A CLOSER LOOK AT SELF ESTEEM AND PERCEIVED SOCIAL SUPPORT: THEIR ROLE IN DEPRESSION AMONG WOMEN DIAGNOSED WITH BREAST CANCER AND CARDIAC ILLNESS

Nasreen  Bano; Salman Shahzad; Shafaq Ali

doi:10.63050/jpps.20.02.255

Nasreen Bano Institute of Clinical Psychology, University of Karachi, Pakistan
Salman Shahzad Institute of Clinical Psychology, University of Karachi, Pakistan
Shafaq Ali Institute of Clinical Psychology, University of Karachi, Pakistan

DOI: https://doi.org/10.63050/jpps.20.02.255

Keywords: Self-esteem, multi-dimensional perceived social support, depression; women, chronic illnesses; cardiac; cancer

Abstract

OBJECTIVES

Chronic illnesses such as, cancer and heart diseases are among those illnesses which are quite prevalent and tax one’s resources to fight with illnesses. Patients with these illnesses have to take the burden of disease both physically and psychologically. Mental health conditions with these illnesses have not been much studied in Pakistan. So, the present study aims to find the predictive association of depression with self-esteem and perceived social support among women with chronic illness (breast cancer and angina).

STUDY DESIGN

Cross-sectional study design

PLACE AND DURATION OF STUDY

Present study was conducted in Karachi, Pakistan from April- July, 2016.

SUBJECTS AND METHODS

A sample of 102 women diagnosed with breast cancer (51) and Angina (51) with the age ranges between 30-60 years (Mean age = 47.6, SD=10.68), were taken. They were recruited from different hospitals including Sindh Government Hospital, Dar-ul-Sukoon and Dow university Hospital Karachi, Pakistan using purposive sampling technique. Patients’ Health Questionaire-9, Rosenberg Self-Esteem, and Multidimensional Perceived Social Support was administered.

RESULTS

Findings show that self-esteem has contributed to lowering depression in women diagnosed with cardiac illness (Angina) as well as cancer (breast Cancer).Perceived social support has a significant effect on depression in women with cardiac illness (Angina) however it has a non-significant contribution in the reduction of depression in women with cancer (breast cancer).

CONCLUSION

Chronic illnesses not only bring physical strains but also affect one's psychological health. Long-term treatments and variations in severity demand psychological resources to cope up with these illnesses. Findings of present study can add in literature and further assist health care professionals in considering the psychological cost of these illnesses and to design and implement evidence based treatment intervention, before, during and after the treatment services for women with chronic illnesses.

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References

Ridder. D., de, Geenen., R., Kuijer., R., & Middendorp. H., Van. (2008). Psychological Adjustment to Chronic Disease. The Lancet, 372(9634), 246-255. DOI:10.1016/S0140-6736(08)61078-8. PubMed.

Health Service Executive. (2008). Chronic Illness Framework. Retrieved from https://www.hse.ie/eng/about/who/population-health/population-health-approach/population-health-chronic-illness-framework-july-2008.pdf

World Health Organization. (2003). The World Health Report. Shaping the Future. Geneva, Switzerland: World Health Organization.

Katon, W. (2003). Clinical and health service relationships between major depression, depressive symptoms and general medical illness. Biological Psychiatry, 54, 216- 226.

Patten, S. B., Beck, C. A., Kassam, A., V. A., Williams, J. Barbui, C., & Metz, L. M. (2005). Long-Term Medical Conditions and Major Depression: Strength of Association for Specific Conditions in the General Population. Canadian Journal of Psychiatry, 49(4), 195-202.

Moussavi.S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet, 370(9590), 851-858.

Niti, M., Ng, T. P., Kua, E. H., Ho, R. C., & Tan, C. H. (2007). Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. International Journal of Geriatric Psychiatry, 22(11), 1087-1094.

Jones, J.M., Huggins, M. A., Rydall, A. C., & Rodin, G. M. (2003). Symptomatic distress, hopelessness, and the desire for hastened death in hospitalized cancer patients. Journal of Psychosomatic Research, 55, 411-418.

Okamura, M., Yamawaki, S., Akechi, T., Taniguchi, K., & Uchitomi, Y. (2005). Psychiatric disorders following first breast cancer recurrence: prevalence, associated factors and relationship to quality of life. Japanese Journal of Clinical Oncology, 35(6), 302-309.

Massie, M. J., & Holland, J. C. (2001). The cancer patients with pain. Psychiatric Complications and their Management, 71, 243-247.

Chen, X., Zheng, Y., Zheng, W., Gu, K., Chen, Z., Lu, W., & Shu, X. O. (2009). Prevalence of depression and its related factors among Chinese women with breast cancer. Acta Oncology, 48(8), 1128-1136.

