Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.



Degree Program

Nursing, PhD

Committee Chair

Hall, Lynne A.

Committee Co-Chair (if applicable)

Christian, Becky J.

Committee Member

Christian, Becky J.

Committee Member

Chlebowy, Diane Orr

Committee Member

Hermann, Caral P.

Committee Member

Schapmire, Tara J.

Author's Keywords

Perceived social support; family relationships; health-related quality of life; breast cancer; cancer; social support


Introduction: Breast cancer is the most common cancer among Jordanian women. Perceived social support (PSS) and family relationships are strongly associated with positive psychosocial outcomes and health-related quality of life (HRQoL). This area was widely explored in Western countries, but little attention was devoted to investigate this area in Middle East region. Purpose: to investigate the interrelationships among PSS, family relationships, and HRQoL of women with breast cancer in Jordan using an exploratory cross-sectional design. Method: The contextual model of HRQoL designed by Ashing-Giwa (2005) provided the foundation for this study. A total of 140 women were recruited from one large governmental hospital in Jordan using convenience sampling. Survey data were collected in the breast cancer clinic using the Medical Outcomes Study--Social Support Survey (MOS-SSS), Family Relationship Index (FRI), and the Quality of Life-Breast Cancer Version (QOL-BC). Statistical analysis included descriptive and inferential statistics; data were analyzed using SPSS. Results: A majority of the participants were 41 to 60 years (70%), married (63.6%), had stage II of breast cancer (41%), and were housewives (80.7%). Women with breast cancer had moderate levels of overall HRQoL, and moderate to high levels of perceived social support. In addition, women scored the highest in spiritual well-being and the lowest in the psychological well-being. Despite the presence of COVID-19, women scored the highest in the affectionate and positive social interaction social support. Women with breast cancer who were supported by their social network members had higher levels of HRQoL and psychological well-being. In addition, women who reported that the pandemic of COVID-19 affected the level of social support they received had lower levels of total HRQoL, physical well-being, psychological well-being, and social well-being. Conclusion: There is an urgent need for psychological counseling services to improve psychological well-being for cancer patients in Jordan. Psychosocial care for cancer patients is still underdeveloped, fragmented, and neglected area. More efforts are needed to focus on other elements of the cancer experience (e.g., social and psychological), besides the physical aspect. The results of this study are beneficial for nursing science and address the gaps in psychosocial cancer care and areas for improvement.

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