventive medicine center, Riga, Latvi, Latvia

Background: The breast cancer is a chronic disease that may often have a relapse. Patients’ survival rate depends on the frequency of relapses, which commonly is defined by the phase and the histology of tumor. Recent investigations show that psychosocial factors are also has a great influence on development of metastasis and the survival rate of the patient.

Objectives: The aim of the present study was to identify priorities and targets for psychosocial support.  In the focus  were work and family in women with breast cancer.

Methods: Monitoring was spent from the 1997 to 2012. There were 1258 women in the age of 25-79 years old with breast cancer. The Occupational Psychosocial Monitoring Questionnaire was used to detect the cause and level of victimization. The  Social Support Questionnaire was used to examine functional support in family (affect, affirmation, aid) and structural support (size of network, duration of relationships, frequency of contact).

Results: The results showed that more than 75% (48% in 1997) of the patients were still working after the diagnosis was defined, 12% (5% in 1997) during the course of chemotherapy and radiotherapy. The main reason to be employed was the absence of social guaranties and very low level of material security. Overall 82% (25% in 1997) of patients returned to their previous job. Leading factors promoting occurrence of relapses and reduction of a life were conflicts at work, overtime hours, shift work, work in a night shift. Findings reveal that   49% (32% in 1997) of women with relapse in cancer treatment and recurrence of the disease perceived  themselves as victims of the conflicts at work. The positive influence of returning to labor activity on life expectancy was established only in 6% of cases in patients with breast cancer. The marital status of women renders an essential influence on occurrence of the relapses of disease and life expectancy of women with breast cancer. The most vulnerable group are the single or divorced women in the age of 40-50 years. Married women felt negative influence of such factors, as "false sexual unattractiveness " and " a complex of the invalid ".The maximal positive influence of family attitudes was established in the women who were married more than 20 years, having adult children and steady communication between members of the family and generations. In 26 % of cases the obvious and latent uncooperative altitudes in family caused development of relapses of disease and reduction of life expectancy. Among these reasons - an alcoholism (25 %), a narcotism (10 %), matrimonial changes (17 %), «biological incompatibility” (9%).

Conclusions: The results of monitoring confirm the assumption that leading psychosocial factors, such as emotional distress at work and in family attitudes which could be provoking in occurrence of breast cancer, continue to render essential influence on development of relapses of breast cancer and life expectancy of women.