Predictors of expectancies for post-surgical pain and fatigue in breast cancer surgical patients

Abstract

Expectancies for post-surgical pain and fatigue have previously been found to predict pain and fatigue among breast cancer surgery patients. However, the study of predictors of these expectancies has been neglected. The present study was designed to investigate predictors of expectancies for postsurgical pain and fatigue among breast cancer surgery patients.Four hundred and eighteen women (M = 48.3 years, SD = 13.66 years) scheduled to undergo excisional breast biopsy or lumpectomy completed questionnaires assessing demographics/medical history, pre-surgical distress, stable personality characteristics, pre-surgical pain and fatigue, and expectancies for post-surgical pain and fatigue.Path analysis revealed: expectancies for post-surgical pain were significantly predicted by trait anxiety, acute pre-surgical distress, and age; and expectancies for post-surgical fatigue were significantly predicted by acute pre-surgical distress, acute pre-surgical fatigue, previous experience with the same surgical procedure, and education (all ps < .05). Examination of an alternative model revealed that the effects of the aforementioned predictors on expectancies were not mediated by acute pre-surgical distress, clarifying the directionality of the distress-expectancy relationship.Expectancies for post-surgical pain and fatigue are influenced by distress, treatment history, stable personality characteristics, extant symptoms, and demographic factors. These variables should be considered in designing clinical interventions to manipulate expectancies for patient benefit.

Pain and Inflammation in Women With Early-Stage Breast Cancer Prior to Induction of Chemotherapy

“…These findings suggest that perceived pain and other adverse symptoms are not related to the extent of BCA surgery, which is consistent with previous findings (Caffo et al, 2003; Montazeri et al, 2008). Pre-surgical distress and expectancies of pain and fatigue have been found to predict post-surgical pain and fatigue in women with BCA (Schnur et al, 2007). While the small sample sizes of each surgical subgroup likely affected the ability to detect significant differences among other cytokine levels, these preliminary results provide some support of altered pro- and anti-inflammatory cytokines levels at one month post-surgery.…”

Evaluating Patients With Chronic Pain After Breast Cancer Surgery

“…3 Patients' expectations for postsurgical pain and fatigue after breast excisional biopsy or lumpectomy can be affected by acute presurgical distress, previous experience with same surgical procedure, anxiety, presurgical pain and fatigue, and age. 15 Consideration of these factors in analysis of pain also may help to identify highrisk patients.…”

Anxiety and Pain in Surgically Treated Breast Cancer Patients

“…This finding may be related with educated women, whom may have much information about breast cancer and its treatment. State anxiety contributes to trait anxiety and increased levels of anxiety result in elevated levels of pain (Cauma et al, 2001;Katz et al, 2005;Schnur et al, 2007). In the study, there is very slightly correlation between trait anxiety and total analgesic consumption.…”

“…Vaughn et al (2007) reviewed literature and they found a positive correlation between preoperative anxiety and postoperative pain. Schnur et al (2007) have reported that patients who experience severe psychological distress prior to surgery are expected to have more postoperative pain. Similarly, Katz et al (2005) have shown that preoperative anxiety contributes to acute pain following surgery.…”