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Analysis of the psychological conditions and related factors of breast cancer patients
Abstract
Sufferers of breast cancer are often plagued by various psychological problems. Mastectomy, which has a serious influence
on the female sex characteristics, can bring about especially serious psychological problems. These problems affect not only
the patients’ quality of life but also the beginning, development, and end of the disease. This paper reviewed the relationships
between the patients’ personal factors, the disease itself, treatment factors, and other socio-psychological factors and psychological
conditions so as to provide new ideas for the psychological intervention on breast cancer patients, comprehensive clinical
diagnosis and treatment, and prevention and cure.
... However, it is important to recognize that older survivors have their own unique stressors, including greater functional, vision, hearing, and cognitive impairments, which contribute to declines in social and role function as well as depression [61,62]. To that end, some studies have reported a higher prevalence of depression, especially more severe depression, in older cancer populations [30,[63][64][65]. ...
To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories.
Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60–98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories.
Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08–1.23) or recovery (OR = 1.26; 95% CI = 1.15–1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90–7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15–0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms.
Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes.
Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.
... The current study also found that females with BC have definite values of patience compared with healthy ones (t = 1.99, df = 198, P ≤ 0.05). Evidence to back this hypothesis is the fact that cancer adversely affects psychological, emotional, physical, spiritual, and social dimensions of the patient and the family [30][31][32][33][34] and that females after cancer diagnosis should tolerate difficulties of the disease as well as its social, familial, cultural, economic, etc. consequences, which needs a great deal of patience. The stages of the disease including the surgery, chemotherapy, radiotherapy, hormone therapy, etc. cause a lot of pain, which may result in greater patience even in people with low patience prior to the disease. ...
... These problems are related to the patients' personal, treatment and other socio-psychological factors. Also, they can weak the sufferers' immunity, aggravate the secondary reaction of treatment and cause the recurrence and deterioration of the disease, thus affecting the therapeutic effect and prognosis [8]. According to Stark et al. study, anxiety symptoms are common in cancer patients [9]. ...
... These problems are related to the patients' personal, treatment and other socio-psychological factors. Also, they can weak the sufferers' immunity, aggravate the secondary reaction of treatment and cause the recurrence and deterioration of the disease, thus affecting the therapeutic effect and prognosis [8]. According to Stark et al. study, anxiety symptoms are common in cancer patients [9]. ...
Background
Breast cancer is the most incident cancer and the fifth cause of death due to malignancies among Iranian women. A strong breast cancer patients' sense of meaning and purpose in life appears to decrease anxiety in their life. The present study has investigated the effectiveness of group Logotherapy on the reduction of anxiety in women with breast cancer.
Methods
The research was quasi-experimental with pre-test, post-test and control group. For this purpose, 30 patients with breast cancer were randomly divided into two experimental group and control group. Then, all patients completed the Beck Anxiety Inventory (BAI). The experimental group received Logotherapy-based group counseling for eight sessions; however, the control group did not receive any specific training. In the end, both groups were tested again. After collecting the questionnaires, data was analyzed by the statistic software SPSS version 18 and using analysis of covariance.
Results
The research results showed that group Logotherapy was effective in reducing anxiety in women with breast cancer (p<0.005). In other words, this intervention could reduce anxiety in the experimental group.
Conclusion
The results suggest that in line with current medical treatment, psychosocial interventions can be used to reduce anxiety in the breast cancer patients.
Background:
Improving healthy lifestyle behaviors in breast cancer survivors can promote their physical and mental health, thereby reducing the risk of cancer recurrence. Therefore, it is crucial to identify and control the factors affecting healthy lifestyle behaviors among breast cancer survivors.
Objective:
This study aimed to examine the effects of physiological, psychological, and situational factors and symptoms on healthy lifestyle behaviors in breast cancer survivors.
Methods:
Data were collected from August to September 2021, and a questionnaire was administered through an online breast cancer patient community's bulletin board. Finally, 162 questionnaires were included in the analysis.
Results:
The model was statistically significant, explaining 33.2% of the variance. A decrease in healthy lifestyle behaviors in breast cancer survivors was influenced by an age of 40 years or younger, 5 years or more since a breast cancer diagnosis, low income, fear of cancer recurrence, and fatigue.
Conclusions:
Intervention strategies, such as easily accessible online content that accounts for age and survival period after cancer diagnosis, should be used to promote healthy lifestyle behaviors among breast cancer survivors. Healthcare providers should be given appropriate guidelines on managing patients' fear of cancer recurrence and reducing fatigue to ensure timely access to clinical interventions. Adequate financial support from local communities and governments is needed to promote healthy lifestyle behaviors.