Gadet, A. (2011). Pattern of Mental health morbidity. Journal of Personality and Social Psychology, 11, 706-708.

Jadoon, N. A., Munir, W., Shahzad, M. A., & Choudhry, Z. S. (2010). Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study. Bio Med Central, 10(594), 1471-2407. doi:10.1186/14712407-10-594.

Abela, J. R., & D'Alessandro, D. U. (2010). Beck's cognitive theory of depression: A test of the diathesis-stress and causal mediation components. British Journal of Clinical Psychology, 41(2), 111-128. DOI: 10.1348/014466502163912.

Suzuki, N., Ninomiya, M., Maruta, S., Hosonuma, S., Nishigaya, Y., Kobayashi, Y., Kiguchi. K., & Ishizuka, B. (2011). Psychological characteristics of Japanese gynecologic cancer patients after learning the diagnosis according to the hospital anxiety and depression scale. Journal of Obstetrics and Gynecology Research, 37 (6), 800-808. doi: 10.1111/j.1447-0756.2010.01437.

Frasure-Smith, N., Lesperance, F., & Talajic, M. (1995). Depression and 18-month prognosis after myocardial infarction. Circulation, 91(4), 999-1005.

Khan, S., Khan, A., Ghaffar, R., & Awan, Z. A. (2012). Frequency of Depression in Patients with Chronic Heart Failure. Journal of Ayyub Medical College Abbottabad, 24(2), 26-29.

Civilotti, C., Maran, D. A., Santagata, F., Varetto, A. & Stanizzo, M. R. (2020). The use of the Distress Thermometer and the Hospital Anxiety and Depression Scale for screening of anxiety and depression in Italian women newly diagnosed with breast cancer. Support Care Cancer, 28, 4997–5004.

Beck, A. T. (1983). Cognitive therapy of depression: New perspectives. In P. J. Clayton, & J. E. Barett (Eds.), Treatment of depression. Old controversies and new approaches (pp 265-284). New York: Raven Press.

Ha, H., E. & Cho, K., Y. (2014). The Mediating Effects of Self-Esteem and Optimism on the Relationship between Quality of Life and Depressive Symptoms of Breast Cancer Patients. Psychiatry Investigation, 11(4), 437-445.

Juth, V., Smyth, M. J. & Santuzzi, M. A. (2008). How do you feel? Self-esteem predicts affect, stress, social interaction, and symptom severity during daily life in patients with chronic illness. Journal of Health Psychology, 13(7), 884–894. doi: 10.1177/1359105308095062.

Qin, Z., Mie, S., Gao, T., Liang, L., Li, C., Hu, Y., Guo, X., Meng, C., , Lv, J., Yuan, T, Fei, J., Tong, Q., & Yang, Y., (2021). Self-Esteem as a Mediator between Life Satisfaction and Depression among Cardiovascular Disease Patients. Clinical Nursing Research, 31(1), 115-121.

Petra, S., & Ronald.F, (2003). Self-esteem and social support in chronic ill patients. Health Psychology, 22(2), 123-129.

Nausheen, B., & Kamal, A. (2007). Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample. Psycho-Oncology, 16(9), 859–862.

Walker, M. S., Zona, D. M., & Fisher, E. B. (2006). Depressive symptoms after lung cancer surgery: their relation to coping style and social support. Psycho-Oncology, 15(8), 684–693.

Dedeli, O., Fadıloğlu, C., & Uslu, R. (2008). Evaluation of functional state of the cancer patients and their perceived social support. Turkish Oncology Journal, 23, 132-139.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th. TR, Ed.). Washington, DC: Author

Spitzer, R., Kroenke, K., & Williams, J. (2001). Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. Journal of the American Medical Association, 282, 1737-1744.

Monahan, P. O, Shacham, E., Reece, M., Kroenke, K., Ong'or, W. O., Omollo, O., Yebei, V. N., & Ojwang, C. (2009). Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. Journal of General Internal Medicine, 24(2), 189-197. doi: 10.1007/s11606-008-0846.

Hussain, N., Gater, R., Tomenson, B., & Creed, F. (2006). Comparison of the Personal Health Questionnaire and the Self Reporting Questionnaire in rural Pakistan. Journal of Pakistan Medical Association, 56(8), 366-370.

Ali, B. S., Jehan, I., Reza, H. & Khan, M. M. (1998). Development of an Indigenous Screening Instrument in Pakistan: The Aga Khan University Anxiety and Depression Scale. The Journal of American Medical Association, 48, 261-265.

Blascovich, J., & Tomaka, J. (1991). The Self-Esteem Scale. In J. P. Robinson, P. R. Shaver, & L. S. Wrightsman (Eds.), Measures of personality and social psychological attitudes. New York: Academic Press.

