Relationship Between Social Support,Sense Of Coherence And Readiness For Return-to-work In Breast Cancer Patients

[Objective]To analyze the level of readiness for return-to-work,sense of coherence and social support of breast cancer patients,explore the relationship among social support,sense of coherence and readiness for return-to-work of breast cancer patients,and clarify the factors affecting readiness for return-to-work of breast cancer patients.[Methods]This study is a cross-sectional study.From October 2021 to December 2022,the patients with breast cancer were continuously included in the nail and breast surgery department of two Grade Ⅲ Grade A hospitals in Suzhou for questionnaire survey.The survey tools include general information questionnaire,readiness for return-to-work scale(the scale is divided into two parts.The first part is about the readiness for return-to-work of patients who have not returned to work,including four dimensions.The readiness for returnto-work level is from low to high,which is pre-intention,intention,action preparation-selfassessment and action preparation-behavioral dimension;the second part is about the work maintenance of patients who have returned to work,including two dimensions,uncertain maintenance and active maintenance stage),sense of coherence scale and social support scale.Descriptive analysis was used to analyze the level of readiness for return-to-work,sense of coherence and social support of breast cancer patients,Spearman rank correlation sand Pearson correlation were used to analyze the correlation of readiness for return-to-work,sense of coherence and social support.The Mann-Whitney U test and Kruskal-Wallis H test of non-parametric rank sum test were used to analyze the influence of patients’ general information on readiness for return-to-work and logistic regression was used to analyze the influencing factors of return-to-work readiness of breast cancer patients.[Results]1.A total of 421 patients with breast cancer were investigated,and 404 valid questionnaires were collected.The average age was(41.41±6.07)years,of which 304 did not return to work and 100 had returned to work.The incidence of return to work was 24.75%.The readiness for return-to-work of breast cancer patients who did not return to work was at a low level(87.2%),including 117 cases in the pre-intention dimension,148 cases in the intention dimension,27 cases in the action preparation self-assessment dimension,and only 12 cases in the action preparation behavior dimension;The breast cancer patients who have returned to work have a high level of maintenance for returning to work.88 patients are in the active maintenance stage,and 12 patients are in the uncertain maintenance stage.2.The survey results of sense of coherence and social support of breast cancer patients showed that:Among 304 breast cancer patients who did not return to work,the total score of sense of coherence was(64.51 ± 9.50),the highest score was sense of meaning(5.18±0.84),followed by sense of understandability(5.02±0.91),and the lowest score was sense of control(4.67±1.06).The total score of social support was(43.37±5.88),and the scores of each dimension in descending order were:subjective support(6.49±0.95),objective support(3.30±0.74),and utilization of support(2.50±0.72).Among 100 breast cancer patients who had returned to work,the total score of sense of coherence was(67.85±10.75),and the score of sense of meaning was the highest(5.53±0.94),followed by sense of understandability(5.19±0.94),and sense of control was the lowest(4.95±1.10).The total score of social support was(46.20±5.99),and the scores of each dimension in descending order were:subjective support(6.83±0.87),objective support(3.46±0.70)and utilization of support(2.84 ± 0.71).3.The results of correlation analysis among breast cancer patients’ sense of coherence,social support and readiness for return-to-work showed that among 304 breast cancer patients who did not return to work,the sense of coherence was positively correlated with social support(r=0.310),the sense of coherence was positively correlated with readiness for return-to-work(rs=0.197),and the social support was positively correlated with return-towork readiness(rs=0.189).Among 100 breast cancer patients who have returned to work,there is a positive correlation between sense of coherence and social support(r=0.356),between sense of coherence and maintenance for return-to-work(rs=0.140),and between social support and maintenance for return-to-work(rs=0.473).4.The results of the investigation on the influencing factors of readiness for return-towork of 404 breast cancer patients showed:The Mann-Whitney U test and Kruskal-Wallis Htest were used in 304 breast cancer patients who did not return to work.The results showed that the patients’ age,place of residence,education level,per capita monthly family income,job nature,length of resignation and TNM stage were different among the groups in the readiness for return-to-work.According to multiple logistic regression analysis,the average monthly family income of 6001～9000 yuan is the obstacle factor to improve the level of readiness for return-to-work,the age<30 years old,TNM stage Ⅱ,high level of sense of coherence and social support are the promoting factors to improve the level of readiness for return-to-work of breast cancer patients who have not returned to work.The Mann-Whitney U test and Kruskal-Wallis H test were used in 100 breast cancer patients who had returned to work.The results showed that the work nature and surgical methods of the patients had differences in the maintenance for return-to-work among the groups.Based on the binary logistic regression analysis,breast-conserving surgery,high level of sense of coherence and social support are the promoting factors to improve the maintenance of breast cancer patients who have returned to work.[Conclusion]1.In this study,the return-to-work rate of breast cancer patients is low,and the level of return-to-work readiness of patients who have not returned to work is low.Improving the level of sense of coherence and social support will help to improve the readiness for returnto-work of breast cancer patients who have not returned to work and the maintenance of breast cancer patients who have returned to work.2.The medical staff should focus on the management of the readiness for return-towork of breast cancer patients who are younger than 30 years old,whose TNM stage is Ⅱ,and whose per capita monthly income is 6001～9000 yuan.In addition,attention should be paid to the return-to-work maintenance of breast cancer patients who have returned to work and choose breast conserving surgery.