Implications for practice:
To improve breast cancer survivors' healthy lifestyle behaviors, an understanding of the influencing factors and a multidimensional approach are required. Nurses play a role in developing and implementing interventions to improve healthy lifestyle behaviors.
Objective
The purpose of this study was to summarize and discuss the application of video-assisted thoracoscopic surgery (VATS) in the treatment of 58 chest cancers.
Methods
The clinical data of 58 patients with thoracic tumor were analyzed retrospectively in treatment with VATS from July 2005 to June 2007. The surgery treatments included pulmonary wedge resection, enucleation of esophageal leiomyoma, bronchogenic cyst excision, mediastinal cyst excision, etc.
Results
All patients were treated with VATS. Three patients of those with lung cancer underwent open-chest lobectomy resection. All patients had no death and few complications, and all discharged.
Conclusion
VATS has advantages of less trauma, suffering light, quick recovery and small postoperative complications and has a great advantage in the treatment of chest benign tumors. But in the treatment of chest malignant tumors we should strictly control indications.
Effective breast-conserving surgical techniques for early-stage disease were developed to improve breast cancer patients' quality of life. The literature comparing the psychosocial sequelae of these newer treatments with mastectomy is ambiguous and shows an unexpected lack of substantial benefits. To clarify these inconsistencies, meta-analytic methods were used to summarize the findings of 40 investigations. Mean weighted effect sizes were calculated for 6 psychosocial outcomes. Modest advantages for breast-conserving surgery were identified for psychological, marital-sexual, and social adjustment; body/self-image; and cancer-related fears and concerns. Method of assignment to treatment and timing of assessment were relevant for some outcomes.
This analysis was designed to evaluate the association between coping strategies and breast cancer survival among Black and White women in a large population-based study. A total of 442 Black and 405 White US women diagnosed with invasive breast cancer during 1985-1986 and actively followed for survival through 1994 were administered a modified Folkman and Lazarus Ways of Coping questionnaire. Coping strategies were characterized via factor analyses of the responses. Hazard ratios associated with coping strategies were estimated using Cox proportional hazards models, with adjustment for age, race, tumor stage, study location, tumor hormone responsiveness, comorbidity, health insurance status, smoking, relative body weight, and alcohol consumption. Emotion-focused coping strategies were significantly associated with survival. Expression of emotion was associated with better survival (hazard ratio = 0.6; 95% confidence interval: 0.4, 0.9). When it was considered jointly with the presence or absence of perceived emotional support, women reporting low levels of both emotional expression and perceived emotional support experienced poorer survival than women reporting high levels of both (hazard ratio = 2.5; 95% confidence interval: 1.7, 3.7). Similar risk relations were evident for Blacks and Whites and for patients with early and late stage disease. These results suggest that the opportunity for emotional expression may help improve survival among patients with invasive breast cancer.
This analysis was designed to evaluate the association between coping strategies and breast cancer survival among Black and White women in a large population-based study. A total of 442 Black and 405 White US women diagnosed with invasive breast cancer during 1985-1986 and actively followed for survival through 1994 were administered a modified Folkman and Lazarus Ways of Coping questionnaire. Coping strategies were characterized via factor analyses of the responses. Hazard ratios associated with coping strategies were estimated using Cox proportional hazards models, with adjustment for age, race, tumor stage, study location, tumor hormone responsiveness, comorbidity, health insurance status, smoking, relative body weight, and alcohol consumption. Emotion-focused coping strategies were significantly associated with survival. Expression of emotion was associated with better survival (hazard ratio = 0.6; 95% confidence interval: 0.4, 0.9). When it was considered jointly with the presence or absence of perceived emotional support, women reporting low levels of both emotional expression and perceived emotional support experienced poorer survival than women reporting high levels of both (hazard ratio = 2.5; 95% confidence interval: 1.7, 3.7). Similar risk relations were evident for Blacks and Whites and for patients with early and late stage disease. These results suggest that the opportunity for emotional expression may help improve survival among patients with invasive breast cancer.