Sardar, S. (1998).Study of relationship among childhood paternal loss, sex role orientation, self esteem and locus of control in male and female students. Unpublished doctoral dissertation. University of Karachi, Karachi- Pakistan.

Blascovich, J., & Tomaka. J. (1993). "Measures of Self-Esteem." Pp. 115-160 in J.P. Robinson, P. R. Shaver, and L. S. Wrightsman (eds.), Measures of Personality and Social Psychological Attitudes. Third Edition. Ann Arbor: Institute for Social Research.

Rosenberg, Morris. (1986). Conceiving the Self. Krieger: Malabar, FL.

Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

Silber, E., & Tippett, J. (1965). "Self-esteem: Clinical assessment and measurement validation. Psychological Reports, 16, 1017-1071

Cooper-Evans, S., Alderman, N., Knight, C., & Oddy, M. (2008). Self-esteem as a predictor of psychological distress after severe acquired brain injury: An exploratory study. Neuropsychological Rehabilitation, 18(5-6), 607-626. doi: Doi 10.1080/09602010801948516

Carroll, E., & Coetzer, R. (2011). Identity, grief and self-awareness after traumatic brain injury. Neuropsychological Rehabilitation, 21(3), 289-305. doi: Pii 934339402 Doi 10.1080/09602011.2011.555972

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, 30-41.

Akhtar. A., Rahman. A., Husain, M., Chaudhry, I. B., Duddu, V., & Husain, N. (2010). Multidimensional scale of perceived social support: psychometric properties in a South Asian population. Journal of Obstetrics and Gynaecology Research. 36(4), 845-51. doi: 10.1111/j.1447-0756.2010.01204.x.

Lueboonthavatchai, P. (2007). Prevalence and psychosocial factors of anxiety and depression in breast cancer patients. Journal of Medical Association Thailand, 90(10), 2164-2174.

Purkayastha, D., Venkateswaran, C., Nayar, K., & Unnikrishnan, U. G. (2017). Prevalence of Depression in Breast Cancer Patients and its Association with their Quality of Life: A Cross-sectional Observational Study. Indian Journal of Palliative Care, 23(3), 268-273. doi: 10.4103/IJPC.IJPC_6_17

Bener, A., Alsulaiman, R., Doodson, L., & Agathangelou, T. (2017). Depression, hopelessness and social support among breast cancer patients:in highly endogamous population. Asian Pacific Journal of Cancer Prevention 18, 1889–1896. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103579/

Boing, L., Rafael, A. D., Braga, H. O., Moraes, A., Sperandio, F. F. & Guimaraes, A. C. A. (2017).Dance as treatment therapy in breast cancer patients–a systematic review. Revista Brasileira de Atividade Física & Saúde 22(4), 319, DOI:10.12820/rbafs.v.22n4p319-331

Sharma. K., Poudel. P., & Dhital. P. R. (2018). Anxiety and Depression among Patients with Coronary Artery Disease Attending at a Cardiac Center, Kathmandu, Nepal. Nursing Research and Practice. https://doi.org/10.1155/2018/4181952.

Awasthi, P., & Mishra, R. C. (2010). Illness Beliefs of Women Cancer Patients and their Relationships with Social Support. Journal of the Indian Academy of Applied Psychology, 36 (2), 317-327.

Mavandadi, S., Zanjani, F., Ten Have, T. R., & Oslin, D. W. (2009). Psychological well-being among individuals aging with HIV: the value of social relationships. Journal of Acquired Immune Deficiency Syndrome, 51(1), 91-98.

Bisschop, M. I, Kriegsman, D. M. W., Beekman, A. T. F., & Deeg, D. J. H. (2004). Chronic diseases and depression: The modifying role of psychosocial resources. Social Science and Medicine, 59, 721–733.

Drageset, S., Lindstrøm, T. C., Giske, T., & Underlid, K. (2016). Women's experiences of social support during the first year following primary breast cancer surgery. Scandinavian Journal of Caring Science. 30, 340–348. doi: 10.1111/scs.12250

Curtis, R., Groarke, A., McSharry, J., & Kerin, M., (2014). Experience of Breast Cancer Burden, Benefit, or Both? In Sigrunn, D, Torril, C., and Kjell, U. European Journal of Oncology Nursing, 21, 205-211.

Boinon, D., Sultan, S., Charles, C., Stulz, A., Guillemeau, C., Delaloge, S., & Dauchy, S. (2013). Changes in psychological adjustment over the course of treatment for breast cancer: the predictive role of social sharing and social support. Psycho-Oncology, 23(3), 291-298. doi:10.1002/pon.3420

Shiozaki, M., Hirai, K., Koyama, A., Inui, H., Yoshida, R., & Tokoro, A. (2011). Negative support of significant others affects psychological adjustment in breast cancer patients. Psychology and Health, 26, 1540–1551. doi: 10.1080/08870446.2010.551211