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ABSTRACT: It is generally assumed that coping strategies impact quality of life (QOL). It is plausible that QOL determines use of coping strategies. This research examines coping strategies over time and the reciprocal relationship between coping strategies and QOL among younger women with breast cancer. Women with breast cancer (N = 267; mean age = 43 years) completed surveys within 6 months of diagnosis and 6 weeks and 6 months later. Surveys included questions on coping strategies, QOL, medical factors, and sociodemographics. Positive cognitive restructuring was the most frequently used strategy. Over time, use of seeking social support, spirituality, and wishful thinking declined, while detachment increased. Prior QOL predicted three subsequent coping strategies (seeking social support, keeping feelings to self, wishful thinking). Coping strategies were minimally related to subsequent QOL. Coping strategies and QOL are dynamic processes. QOL may predict coping strategies equally or more than vice versa.
Journal of Behavioral Medicine 04/2009; 32(4):371-9. · 3.10 Impact Factor
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ABSTRACT: To describe quality of life (QOL) of younger women 4 to 42 months after breast cancer diagnosis and to identify factors associated with impaired QOL.
A total of 202 women diagnosed with stage I to III breast cancer at age 50 or younger from 4 to 42 months after breast cancer diagnosis previously completed a mailed survey. Global QOL; health-related QOL as measured by the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B); medical history; symptoms; days of work/activity missed after diagnosis; relationship, sexual, and body image problems; coping strategies; and feelings of preparedness were measured.
General aches and pains and unhappiness with appearance were reported by more than 70% of women. Hot flashes (P = .0007), pain with sexual intercourse (P = .02), and difficulty with bladder control (P = .002) all significantly increased with age. Global QOL was significantly lower than for a nonpatient sample of younger women (P < .0001). In general, few sociodemographic and medical factors were related to QOL. In multivariate analyses, days of work/usual activity missed immediately after diagnosis; relationship, sexual, or body image problems after diagnosis; and coping strategies were related to almost all QOL domains. Ongoing treatment, vaginal dryness, and feeling unprepared for the impact of breast cancer were related to some domains.
Younger breast cancer survivors are at risk for impaired QOL up to several years after diagnosis. Younger women, especially those at high risk for lower QOL, may need interventions that specifically target their needs related to menopausal symptoms and problems with relationships, sexual functioning, and body image. Preparing younger woman for the impact of breast cancer may also prove beneficial.
Journal of Clinical Oncology 05/2005; 23(15):3322-30. · 18.37 Impact Factor
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ABSTRACT: Women diagnosed with breast cancer at a younger age often have concerns less frequently faced by older women. A cross-sectional survey of 204 women diagnosed with breast cancer at age 50 or younger within the past 3.5 years was conducted to examine issues particularly faced by younger women. The questionnaire included standardized measures of problems related to breast cancer (CARES) and open-ended questions asking women about their experiences. Concerns about premature menopause and pregnancy related issues, among those women for whom these issues were applicable, had the highest ratings as problems experienced by women since their diagnosis. Among all women, sexual functioning was a greater problem than lack of sexual interest, and body image was of moderate concern. Overall, relationships with partners were not a problem. In multivariate analyses, having a mastectomy was associated with greater problems with body image and interest in sex. Chemotherapy was associated with greater sexual dysfunction. Responses to open-ended questions were particularly informative and reflected the diversity of responses women have to breast cancer. Findings reinforce the need to develop interventions to help women deal with premature menopause and problems with sexual functioning following chemotherapy.
Psycho-Oncology 06/2004; 13(5):295-308. · 3.34 Impact Factor