To solve the problem of hydraulic bumper of a type of large-caliber sniper rifle that its flow gap area can not be adjusted, this article improved its structure with the help of computer. The flow area of hydraulic bumper was redesigned to be a groove which has variable depth. The outline of the groove was created by cubic spline. A set of optimized parameters were got by using the optimization toolbox of MATLAB. After improvement, the peak value of kick of the rifle descends by 54% and the kick changes more smoothly
Two recently reported randomized trials, one among patients with advanced breast cancer and the other among patients with early stage melanoma, suggested that social support may affect survival favorably. This study assesses relationships of social support indicators with 7-year survival among women diagnosed with localized or regional stage breast cancer.
All newly diagnosed patients with surgically treated localized or regional disease in seven Quebec City hospitals in 1984 were considered for this analysis. Among 235 eligible patients, 224 (95%) participated in a home interview 3 months after surgery. This interview provided information on the use of confidants in the 3 months after surgery. Data on disease and treatment characteristics were abstracted from patients' medical records.
Compared with women who used no confidant in the 3 months after surgery, the hazard ratio for the 7-year period was 0.61 (95% confidence interval [CI], 0.33-1.12) among those who had used at least one confidant, 0.54 (95% CI, 0.28-1.06) in women who used two or more types of confidant, and 0.51 (95% CI, 0.22-1.18) among those whose confidants included either physician or nurse. These results were adjusted for age, presence of invaded axillary lymph nodes, adjuvant radiotherapy, and adjuvant systemic therapy (hormone or chemotherapy).
These results support the view that social support may be associated with longer survival among women with localized or regional stage breast cancer.
To explore variables associated with illness uncertainty and emotional distress for disease-free survivors of breast cancer.
Cross-sectional, descriptive, and correlational.
Regional cancer center in the southeastern United States.
109 women one to six years post-treatment for stage I-III nonmetastatic breast cancer.
Face-to-face data gathering using five questionnaires with established reliability.
Symptom distress, concurrent illness, fear of recurrence, illness uncertainty, positive reappraisal, and emotional distress.
The antecedent variables symptom distress, fear of recurrence, and concurrent illness problems were positively related to illness uncertainty. Illness uncertainty and the antecedent variables were positively related to emotional distress. The antecedent variables explained 40% of the variance in uncertainty. Uncertainty, its antecedents, and positive reappraisal collectively explained 51% of the variance in emotional distress.
Illness uncertainty related to symptoms and fear of recurrence was linked with emotional distress for some women, even years after treatment. Positive reappraisal may help to reduce this distress.
Nurses need to identify, monitor, and assist women who are at risk for illness uncertainty and emotional distress after breast cancer treatment. They also should explore with women positive, growth-promoting aspects of breast cancer, as well as aspects of the disease that are threatening.
Women who are diagnosed with breast cancer are at high risk for experiencing affective distress; however, previous research suggests that older women may be less likely than younger women to experience extreme distress. Two issues remain unclear regarding age and affective distress: (a) the psychological processes that account for the association of age and distress, and (b) whether this association remains stable over the course of treatment and recovery from breast cancer. This study investigated symptoms of anxiety and depression in 80 women ages 36-80 years old with newly diagnosed breast cancer near the time of their diagnosis and at 3 and 6 months post-diagnosis. Disease severity and coping style were also examined. Symptoms of anxiety/depression and age were negatively correlated near the time of diagnosis. Path analysis controlling for disease severity revealed that coping involving the ventilation of emotion fully mediated the effect of age on symptoms of anxiety and depression. However, the association of age with symptoms of anxiety/depression was no longer significant at 3 and 6 months post-diagnosis, although emotional ventilation still predicted greater emotional distress at 6 months. These findings suggest that age is a salient factor to consider in the psychological adjustment of women with breast cancer near the time of initial diagnosis, with younger women exhibiting greater affective distress and a tendency to engage in less adaptive ways of coping. However, younger and older women do not differ in their adjustment over the subsequent course of their treatment and initial recovery. The use of emotional ventilation coping remains associated with poorer adjustment, independent of patients' age.
To explore oncology nurses' experiences with receiving requests for assisted dying from terminally ill patients with cancer.
Descriptive, naturalistic.
RNs who identified themselves as direct care providers or clinical nurse specialist members of the Oncology Nursing Society.
40 oncology nurses who responded to a randomized, sequential direct mailing submitted 48 stories for analysis.
Anonymously submitted written stories analyzed using Denzin's process of interpretive interactionism.
The experience of receiving a request for assisted dying.
Four main themes emerged from the thematic analysis: Control, Conflict, Covert Communication, and the Enduring Influence. Eleven subthemes included the Cry for Help, Hastening the Process, What if, Managing the Morphine, Countering With Palliative Care, Collision of Values, Sense of Distress, Dialogue Around the Request, Silent Knowing, the Unforgettable, and Reflections on Lessons Learned.
