Correlates of self-transcendence in women with advanced breast cancer.
AuthorCoward, Doris Dickerson.
AdvisorLongman, Alice J.
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractThis study examined how women with advanced breast cancer manage adverse effects of disease and treatment so that they maintain energy for continued personal development and life quality during what may be a long period of dying. The specific purpose was to test a theory proposing that psychosocial resources mediate between illness related distress and self-transcendent views and behaviors that, in turn, lead to emotional well-being. The study employed a cross-sectional correlational design with a convenience sample (n = 107) of women with Stage IIIb or Stage IV breast cancer. Subjects had lived with advanced disease for a mean length of time of 1.7 years with bone being the most common site of metastases. Subjects completed a questionnaire consisting of 10 instruments indexing symptom distress, functional disability, concurrent distressful life events, financial concerns, perceived personal control, social support, spiritual perspective, self-transcendence, affective well-being and cognitive well-being. Factor analytic structural equations modeling was used for data analysis. There was no relationship between degree of illness distress and available psychosocial resources. Therefore, psychosocial resources did not serve as mediators between illness distress and self-transcendence. Self-transcendence mediated the positive link between psychosocial resources and emotional well-being. Negative paths between illness distress and both self-transcendence and emotional well-being led to a reconceptualization of the theory. An alternative model was analyzed with illness distress as a dependent variable. Self-transcendence continued to mediate between psychosocial resources and emotional well-being. Emotional well-being became a mediator between self-transcendence and decreased illness distress. Psychosocial resources indirectly served to decrease distress through their effect on self-transcendent perspectives and emotional well-being. However, the direct effect of resources was to increase illness distress. Further research is needed to support the reconceptualized theory and to clarify the apparent paradoxical role of psychosocial resources found in this study. Interventions that facilitate self-transcendent perspectives and activities may lead to increased emotional well-being and reduced distress associated with advanced breast cancer.