Appraisal and psychological distress six months after diagnosis of breast cancer

Abstract

OBJECTIVES: Four in ten women with breast cancer experience high levels of anxiety or depression, despite advances in oncology treatments. The study investigates the role of psychosocial, disease and treatment characteristics, and appraisal processes to better understand factors contributing to this high psychological morbidity. DESIGN: A postal survey was employed to observe psychological morbidity in women 2 and 6 months after initial diagnosis and treatment of breast cancer. The study was conducted as an adjunct to an Australian multi-centre feasibility study of an evidence-based specialist breast nurse (SBN) model of care. METHODS: In total, 195 women with a new diagnosis of early or locally advanced breast cancer completed the data collection relating to this study. Psychosocial, disease and treatment information for each woman at diagnosis was recorded in research logs. Women completed the GHQ-12 questionnaire 2 months after diagnosis, and at 6 months they completed the GHQ-12 and an appraisal process questionnaire designed by the National Breast Cancer Centre (NBCC). Bivariate and multiple regression analyses were undertaken to build a statistical model to account for GHQ-12 scores at 6 months. RESULTS: According to the GHQ-12, 43% of women had a likely affective disorder at either 2 or 6 months after diagnosis. Point prevalence decreased from 2 to 6 months yet remained substantial compared with general population statistics. Psychological functioning in women with breast cancer is related to a woman's psychiatric history, grade of tumour, and her appraisal processes. Most importantly, improved psychological functioning from 2 to 6 months after diagnosis is related to a woman having a lower primary appraisal of threat and a greater secondary appraisal of self-efficacy in terms of having confidence in her own ability to cope with concerns associated with the illness. CONCLUSION: Appraisal processes play a significant role in psychological adjustment to breast cancer. Adjustment may be facilitated by ensuring that the treatment team responds to shortfalls in a woman's appraisal of her illness and her perceived ability to cope, especially where a difficult prognosis is evident.

Describing and predicting psychological distress after colorectal cancer

“…A less negative cancer threat appraisal has been found to predict lower decision-related distress and better psychological adjustment in prostate and breast cancer patients. 16,21,22 Social support that encompasses emotional, informational, and practical support may mitigate the adverse psychological effects of a cancer diagnosis by acting as a coping resource and is associated with lower distress after breast and colorectal cancer. 15,17,23 In combination these psychosocial variables have been found to concurrently predict up to 38% of baseline mood in breast cancer patients; however, such effects typically diminish at subsequent prospective assessments where baseline distress is accounted for.…”

Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer

“…It is also specified that 4 in every 10 patients with breast cancer experience high levels of anxiety or depression (44). A study that assessed the patients during both the preoperative period and 3 rd and 12 th months within postoperative period detected that 55% of patients had anxiety and/or depression at any one or more assessment (45).…”

Posttraumatic Growth, Dyadic Adjustment, and Quality of Life in Breast Cancer Survivors and Their Husbands

“…유방암 생존자는 치료과정을 거 치는 동안 피로, 통증, 및 탈모와 같은 부작용과 일시적이고 영구적 인 외모의 변화, 장래계획의 변화, 및 질병 재발의 잠정적 위협 등의 많은 부정적 사건들에 부딪히게 된다. 이러한 경험들로 인해 유방암 환자의 7-46%가 임상적으로 의미있는 우울 증상, 불안 및 심리적 디 스트레스를 경험하였다 [3,4]. 정신장애의 진단 및 통계편람 제4판…”