Iran Journal of Nursing

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Ghamary L, Sadeghi N, Azarbarzin M. The Correlations between Perceived Family Support and Psychosocial Adjustment in Disease in Adolescents with Cancer. IJN 2020; 33 (125) :28-41
URL: http://ijn.iums.ac.ir/article-1-3242-en.html

Background & Aims: With the advancement of science and technology in the current era, cancer in adolescents is not as deadly as before and has only become a chronic disease with a higher survival rate. Despite the advances in cancer treatment and care, the disease is still associated with severe psychological consequences. The impact of cancer on various dimensions of adolescents' life (especially psychological dimensions) necessitates interventions to foster adaptation in the psychosocial dimension. Adolescents with cancer use a variety of social support resources to deal with the diagnosis and treatment of their disease. Family plays a pivotal role in providing the emotional and social support to these patients, and the perception of family support is considered to be the most important facilitator of health behavior, as well as the most potent strategy to successfully deal with stressors. It seems that the provision of emotional support by the family to adolescents with cancer helps these patients rely on the family and feel confident in coping with their difficult and critical condition, refrain from isolation, and feel encouraged. The present study aimed to evaluate the correlations between perceived family support and psychosocial adjustment with the disease in adolescents with cancer.
Materials & Methods: This descriptive-correlational study was conducted based on the error level of α=0.05 with 80% test power and sample size of 85. Considering 10% attrition, 95 adolescents aged 11-20 years diagnosed with cancer, who referred to two hospitals affiliated to Shiraz University of Medical Sciences in 2019, were selected via convenience sampling. Data were collected using a questionnaire containing three sections of demographic characteristics, perceived family support questionnaire, and psychosocial adjustment questionnaire during July-November 2019. Data analysis was performed in SPSS version 16 using descriptive and analytical statistics at the significance level of P<0.05.
Results: The mean age of the patients was 14.3 ± 2.7 years. The sample population included 36 females (37.9%) and 59 males (62.1%). The mean duration of cancer in the patients was 1.9 ± 1.8 years, and the majority of the patients were the youngest child in the family (41.1%). Among the patients, 41 cases (43.2%) were residents of small towns. In 33 cases (34.7%), the patients had a family history of a similar disease. The majority of the patients had acute lymphocytic leukemia (57.89%), and among the other diagnosed cancers were neurological (14.7%), lymphatic system (11.6%), kidney (6.3%), bone and joint (3.2%), and soft tissue cancer (3.2%). The mean score of perceived family support was significantly higher in the female patients compared to the males. However, the total score of psychosocial adjustment was not significantly different between the males and females, and the mean score of perceived family support and total score of psychosocial adjustment also had no significant differences between the patients with leukemia and other cancers. Furthermore, the total score of perceived family support (mean: 26.16 ± 5.51) was considered moderate, while psychosocial adjustment with the disease (total mean score: 2.01 ± 0.41) was considered high. The highest adjustment was observed in the dimensions of attitude toward the disease, and the lowest adjustment belonged to the dimension of psychological disorders. Perceived family support was directly correlated with the female gender, while psychosocial adjustment was inversely correlated with age and directly correlated with maternal education level. However, no significant associations were denoted between the other variables.
Conclusion: The results of the study indicated a direct correlation between the perceived family support and psychosocial adjustment with the disease in the adolescences diagnosed with cancer. Evidently, the sense of security and confidence in the home environment and encouragement of the family members and companions who will not leave them alone in any particular and critical situations helps adolescents with cancer become empowered and gain extra motivation to accept and cope with the disease and the new life situation with positive feelings. Based on our findings and the results of similar studies, it could be stated that family support plays a key role in the confrontation and psychosocial adjustment with cancer. Therefore, it is recommended that healthcare managers and officials emphasize and strengthen the role of family support in the psychosocial adjustment of adolescents against cancer through proper planning by adopting strategies to maintain and promote the psychosocial health of these patients. Moreover, informing parents and medical staff on the results of this research and provision of proper training to these individuals make it possible to provide family support through the optimal implementation of family-oriented care. It is also suggested that psychiatrists and psychologists pay more attention to the family support of adolescents with cancer, and the presence of a counselor or psychologist in the oncology department could be beneficial in this regard. The presence of trained nurses in these wards and their close communication with adolescents with cancer and their families could also largely contribute to the effective provision of family-oriented care and training on the care and support skills of the families.