ABSTRACT
PURPOSE: We analyzed health care utilization (HCU) and its predictors in the first year after the diagnostic process for breast cancer (BC) or benign breast disease (BBD) using questionnaires. The impact of trait anxiety on HCU was examined. RESULTS: In total 591 women were analyzed, 440 with BBD and 151 with BC. In women with BBD and high trait anxiety (HTA) increased HCU was found. In women with BC and HTA only more use of psychosocial care (PS) was found. HCU in BBD was predicted by lower Quality of Life (QoL) and (adjuvant) treatment predicted HCU in BC. CONCLUSIONS: The most important factors for higher HCU were HTA and lower QoL, especially in BBD. In women with BC increased PS use was seen in chronically anxious women. Therefore, it is important to identify these women using a psychometric test and to anticipate to their specific (mental) health care needs.
Subject(s)
Anxiety/complications , Breast Diseases , Health Services/statistics & numerical data , Personality , Quality of Life , Adult , Breast Diseases/complications , Breast Diseases/diagnosis , Breast Diseases/psychology , Breast Diseases/therapy , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Depression/complications , Fatigue/complications , Female , Health Care Surveys , Humans , Longitudinal Studies , Middle Aged , Multivariate Analysis , Netherlands , Prospective Studies , Regression Analysis , Surveys and QuestionnairesABSTRACT
PURPOSE: To determine the relationship between pre-diagnosis state anxiety, depressive symptoms, and combined state anxiety and depressive symptoms (CADS) with quality of life (QOL), fatigue, state anxiety and depressive symptoms one and two years after surgery in women with breast cancer. METHODS: Women with breast problems referred to a Dutch outpatient clinic were recruited for the study. Participants (N=428) completed a set of questionnaires before diagnosis (Time0) and the women with breast cancer subsequently received questionnaires at 12 (Time1) and 24 months (Time2) after surgical treatment. The questionnaire set consisted of questionnaires on demographics, state anxiety, depressive symptoms, fatigue, QOL, neuroticism, and trait anxiety. Chi-square tests, independent samples T-tests, and multivariate linear regression analyses were used to do the analyses. RESULTS: Before their diagnosis of breast cancer, 111 women (28%) had CADS. Of the CADS-group, a higher percentage had elevated levels of anxiety, depressive symptoms, and CADS at all follow-up moments than of the non-CADS-group. CADS-score at before diagnosis and neuroticism were the most important predictors of outcome measures at Time1 and Time2. CONCLUSIONS: More than one in four women, who later received the diagnosis breast cancer, had elevated levels of both state anxiety and depressive symptoms (CADS) just before diagnosis. This factor was also a major predictor of QOL, state anxiety, depressive symptoms, and fatigue 12 and 24 months after surgery. This implies that women with a higher score on both state anxiety and depressive symptoms should be identified as soon as possible in the process of diagnosis and treatment of breast cancer using validated questionnaires or screening instruments. Only by identifying this group of patients, tailored psychological care can be accomplished.
Subject(s)
Anxiety/psychology , Breast Neoplasms/psychology , Depression/psychology , Adult , Aged , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Fatigue , Female , Follow-Up Studies , Humans , Middle Aged , Prospective Studies , Quality of LifeABSTRACT
PURPOSE: The aim of this study was to analyze the possible negative psychological consequences of a false positive screening mammogram (FPSM). We compared anxiety evoked by first (FSM) versus repeat screening mammogram (RSM). Questionnaires were completed prior to the diagnosis and during follow up. RESULTS: No differences in anxiety, depressive symptoms, and Quality of Life (QoL) were found between FSM (N = 186) or RSM (N = 296) groups. All women experienced high anxiety before diagnosis was known. High trait anxiety was predictive for more anxiety, depressive symptoms, and lower QoL. Women with low score on trait anxiety were more momentary anxious in FSM group compared with RSM group (p = 0.048). CONCLUSION: Negative psychological consequences after an FPSM are seen in all women. These effects are strengthened by personality and timing of the screening mammogram. All women should receive correct information concerning the negative psychological effects and should be offered psychosocial support if needed.
Subject(s)
Anxiety , Depression , Mammography/psychology , Quality of Life , Aged , False Positive Reactions , Female , Humans , Mass Screening , Middle Aged , Netherlands , Prospective Studies , Surveys and QuestionnairesABSTRACT
PURPOSE: The objectives of this study were to examine the differences in health status (HS) of women with breast cancer (BC) at different moments in time, and between women scoring high and not high on trait anxiety, and to identify possible predictors of HS 6 and 12 months after surgery. METHODS: Patients (N = 223) completed a trait anxiety questionnaire before diagnosis. Women who received a diagnosis of BC completed a BC-specific HS questionnaire 1, 3, 6 and 12 months after surgery. ANCOVA for repeated measures and multiple regression analysis were used in the analyses. RESULTS: Women scoring high on trait anxiety had significant (P < .005) lower Body image, worse Future perspective and Sexual functioning, and more Side-effects than women who did not score high on trait anxiety. At 6 and 12 months after surgery, the same aspects of HS were predicted by higher trait anxiety scores. CONCLUSIONS: Higher scores on trait anxiety resulted in worse scores on four HS domains, indicating that there should be more attention for this group of patients, even before treatment starts.
