Volume 23, Issue 1 (April & May 2020)
J Arak Uni Med Sci 2020, 23(1): 34-47 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Firouzi R, Tizdast T, Khalatbari J, Ghorban Shiroudi S. Relationship Between Stress Coping Strategies and Difficulties in Emotion Regulation Mediated by Marital Life Quality in Married Women With Breast Cancer. J Arak Uni Med Sci 2020; 23 (1) :34-47
URL: http://jams.arakmu.ac.ir/article-1-6163-en.html
URL: http://jams.arakmu.ac.ir/article-1-6163-en.html
1- Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
2- Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran. ,TaherTizdast@yahoo.com
2- Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran. ,
Keywords: Stress coping strategies, Difficulties in emotion regulation, Marital life quality, Breast cancer
Full-Text [PDF 5307 kb]
(2162 Downloads)
| Abstract (HTML) (3859 Views)
Full-Text: (2707 Views)
Extended Abstract
Introduction
Breast cancer is one of the most common cancers in women [1, 2], causing psychological problems [3] and emotional difficulties in women [4]. Coping strategies can reduce disease problems [5]. Coping strategies are a set of efforts used to correct stressful situations [6]. Women with difficulties in emotion-focused coping strategy also experience lower marital quality [7].
According to records, there is a significant relationship between coping strategies and marital quality in women with cancer, and coping strategies can predict marital quality [8]. Therefore, having a problem-focused strategy can reduce emotional difficulties by affecting marital quality [9, 10]. This study aimed to investigate the mediating role of marital life quality in the relationship between coping with stress and difficulty in regulating emotion.
Materials and Methods
This is a descriptive correlational study. The study population consists of married women with breast cancer referred to Arin Clinic, Breast Cancer Diagnosis Center, and medical specialist physician offices in Amol and Babol cities in 2018. Of these, 385 were selected by a convenience sampling method and based on Cochran’s formula. Having breast cancer based on the diagnosis of a specialist, a history of breast surgery, and being married were some of the criteria for entry. Data collection tools were Ways of Coping Questionnaire (WCQ) developed by Folkman’s & Lazarus [11] rated on a 4-point Likert scale from 0 to 3 [12] with convergent validity of 0.33 [13] and Cronbach’s alpha coefficients ranged 0.86-0.93 [14], Difficulties in Emotion Regulation Scale (DERS) developed by Gratz & Roemer [15] having 35 items rated on a 5-point Likert scale with Cronbach’s alpha of 0.93 [16], and Marital Life Quality Scale (MLQS) developed by Busby et al. [17] having 14 items rated on a 6-point Likert scale with Cronbach’s alpha of 0.86 [18]. Data were analyzed using descriptive statistics (mean and standard deviation) and Pearson correlation and Structural Equation Modeling (SEM) in LISREL software.
Results
A total of 385 women participated in the study; 27 (7%) aged 28-38 years, 103 (26.8%) aged 39-49 years, 151 (39.2%) aged 50-60 years, 97 (25.2%) aged 61-71 years, and 7 (1.8%) aged 72 years and older. Their mean age was 53.80±9.732 years. In terms of education, 34 (8.8%) were illiterate; 108 (28.1%), primary school; 125 (32.5%), middle school; 77 (20%) had high school diploma; 15 (3.9%), associate degree; 22 (5.7%), bachelor’s degree; and 4 (1%) master’s degree. Moreover, 267 (69.35%) were housewives and 118 (30.65%) were employees. According to the results of Pearson correlation test shown in Table 1, there is a positive and significant relationship between emotion-focused strategy for coping with stress and difficulty in emotion regulation, and a negative and significant relationship between problem-focused coping strategy and difficulty in emotion regulation.
These results make it possible to perform the SEM analysis. In the final model, all straight paths were significant at P<0.01. According to Table 2, the results of the Bootstrap method for examining indirect mediating pathways showed that strategies for coping with stress (problem- and emotion-focused) have an indirect relationship with difficulty in emotion regulation through marital quality, and the causal path is significant. Moreover, the model fit indices showed the good fit of the study model. According to Table 3, since the value of Root Mean Square Error of Approximation (RMSEA) is less than 0.08 (P<0.05), this value indicates the optimal fit of the model.
Introduction
Breast cancer is one of the most common cancers in women [1, 2], causing psychological problems [3] and emotional difficulties in women [4]. Coping strategies can reduce disease problems [5]. Coping strategies are a set of efforts used to correct stressful situations [6]. Women with difficulties in emotion-focused coping strategy also experience lower marital quality [7].
According to records, there is a significant relationship between coping strategies and marital quality in women with cancer, and coping strategies can predict marital quality [8]. Therefore, having a problem-focused strategy can reduce emotional difficulties by affecting marital quality [9, 10]. This study aimed to investigate the mediating role of marital life quality in the relationship between coping with stress and difficulty in regulating emotion.
