Social Economic Factors, Depression, and Resilience among Women with Breast Cancer in Surakarta


  • Gayatri Kintan Larasati Masters Program in Public Health, Universitas Sebelas Maret, Surakarta
  • Rita Benya Adriani Department of Occupational Therapy, School of Health Polytechnics Surakarta
  • Bhisma Murti Masters Program in Public Health, Universitas Sebelas Maret, Su


Background: Women with breast cancer will experience physical and psychological changes that can cause depression. Social factors related to depression can affect the resilience of breast cancer sufferers. This study aimed to determine the factors that affect depression and resilience in women with breast cancer.

Subjects and Method: This was a cross-sectional study conducted in Kerten, Surakarta, from November to December 2018. A total of 200 women was selected for this study using simple random sampling. The dependent variable was the resilience of women with breast cancer. The independent variables were depression, family support, peer support, group support, self-efficacy, and coping mechanism. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.

Results: Resilience was directly affected by depression (b= -0.09; 95% CI= -0.14 to -0.05; p <0.001), family support (b = 0.22; 95% CI= 0.11 to 0.32; p<0.001), peer support (b = 0.23 ; 95% CI= 0.12 to 0.34; p <0.001), group support (b= 0.18; 95% CI= 0.06 to 0.29; p= 0.002), self-efficacy (b = 0.15; 95% CI= 0.06 to 0.24; p = 0.001), and coping mechanism (b= 0.05; 95% CI= 0.03 to 0.09; p= 0.001). Resilience was indirectly affected by family support, peer support, group support, and self efficacy.

Conclusions: The resilience of women with breast cancer is directly affected by depression, family support, peer support, group support, self-efficacy, and coping mechanism, but it is indirectly affected by family support, peer support, group support, and self-efficacy.

Keywords: resilience, breast cancer, depression, support, self-efficacy, the coping mechanism

Correspondence: Gayatri Kintan Larasati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Central Java 57126. Email: Mobile: +6285655084332.

Indonesian Journal of Medicine, (2018), 3(2): 110-118


Aini, Satiningsih (2015). Ketahanan psikologis pada perempuan penderita kanker payudara. Character: Jurnal Penelitian Psikologi. 03(03).

Akinyemiju TF (2012). Socioeconomic and health access determinants of breast and cervical cancer screening in low income countries: Analysis of the World Health Survey. PLoS ONE. 7(11): e48834. Doi: 10.1371/journal.pone.0048834.

Belcher AJ (2011). Daily support in couples coping with early stage breast cancer: maintaning intimacy during adversity. Health Psychology. 30(6): 665-673.

Costa AL, Heitkemper MM, Alencar GP, Damiani LP, Silva RM, Jarrett ME (2017). Social support is a predictor of lower stress and higher quality of life and resilience in Brazilian Patients with Colorectal Cancer. Cancer Nurs, 40: 352-60.

Dinkes Surakarta (2016). Rekapitulasi data penyakit tidak menular di Kabupaten Surakarta. Surakarta: DKK Surakarta.

Domhardt M, Münzer A, Fegert JM, and Goldbeck L (2015). Resilience in survivors of child sexual abuse: A Systematic review of the Literature. Sage Publication. 16(4):476 - 493. Doi: 10.1177/1524838014557288.

Herawati T, Krisnatuti D, Rukmayani IY (2012). Dukungan sosial dan ketahanan keluarga peserta dan bukan peserta program nasional pemberdayaan mayarakat (PNPM) Mandiri. Jurnal Ilmu Keluarga dan Konsumen. 5(1):1-10. ISSN:1907-6037.

Holland JC, Evcimen YA (2009). Depression in cancer patients. Dalam Ettinger, David S. (Eds.). Supportive Care in Cancer Therapy. USA: Humana Press.

Hu T, Xiao J, Peng J, Kuang X, He B (2018). Relationship between resilience, social support as well as anxiety/depression of lung cancer patients: A Cross-sectional Observation Study. J Can Res Ther, 14:72-7 doi: 10.4103/jcrt.JCRT_849_17

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011). Global cancer statistics. CA: a Cancer Journal for Clinicians. 61 (2): 69–90.

Kemenkes RI (2015). Infodatin Informasi dan Data Kementerian Kesehatan RI. Jakarta: Kemenkes RI.

Kim E, Kim SH, Kim S, Lee Y (2015). Resilience and related factors for patients with breast cancer. Asian Oncol Nurs. 15 (4), 193-202

Koelmel E, Hughes AJ, Alschuler KN, Ehde DM (2017). Resilience mediates the longitudinal relationships between social support and mental health outcomes in multiple sclerosis. Arch Phys Med Rehabil, 98:1139-48.

Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I (2006). Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncol, 24:1105-11.

Lees NF (2009). The ability to bounce back: the relationship beetween resilience, coping and positive outcome. Thesis: Massey University, New Zealand

Li J, Theng YL, Foo S (2015). Does psychological resilience mediate the impact of social support on geriatric depression? An exploratory study among Chinese older adults in Singapore. Asian J Psychiatr, 14:22-7.

Mhaidat NM, Alzoubi KH, Al-Sweedan S, Alhusein BA (2009). Prevalence of Depression among Cancer Patients in Jordan: a National Survey. Support Care Cancer. 17(11):14037. Doi: 10.1007/s00520-009-0600-z.

Philip EJ, Merluzzi TV, Zhang Z, Heitzmann CA (2013). Depression and cancer survivorship: Importance of coping, self-efficacy in posttreatment survivors. Psychooncology, 22(5): 987994. Doi: 10.1002/pon.3088.

Rahmandani A, Subandi (2010). Pengaruh terapi pemaafan dalam meningkatkan penerimaan diri penderita kanker payudara. Jurnal Intervensi Psikologi, 141-167.

Ren J, Jiang X, Yao J, Li X, Liu X, Pang M (2015). Depression, social support, and coping styles among pregnant women after the lushan earthquake in Ya'an, China. PLoS One, 10: e0135809

Retno D (2018). Studi pendahuluan komunitas Lovely Pink Solo. Surakarta: Komunitas Kanker Payudara Surakarta

Ristevska Dimitrоvska G, Stefanovski P, Smichkoska S, Raleva M, Dejanova B (2015). Depression and resilience in breast cancer patients. Open Access Macedonian Journal of Medical Sciences. 3(4):661-665.

Sagonea E, Caroli MED (2013). Relationships between resilience, self-efficacy, and thinking styles in italian middle adolescents. Procedia - Social and Behavioral Sciences 92 (2013) 838 – 845. Doi: 10.1016/j.sbspro.2013.08.763.

Stanton AL, Wiley JF, Krull JL, Crespi CM, Hammen C, Allen JJB (2015). Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer. Breast Cancer Research and Treatment, 154(1):105-115. Doi: 10.1007/s10549-015-3563-4

Southwick SM, Charney DS (2013). Resilience: The Science of Mastering Life's Greatest Challenges. New York: Cambridge.

Taylor SE (2012). Health psychology: eight edition. New York: McGraw Hill.

WHO (2014). Breast Cancer Awareness Month in October.

Yendork JS, Somhlaba NZ (2015). Do social support, self-efficacy and resilience influence the experience of stress in Ghanaian Orphans? An Exploratory Study. Child Care In Practice, 21(2), 140–159. doi: 10.1080/13575279.2014.985286.

Yeung NC, Lu Q (2018). Perceived stress as a mediator between social support and posttraumatic growth among Chinese American Breast Cancer Survivors. Cancer Nurs, 41:53-61.