Development of a comprehensive psychosocial model to predict quality of life of Breast cancer patients

Abstract

Background: There is few comprehensive models to predict quality of life of breast cancer patients based on psychosocial factors. The aim of this mixed method study was to develop a new psychosocial model to predict quality of life of these patients. Methods: This study had three phases: first in a grounded theory qualitative study on 29 participants, themes/subthemes of predicting factors and the provisional model were developed. Then revised by a systematic review of 122 included papers (from 1569 screened papers). Then the confirmed predictors (18 variables) were assessed in a multi-center cross-sectional study along with quality of life (FACT-B) on 224 breast cancer patients to develop the final model by structural equation modeling (SEM). Findings: The main themes after grounded theory and systematic review were "cognitive-emotional" factors such as "coping, body image, Depression/anxiety and concerns", "existential-social" factors such as "spiritual well-being, social support and sense of coherence" and innate factors of "personality and stress". The mean age in third phase was 47.08(SD=9.08). After SEM, in final confirmed model, "spiritual well-being and problem-focused coping" were mediators of effect of "body image, cancer concern, stress and social support" on quality of life and "emotional stability as a personality factor", influenced some of these factors. 78% of quality of life variance was predicted by our SEM model and its psychosocial factors. Discussion: Therapeutic interventions targeted our psychosocial model could be an appropriate strategy to improve quality of life of these patients. Cross-cultural larger studies are suggested to better develop this new model.