title: Social adjustment among Chinese women following breast cancer surgery.
abstract: BACKGROUND
  How breast cancer surgery affects social adjustment among Chinese women is unknown, as are factors predicting such adjustment.
  
  
  METHODS
  405 Chinese women receiving surgery for localized breast cancer completed Social Adjustment Scales (Ch-SAS) at 1-, 4- and 8-months post-operatively. Subscale scores were regressed on baseline (days 3-12 post-operatively) measures of treatment decision-making difficulty (TDMD), self-efficacy (GSeS), consultation satisfaction (C-MISS-R), psychological (CHQ-12) and physical distress (PD), and 1-month follow-up optimism (C-LOT-R), and disappointment (E-OI), fully adjusted for demographic and clinical factors.
  
  
  RESULTS
  All Ch-SAS subscales except appearance & sexuality changed significantly over 8-months follow-up: Enjoyment of social activities (F=27.38, df 2, p<0.001) and self-image (F=3.63, df 2, p=0.027) improved slightly. Family interaction (F=26.63, df 2, p<0.001) and interaction with friends (F=3.37, df 2, p=0.035) declined slightly. Family and friends interaction subscales were predominantly predicted by high self-efficacy and optimism, whereas self-image and appearance & sexuality subscales were predominantly predicted by low treatment outcome disappointment, TDM difficulties, baseline psychological morbidity and high self-efficacy. Enjoyment of social activities was predicted by low baseline psychological distress and concurrent physical symptom distress.
  
  
  CONCLUSIONS
  High self-efficacy and optimism predicted women who have better social relationships with friends and family. Higher self-efficacy, low TDM difficulties, less disappointment with treatment outcome and low psychological and physical distress predicted better adjustment to self-image and body image.
authors.affiliation: Department of Community Medicine and Unit for Behavioural Sciences, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Wendy W T
authors.initials: WW
authors.lastname: Lam
authors.forename: Miranda
authors.initials: M
authors.lastname: Chan
authors.forename: Wai Ka
authors.initials: WK
authors.lastname: Hung
authors.forename: Amy
authors.initials: A
authors.lastname: Or
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D005195:Family Relations; D005260:Female; D006723:Hong Kong; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D011581:Psychological Tests; D012649:Self Concept; D019529:Sexuality; D012917:Social Adjustment