| Background The incidence of breast cancer in women younger than 40 years is increasing. And the number of young breast cancer survivors has become larger. Hope can be a resource for coping. Hope is considered to have a positive influence upon health. It may help young women making trasition from healthy to living with cancer and moving on.However, there are few published studies regarding hope and health-related quality of life (HRQOL) in young breast cancer survivors in the research literature. As conceptualized as a multidimensional dynamic life force, the contents of hope should be explored.Results of this study may shed light on the importance of hope at young breast cancer survivors and therefore support the role of nursing in promoting hope.Objective The purpose of this study was:1)to examine the level of hope and HRQOL in survivors.2) to determine the relationship between hope, self-efficacy and HRQOL,and the influencing variables of hope and HRQOL.3) to determine the changes of hope and HRQOL after 6 months.4) to understand the experience of hope in young breast cancer survivors by exploring meaning of hope, the resource of hope and the influence of hope.Methods Both quantitative and qualitative design were adapted in this study. Firstly a mail survey was completed by 65 breast cancer survivors under 40 years old with a minimum of 3 months after their surgery. Data collected at baseline were information on demographic and clinical characteristics, socres of hope, self-efficacy, HRQOL. Instuments were the Herth Hope Index (HHI), General self efficacy (GSE) and CARES-SF. In quantitative phase of this study, hope, self-efficacy, and HRQOL were assessed 6 months later.Indepth interviews were conducted with the population-based sample:17 women who were under 40 at diagnosis.Results 1) the initial total HHI score was 38.68±6.17,and 38.90±5.906 months later. The change of HHI score was not statistically significant (p>0.05).2) multiple linear regression revealed that,self-efficacy(T1) and occupation status were associated with hope(T1)(R2=0.221,p<0.01),the level of hope at baseline and self-efficacy(T2) were associated with hope at T2 (R2=0.678, p<0.01).3) One-way ANOVA and independent t test indicated that patients with higher education and more income reported a higher HHI score.4) religion,occupation status,income,survival length had weak to moderate relationship with hope.5)GSE score had positively relationship with levels of hope (r=0.40,p<0.01).6) HRQOL and GSE score increased significantly after 6 months.7) education,occupation status,income,survival length,hope had weak to moderate relationship with HRQOL score.8) GSE score was negatively related to HRQOL and 3 domains.9) multiple linear regression revealed that, hope(T1),self-efficacy(T1) and occupation status were associated with T1 HRQOL score (R2=0.40, p<0.01), self-efficacy(T2) and occupation status were associated with T2 HRQOL score.10) The understanding of hope in young breast cancer survivors were addressed in 4 themes:①the understand of hope——hope is the desire to live, grasping today and have a great longing for a bright future.②Hope comes from inner conviction and external social support.③survivors with hope can generate wills to live and a sense of direction, re-planning for future.④hope is a dynamic changing concept and can be consistently internalized while living with cancer.Conclusions This study on hope,self-efficacy and HRQOL of young breast cancer survivors provides a vital understanding on the impact at hope on young breast cancer survivors. The findings of this study underscore the importance of the healthcare professionals in promoting hope at the end of life care, and suggests that hope is not taken away by diagnosed as breast cancer. The experience of hope in young breast cancer survivors is particularly unique. Health professionals should communicate with survivors, understanding their feelings and the expectations, providing psychosocial interventions appropriately to increase their quality of life. |
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