The purposes of this study were to examine differences in self-esteem and well-being among 64 women with breast cancer and 64 age-matched comparison women, and to examine the relationship between self-esteem and well-being. This research addressed limitations in conceptualizing and measuring self-esteem to promote understanding of self-esteem, and its relationship to well-being. By including measures of well-being, this research considered the possibility that illness can trigger positive growth and development in some individuals.
Participants were recruited through newspaper ads, a breast clinic, and friends. Women with breast cancer were at least 2 months following completion of treatment but less than 55 months post-diagnosis. Comparison women without cancer were age-matched to within four years. Measures included Rosenberg's Self-Esteem Scale, Self-Anchoring Self-Esteem Scale, Ryff's Self-Acceptance Scale, and Ryff's Measures of Well-Being (autonomy, environmental mastery, personal growth, positive relations with others, and purpose in life). Demographic and disease and treatment information were collected. The Self-Anchoring Scale allowed for collection of numerical and narrative data, thus enhancing investigation of self-esteem. Data from individual interviews were tape recorded and transcribed. Quantitative analysis consisted of descriptive statistics, analyses of covariance with contrast analysis, and correlations. Narrative analysis included various techniques such as thematic and contrast analyses.
Group differences were found in relation to (a) the trajectory of self-esteem and well-being across age, (b) the structure of well-being, and (c) relationship between self-esteem and well-being. Relationships among self-esteem measures supported construct validity of the Self-Anchoring Scale. Among women with breast cancer, self-esteem and well-being showed a decremental change followed by incremental change across age, with lowest scores among women aged 50 to 59. The opposite pattern held true among comparison women. Positive relations with others was more central to well-being among women with breast cancer. Self-acceptance, in comparison to self-esteem, was more highly correlated with well-being among women with breast cancer while the opposite was true among comparison women. Narrative analysis of self-esteem data revealed additional group differences in (a) types of characteristics evaluated and (b) type of discrepancy between actual and desired self-concepts.
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