Relationship between family functioning and self-transcendence in patients with breast cancer: A network analysis

Abstract

Background: For patients with breast cancer, family functioning is an important factor affecting self-transcendence, which is a key source of happiness. However, network analysis studies of family functioning and self-transcendence are lacking, particularly among patients with breast cancer.

Purpose: The present study investigated the network structure of family functioning and self-transcendence in patients with breast cancer and aimed to identify bridge items to provide some theoretical support for the improvement and intervention of self-transcendence in patients with breast cancer.

Methods: A total of 294 patients with breast cancer were enrolled in our study. Self-transcendence was evaluated with the Self-Transcendence Scale. Family functioning was evaluated with the Family Adaptation, Participation, Growth, Affection, Resolution (APGAR) Scale. Network analyses were used for the statistical analysis.

Results: In the network of family functioning and self-transcendence in patients with breast cancer, there were 22 edges across communities, of which the 5 strongest edges connected to the 5 dimensions of family functioning are "Adaptation" with "Enjoyment of hobbies", "Participation" with "Life enjoyment", "Growth" with "Acceptance of bodily changes", "Affection" with "Life enjoyment", "Resolution" with "Help acceptance". "Adaptation" had the highest bridge expected influence value (0.30) in the family functioning community, while "Life enjoyment" had the highest bridge expected influence value (0.27) in the self-transcendence community.

Conclusion: Complex patterns of associations existed in the fine-grained relationship between family functioning and self-transcendence in patients with breast cancer. From the perspective of network analysis, the "Adaptation" aspect of family functioning and the "Life enjoyment" aspect of self-transcendence may be the best targets for improving self-transcendence. These results have important implications to clinical practice, which provided potential targets for interventions to improve self-transcendence from the perspective of family functioning.

Keywords: breast cancer; family functioning; network analysis; nursing; self-transcendence.

Figure 1

The network model of family functioning and self-transcendence and the bridge expected influence. (A) The network model of family functioning and self-transcendence. The nodes represent items of family functioning and self-transcendence, the blue edges represent connections between items, and thick lines and saturated colors represent close connections. In cross-community edges, the strongest correlation of F1 was with T1, the strongest correlation of F2 was with T14, the strongest correlation of F3 was with T5, the strongest correlation of F4 was with T14, the strongest correlation of F5 was with T13. (B) The bridge expected influence indices in the network of family functioning and self-transcendence (raw score). F1 had the highest bridge expected influence value (0.30) in the family functioning community, while T14 had the highest bridge expected influence value (0.27) in the self-transcendence community. F1 = adaptation; F2 = participation; F3 = growth; F4 = affection; F5 = resolution; T1 = enjoyment of hobbies; T2 = acceptance of aging; T3 = involvement with people; T4 = adjustment to life; T5 = acceptance of bodily changes; T6 = experience sharing; T7 = meaning of the past; T8 = helping others; T9 = interest in learning; T10 = problem solving; T11 = death acceptance; T12 = meaning in faith; T13 = help acceptance; T14 = life enjoyment; T15 = letting go of the past.