Materials and Methods
This is a descriptive correlational study. The study population consists of married women with breast cancer referred to Arin Clinic, Breast Cancer Diagnosis Center, and medical specialist physician offices in Amol and Babol cities in 2018. Of these, 385 were selected by a convenience sampling method and based on Cochran’s formula. Having breast cancer based on the diagnosis of a specialist, a history of breast surgery, and being married were some of the criteria for entry. Data collection tools were Ways of Coping Questionnaire (WCQ) developed by Folkman’s & Lazarus [11] rated on a 4-point Likert scale from 0 to 3 [12] with convergent validity of 0.33 [13] and Cronbach’s alpha coefficients ranged 0.86-0.93 [14], Difficulties in Emotion Regulation Scale (DERS) developed by Gratz & Roemer [15] having 35 items rated on a 5-point Likert scale with Cronbach’s alpha of 0.93 [16], and Marital Life Quality Scale (MLQS) developed by Busby et al. [17] having 14 items rated on a 6-point Likert scale with Cronbach’s alpha of 0.86 [18]. Data were analyzed using descriptive statistics (mean and standard deviation) and Pearson correlation and Structural Equation Modeling (SEM) in LISREL software.
Results
A total of 385 women participated in the study; 27 (7%) aged 28-38 years, 103 (26.8%) aged 39-49 years, 151 (39.2%) aged 50-60 years, 97 (25.2%) aged 61-71 years, and 7 (1.8%) aged 72 years and older. Their mean age was 53.80±9.732 years. In terms of education, 34 (8.8%) were illiterate; 108 (28.1%), primary school; 125 (32.5%), middle school; 77 (20%) had high school diploma; 15 (3.9%), associate degree; 22 (5.7%), bachelor’s degree; and 4 (1%) master’s degree. Moreover, 267 (69.35%) were housewives and 118 (30.65%) were employees. According to the results of Pearson correlation test shown in Table 1, there is a positive and significant relationship between emotion-focused strategy for coping with stress and difficulty in emotion regulation, and a negative and significant relationship between problem-focused coping strategy and difficulty in emotion regulation.
Discussion
The results of this study are consistent with the findings of previous studies (9, 19, 20, 21, 22, 23, 24). Effective problem-focused coping strategies are often associated with reduced psychological stress, and by increasing the confidence of a woman’s breast cancer, her problem-solving skills improve and lead to greater marital satisfaction. A person who has a higher level of marital satisfaction also has a better quality of marital life. Therefore, this increase in the quality of marital life, due to its positive functions, leads to coherence and agreement in the patient’s married life and equips her with some abilities and strategies that can maintain emotional management in stressful conditions.
However, with emotion-focused coping strategy, the patient tries to control the emotional consequences of the stressor to maintain emotional balance, which in turn increases her anxiety and remains her marital problems unsolved, reducing her quality of marital life. On the other hand, married women with breast cancer, due to the stresses caused by their illness, when are involved in marital problems with their husbands and use an emotion-focused coping strategy, it makes it difficult for them to regulate and manage their emotions.
To generalize the results of this study, it is suggested that further research should be conducted in other cities to provide further evidence of the relationships obtained. It is recommended that psychologists, with the help of health care centers, try to solve the emotional problems of women with breast cancer by designing training courses on coping strategies in the form of couples therapy.
Ethical Considerations
Compliance with ethical guidelines
This study received its ethical approval from Islamic Azad University of Tonekabon Branch (Code: IR.IAU.TON.REC.1397.029). Informed consent was obtained from all participants.
Funding
This article was extracted from the PhD. thesis of the first author Raheleh Firoozi, Department of Psychology, Islamic Azad University, Tonekabon Branch.
Authors' contributions
All authors contributed in preparing this article.
Conflicts of interest
The authors declare no conflict of interest.
The results of this study are consistent with the findings of previous studies (9, 19, 20, 21, 22, 23, 24). Effective problem-focused coping strategies are often associated with reduced psychological stress, and by increasing the confidence of a woman’s breast cancer, her problem-solving skills improve and lead to greater marital satisfaction. A person who has a higher level of marital satisfaction also has a better quality of marital life. Therefore, this increase in the quality of marital life, due to its positive functions, leads to coherence and agreement in the patient’s married life and equips her with some abilities and strategies that can maintain emotional management in stressful conditions.
However, with emotion-focused coping strategy, the patient tries to control the emotional consequences of the stressor to maintain emotional balance, which in turn increases her anxiety and remains her marital problems unsolved, reducing her quality of marital life. On the other hand, married women with breast cancer, due to the stresses caused by their illness, when are involved in marital problems with their husbands and use an emotion-focused coping strategy, it makes it difficult for them to regulate and manage their emotions.
To generalize the results of this study, it is suggested that further research should be conducted in other cities to provide further evidence of the relationships obtained. It is recommended that psychologists, with the help of health care centers, try to solve the emotional problems of women with breast cancer by designing training courses on coping strategies in the form of couples therapy.
Ethical Considerations
Compliance with ethical guidelines
This study received its ethical approval from Islamic Azad University of Tonekabon Branch (Code: IR.IAU.TON.REC.1397.029). Informed consent was obtained from all participants.
Funding
This article was extracted from the PhD. thesis of the first author Raheleh Firoozi, Department of Psychology, Islamic Azad University, Tonekabon Branch.
Authors' contributions
All authors contributed in preparing this article.
Conflicts of interest
The authors declare no conflict of interest.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