Experiences included a mixture of direct-patient and family requests for pain relief, anticipatory fear of future pain, desire to end life before unacceptable deterioration, family requests to hasten the dying trajectory, and others. Stories reflected the larger societal struggle with desires to control life, health, and the dying process.
Nurses should be prepared to respond to such requests in a compassionate and helpful way that is respectful of both the patient's and the nurse's personal values. Diversity of individual values and priorities may trigger some patients to seek assistance in controlling the timing and circumstances of death. Thus, continued study of nurse, patient, and family member experiences with this ethical dilemma is warranted.
Breast conserving operations have become the standard operation for early breast cancer. They were performed in about 40% of all breast cancer patients in Japan in 2000, and the percentage is still increasing. Ductal carcinoma in situ (DCIS) accounts for about 7% of all breast cancers and breast conserving operations for DCIS have been followed by a low in-breast recurrence rate, leading to wider indications for breast conserving operations as screening mammography has come to be used in Japan. In-breast recurrence is correlated to surgical margin status. It is important to evaluate the surgical margin for volume of cancer cell nests as well as for positivity. Neoadjuvant chemotherapy has become popular as an in vivo sensitivity test and as a means of down-staging to increase the possibility of performing a breast conserving operation. There are two patterns of shrinkage when neoadjuvant chemotherapy is effective: cocentric and honeycomb, and the pattern of residual cancer cell nests must be determined before surgery. MRI is an effective method of evaluating residual cancer cell nests. The in-breast recurrence rate after down-staging to perform breast conserving operations is reported to be higher than among candidates for breast conserving operation at the start. Sentinel node biopsy techniques and endoscopic operations are now being assessed in conjunction with breast conserving operations. The current status of breast conserving operations in Japan is reviewed in comparison with their status in Western countries.
Cognitive side effects of systemic chemotherapy have become an increasing concern among breast cancer survivors, their families, and health care professionals. A growing body of research supports the hypothesis that chemotherapy can produce long-term cognitive changes in at least a subgroup of cancer survivors. We review evidence implicating systemic chemotherapy as the cause of cognitive changes; describe the limitations due to lack of longitudinal studies and gaps in knowledge (ie, no clear mechanism by which chemotherapy can produce cognitive changes has been proposed); discuss possible factors like age, intelligence quotient/education, and psychological, genetic, and hormonal factors that might increase risk for chemotherapy-induced cognitive changes; and outline future directions for research. Such future research includes large-scale, longitudinal studies of pretreatment neuropsychological assessments, use of imaging techniques and the development of animal models to study the mechanisms of chemotherapy-induced changes in cognitive functioning, and the development of interventions to prevent or reduce the negative cognitive effects of chemotherapy
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, improvedpsychological functioning from 2 to 6 months after diagnosis is related to a woman having a lower primary appraisal of threat and a greatersecondary 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.
The long-term impact of breast carcinoma and its treatment was assessed in 153 breast carcinoma survivors previously treated on a Phase III randomized trial (Cancer and Leukemia Group B [CALGB 7581]) a median of 20 years after entry to CALGB 7581.
Survivors were interviewed by telephone using the following standardized measures: Brief Symptom Inventory (BSI), PostTraumatic Stress Disorder Checklist with the trauma defined as survivors' response to having had cancer (PCL-C), Conditioned Nausea, Vomiting and Distress, European Organization for Research and Treatment of Cancer QLQ-C30 (quality of life), Life Experience Survey (stressful events), MOS Social Support Survey, comorbid conditions (Older Americans Resources and Services Questionnaire), and items developed to assess long-term breast carcinoma treatment side effects and their interference with functioning.
Only 5% of survivors had scores that were suggestive of clinical levels of distress (BSI), 15% reported 2 or more posttraumatic stress disorder (PTSD) symptoms (PCL-C) that were moderately to extremely bothersome, 1-6% reported conditioned nausea, emesis, and distress as a consequence of sights, smells, and tastes triggered by reminders of their treatment, 29% reported sexual problems attributed to having had cancer, 39% reported lymphedema, and 33%, reported numbness. Survivors who reported greater lymphedema and numbness that interfered with functioning had significantly worse PTSD (PCL-C; P = 0.008) com- pared with survivors who reported less lymphedema and numbness. Survivors with a lower level of education (P = 0.026), less adequate social support (P = 0.0033), more severe negative life events (P = 0.0098), and greater dissatisfaction with their medical care (P = 0.037) had worse PTSD compared with other survivors.
