The psychosocial determinants of quality of life in breast cancer survivors: a scoping review

Abstract

Background Breast cancer care today involves state-of-the-art biomedical treatment but can fail to address the broader psychosocial and quality-of-life (QoL) issues associated with the transition to breast cancer survivorship. This scoping review examines the evidence on the influence of psychosocial determinants on QoL in breast cancer survivors. Methods Scoping review methodology was used to: (1) identify the research question(s); (2) identify relevant studies; (3) undertake study selection; (4) extract data; (5) collate, summarise and report the results. Results A total of 33 studies met the inclusion criteria. The majority of studies were conducted in the US (n = 22, 67%) and were mainly cross-sectional (n = 26, 79%). Sixteen psychosocial determinants of QoL were identified. Social support (n = 14, 42%), depression (n = 7, 21%) and future appraisal and perspective (n = 7, 21%) were the most frequently investigated determinants. Twelve different QoL measures were used. A range of different measurement tools were also used per psychosocial determinant (weighted average = 6). The 14 studies that measured the influence of social support on QoL employed 10 different measures of social support and 7 different measures of QoL. In general, across all 33 studies, a higher level of a positive influence and a lower level of a negative influence of a psychosocial determinant was associated with a better QoL e.g. higher social support and lower levels of depression were associated with a higher/better QoL. For some determinants such as spirituality and coping skills the influence on QoL varied, but these determinants were less commonly investigated. Conclusion Consensus around measures of QoL and psychological determinants would be valuable and would enable research to determine the influence of psychosocial determinants on QoL adequately. Research in other healthcare settings beyond the US is required, in order to understand the influence of organisation and follow-up clinical and supportive care on psychosocial determinants and QoL and to improve the quality of care in breast cancer survivors.

The mediator role of resilience between psychological predictors and health-related quality of life in breast cancer survivors: a cross-sectional study

“…This reflects the fact that positive psychological states can be shown in different aspects, and are positively correlated with each other [23]. Consistent with previous reports, it was found that confrontation, perceived social support, and resilience were positively associated with HRQoL, which indicated that a sound psychological state was beneficial to HRQoL improvement [8][9][10][11][12]. Although avoidance is a negative coping style, it was still helpful in protecting the BCSs' psychological defense system, which allowed more time for them to recover from their distress [24].…”

“…With the increased survival rate, health professionals have paid more attention to the psychological rehabilitation of BCSs [4]. The variables most commonly focused on were social support, psychological symptoms, emotional functioning, coping styles, confidence and self-efficacy, and future perspective and appraisal [8,10].…”

“…Although many psychological factors are related to HRQoL, the correlation among these factors and their role mechanisms to HRQoL have rarely been explored [8][9][10][11][12][13]. Considering the importance of resilience at the early stage of breast cancer rehabilitation [11], it is imperative to identify the psychological predictors of resilience, especially the variables reflecting personal coping styles and perception of social support.…”

Exploring the challenges in accessing care and support for cancer survivors in Australia during COVID-19

“…The literature highlights the significant impact of social support related to health-related quality of life. 9,10 Health care providers need to consider whether there is sufficient support available to deal with the increased concerns faced by cancer survivors during this pandemic. In order to ensure that the health needs and quality of life of cancer patients is not negatively impacted, providers of psychosocial support may need to make strategic changes in the provision of access to health and support services.…”

The non-fatal burden of cancer in Belgium, 2004–2019: a nationwide registry-based study

“…Thanks to early diagnosis and more effective therapies, the long-term survival of some cancer patients increased over the years [ 11 ], e.g., breast cancer 5-year net survival in high income countries is now 85–90% [ 12 ]. Nevertheless, the disease still affects the independence in performing daily living activities, also due to treatment-related disabling complications (e.g., breast cancer-related lymphedema, axillary web syndrome) [ 11 ] and psychosocial distress [ 13 ]. To date, however, country-specific estimates of the morbidity burden of cancer in terms of YLD are lacking, despite the existence of an exhaustive cancer registry.…”