Association of marital and parental status with stress, support, adherence, and quality of life among breast cancer women

Abstract

Backgrounds Breast cancer presents multifaceted challenges that extend beyond physical illness, profoundly influencing patients’ psychological well-being, treatment adherence, and social relationships. Marital and parental status further affect these experiences by influencing coping capacity, emotional stability, and perceived support systems. This study aimed to assess how marital and parental status influence the lives of women with breast cancer, particularly their psychological well-being, support, treatment adherence, and overall quality of life (QoL). Methods This cross-sectional study of 503 patients utilized validated research instruments for data collection: The Depression, Anxiety, and Stress Scale (DASS-21), the Multidimensional Scale of Perceived Social Support (MSPSS), the Medication Adherence Report Scale (MARS-5), and the WHOQOL-BREF. Descriptive statistics, Kruskal-Wallis tests, and Spearman’s correlation (95% CI) were used as an exploratory data analysis. Multiple linear regression was utilized to measure the effect of different variables on the domains of QoL. The p<0.05 was considered significant. Results Across marital status, psychological distress, notably depression (median = 16.5, Q1-Q3 = 15–22.8, p>0.001), was predominantly observed in divorced/widowed women, whereas single women exhibited better social support (median = 72, Q1-Q3 = 60–81.2, p > 0.001) and overall WHOQOL (median = 86, Q1-Q3 = 79–93, p > 0.001). Relating to parental status, mothers, particularly those with multiple children, experienced greater psychological distress (median = 16, Q1-Q3 = 12–18, p > 0.001). At the same time, childless women exhibited better social support (median = 72, Q1-Q3 = 60–76, p > 0.001) and QoL (median = 86, Q1-Q3 = 79–93, p > 0.001). A negative relationship of medication adherence with both social support and QoL was observed, while it showed a positive correlation with psychological distress in breast cancer patients, with a significant value (p > 0.001). Conclusions In breast cancer patients, depression was highest among divorced/widowed women and mothers with multiple children, while single and childless women reported greater social support and QoL. Medication adherence showed a positive association with psychological distress and a negative correlation with both social support and QoL.