Twenty years after the initial treatment, the impact of breast carcinoma on survivors' adjustment was minimal. However, the higher prevalence of PTSD symptoms in response to having had cancer is indicative of continuing psychologic sequelae long after treatment completion. Findings related to lymphedema and numbness and continued symptoms of PTSD suggest that the long-term psychologic and medical sequelae on adjustment may be underrecognized. To establish in more detail whether survivors' overall psychologic state is any different from that of individuals without cancer, a population of community residents without cancer would need to be studied.
To provide an overview of chemotherapy-related cognitive dysfunction in breast cancer survivors, focusing on its pathophysiology, risk factors, assessment, and management.
Published biomedical literature.
Chemotherapy-related cognitive dysfunction in patients with breast cancer is multifactorial and possibly related to anemia or a direct effect of chemotherapy on brain function. Clinical observation and subjective reports are useful assessments. Therapies directed at alleviating or preventing cognitive deficits are being investigated.
Oncology nurses are important in monitoring cognitive function in patients with breast cancer receiving chemotherapy. Nurses who are aware of the risks, assessment, and management of cognitive impairment are better able to discuss these issues with patients and caregivers.
The bulge region of hair follicle has been reported as a putative reservoir of hair follicle stem cell (HFSC) for years; however, few studies were done about the characteristics of bulge-originated cells in vitro up to now. In this experiment, the bulge cells isolated from human hair follicles by enzymatic digestion and microdissection were cultured and passaged, and the morphological and biological features of cultured bulge cells were investigated by microscopy and immunocytochemistry. The result showed that new-proliferated cells could be observed on the second day after inoculation, and the quantity of the cells with a greater proliferation potential, reached a peak at the 6th day and maintained this higher level for several days. The mitotic figures of bulge cells were seen and these cells showed undifferentiated morphologic features. The bulge cells strongly expressed K19 and beta1-integrin, which are the markers of HFSC, in a descensive way with the culture time. The result indicates that the cultured bulge cell from human hair follicle possesses the properties of primitive cells and supports the hypothesis that HFSC resides in the bulge area.
On the sexual problems of post-mastectomy patients. Chinese Sexology Analysis of psychological states and psychological intervention of postoperation breast cancer patients
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- J Song
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Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy Oncology nLirse-experiences with requests for assisted dying from terminally ill patients with cancer
- Kornblith Ab
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A study of the influence of profession and income on the psychological barriers of breast cancer women About the psychological nursing of breast cancer patients
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Quality of marital life among women with mastectomy Adjustment to breast can-cer: age-related differences in coping and emotional distress
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- Mf Stoll
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Study on the time and geography distribution of reproduction-endocrine related tumors in China
- J Y Li
- R S Luan
- D S Wu
- J.Y. Li
Quality of marital life among women with mastectomy
- G F Guo
- J Q Xiao
- Y F Piao
- G.F. Guo
Difference of psychological health conditions between senile and young breast cancer patients
- S L Xie
- M G Zhu
- Y H Cao
- S.L. Xie
A study of the influence of profession and income on the psychological barriers of breast cancer women
- S H Jia
- C Jiang
- Y Zhao
- S.H. Jia
About the psychological nursing of breast cancer patients
- Y D Zeng
- Y.D. Zeng
The influence of psychological factors on the survival rates of breast cancer patients
- J Qian
- R Lou
- D Li
- J. Qian
Psychological analysis on postoperative breast cancer patients after underwent adenomammectomy
- P Li
- P. Li
Analysis of psychological states and psychological intervention of postoperation breast cancer patients
- Y B Han
- J Song
- Y M Zhang
- Y.B. Han
Psychological nursing of breast-conserving patients of early-stage breast cancer
- Y H Zhang
- X F Li
- A L Zhang
- Y.H. Zhang
Mental problems of the patients with maligant tumor before chemotherapy and nursing
- K M Zhu
- H Sheng
- Z X Cai
- K.M. Zhu
Clinical study on the coping style personality for patients with breast cancer patients during operation period
- Y Q Yu
- L X Xiao
- C S Zheng
- Y.Q. Yu
Education and the duration of marriage contributing on psychiatric disorder of MMP1-rated among breast cancer women
- S H Jia
- C Jiang
- Y Zhao
- S.H. Jia