Trajectories of illness intrusiveness domains following a diagnosis of breast cancer.

Abstract

Objective To identify trajectories of illness intrusiveness over the first two years following a breast cancer diagnosis and describe associated patient and treatment characteristics. Illness intrusiveness, or how much an illness disrupts life domains, has been shown to be highly related to quality of life. Methods Women recruited within 8 months of a breast cancer diagnosis (n=653) completed questionnaires at baseline and 6, 12, and 18 months post baseline. Group-based trajectory modeling was used to identify trajectories in three established domains of illness intrusiveness: instrumental, intimacy, and relationships and personal development. Bivariate analyses identified contextual, disease/treatment, psychological and social characteristics of women in trajectory groups. Results Forty-one percent of women fell into a trajectory of consistently low illness intrusiveness (Low) across all three domains. Other women varied such that some reported illness intrusiveness that decreased over time on at least one domain (9-34%), and others reported consistently high intrusiveness on at least one domain (11-17%). A fourth trajectory of increased illness intrusiveness emerged in the relationship and personal development domain (9%). Characteristics of women in the Low group were older, less likely to have children at home, stage I cancer, fewer symptoms, and better psychosocial status. Conclusions Women experienced different patterns of illness intrusiveness in the first two years following a diagnosis of breast cancer with a high percentage reporting Low intrusiveness. However, women differentially followed the other trajectory patterns by domain, suggesting that the impact of breast cancer on some women’s lives may be specific to certain areas.

Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors

“…The study was developed to evaluate age differences in adjustment to breast cancer. Study design has been previously described [27–29]. Briefly, eligibility criteria included first time breast cancer diagnosis, cancer stage I–III, completion of baseline survey within 8 months of diagnosis, at least 18 years of age (although no one in the study was younger than age 25), and ability to read and understand English.…”

A longitudinal analysis of chronic arm morbidity following breast cancer surgery

“…A majority of women reported consistently low illness intrusiveness across these domains, while another group consistently reported high intrusiveness in at least one domain. Another trajectory of illness intrusiveness was characterized with a decrease in at least one domain overtime [48]. Taken together, the present study findings and the results of the illness-intrusiveness trajectory study emphasize the need for interventions that increase a woman's sense of perceived ability to perform tasks of daily living, particularly in the first 2 years following surgery.…”

“…With time, as BC survivors learn to cope with AM, particularly restrictions in ROM, as they adopt strategies to lessen the intrusiveness in their daily lives, make gains in their physical recovery, and achieve greater acceptance of their disease and side-effects, this sense of perceived disability may decrease. A study revealed certain trajectories of illness intrusiveness in certain domains: instrumental, intimacy, and relationships and personal development [48]. A majority of women reported consistently low illness intrusiveness across these domains, while another group consistently reported high intrusiveness in at least one domain.…”

“…The Illness-Intrusiveness model has served as the theoretical framework for numerous studies investigating BC survivors' adaptation to their illness (e.g., [41,42,44,[46][47][48]). In a study investigating this construct in BC, illness intrusiveness was found to mediate the effect of disease and treatment factors (such as illness severity, bodily pain, symptom distress) on quality of life in young women with BC [46].…”

Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors

“…The study was developed to evaluate age differences in adjustment to breast cancer. Study design has been previously described [27][28][29]. Briefly, eligibility criteria included first time breast cancer diagnosis, cancer stage I-III, completion of baseline survey within 8 months of diagnosis, at least 18 years of age (although no one in the study was younger than age 25), and ability to read and understand English.…”