Path Analysis on the Biopsychosocial Factors Affecting the Quality of Life in Patients with Breast Cancer

Rizka Amalia Dewi, Ambar Mudigdo, Eti Poncorini Pamungkasari


Background: Breast cancer is the most com­mon cancer among women, affecting 2.1 mil­lion women every year. Assessment of quality of life is con­sidered the most important and strong in­dicator for breast cancer outcomes. The purpose of this study was to analyze biopsychosocial factors that affect the quality of life of breast cancer patients.

Subjects and Method: A cross-sectional study was conducted in the breast cancer community in Su­ra­karta, Central Java from December 2019 to January 2020. A sample of 200 breast cancer patients was selected by simple random sam­pling. The dependent variable was the quality of life of breast cancer patients. The independent var­i­ables were stadium, chemotherapy, length of diag­nosis, age, depression, coping strategies, social net­­­­works, level of knowledge, education level, income level, employment status, and marital sta­­­tus. Quality of life was measured by WHO-QOL-BREF. Other data were collected by question­naire. Data were analyzed by path ana­lysis using the Stata 13 application.

Results: The quality of life of breast cancer pa­tients was directly increased by high family income (b=­ 3.27; 95% CI= 1.67 to 4.87; p<0.001), strong social network (b= 2.61; 95%CI= 0.96 to 4.26; p= 0.002), length of diagnosis ≥24 months (b= 2.68; 95% CI= 0.98 to 4.39; p= 0.002), good coping strategy (b= 1.65; 95% CI= 0.12 to 3.19; p= 0.034), and finish­ed chemotherapy (b=1.32; 95% CI = -0. 22 to 2.87; p= 0.093). The quality of life of breast can­­cer patients was directly decre­ased by depression (b= -2.78; 95% CI=-4.41 to -1.15; p= 0.001) and ad­van­ced stage (b=-2.43; 95% CI= -4.04 to 0.83; p=­ 0.­003). Quality of life was in­directly affected by cop­­ing strategy, marital status, chemotherapy, know­ledge, length of diag­nosis, age, employment, and education.

Conclusion: The quality of life of breast cancer pa­tients is directly increased by high family in­come, strong social network, length of diagnosis ≥24 months, good coping strategy, and finish­ed chemotherapy. The quality of life of breast can­­cer patients is directly decre­ased by depression and ad­van­ced stage. Quality of life is in­directly affect­ed by cop­­ing strategy, marital status, chemothe­rapy, know­ledge, length of diag­nosis, age, employment, and education.

Keywords: quality of life, breast cancer, path analysis

Correspondence: Rizka Amalia Dewi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. E­mail:  Mobile: +62823­13­12­1768.

Journal of Epidemiology and Public Health (2020), 05(01): 119-131

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