ABSTRACT
BACKGROUND: To assess emotional distress, anxiety and stress reactions in breast cancer (BC) patients before the follow-up visits. STUDY DESIGN: Between September 2009 and December 2011 a total of 284 patients completed the BC-psychosocial assessment screening scale (PASS) and a questionnaire about their views of follow-up after treatment for BC. RESULTS: Of the patients 64% reported low level of distress on the BC-PASS. The mean scores on the physical well-being scale was 5.3, the satisfaction/sense of coherence scale 7.4, and the emotional distress scale 8.1. Women rated mammography as the most important component (71%), followed by breast ultrasound (63%) and the consultation with the physician (60%). Of the patients 94% were satisfied with the current follow-up regimen. CONCLUSIONS: In this series BC patients were satisfied with their aftercare. Mammography was thought to be the most important component of aftercare. Patient-reported outcomes should be taken into account when planning follow-up.
Subject(s)
Aftercare/psychology , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Carcinoma, Ductal/psychology , Carcinoma, Ductal/therapy , Patient Satisfaction , Stress Disorders, Post-Traumatic/psychology , Adult , Aged , Anxiety/diagnosis , Anxiety/psychology , Austria , Carcinoma, Intraductal, Noninfiltrating/psychology , Carcinoma, Intraductal, Noninfiltrating/therapy , Female , Follow-Up Studies , Humans , Middle Aged , Physician-Patient Relations , Sense of Coherence , Stress Disorders, Post-Traumatic/diagnosis , Surveys and Questionnaires , Ultrasonography, Mammary/psychologySubject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Breast Neoplasms/drug therapy , Breast Neoplasms/psychology , Carcinoma, Ductal/drug therapy , Carcinoma, Ductal/psychology , Citalopram/adverse effects , Cytochrome P-450 CYP2D6 Inhibitors , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/psychology , Paroxetine/adverse effects , Selective Serotonin Reuptake Inhibitors/adverse effects , Tamoxifen/adverse effects , Antineoplastic Agents, Phytogenic/therapeutic use , Citalopram/therapeutic use , Drug Interactions , Female , Hot Flashes/chemically induced , Humans , Middle Aged , Paroxetine/therapeutic use , Selective Serotonin Reuptake Inhibitors/therapeutic use , Tamoxifen/therapeutic useABSTRACT
Emotional suppression has played an important role in the research on psychosocial factors related to cancer. It has been argued to be an important psychological factor predicting worse psychosocial adjustment in people with cancer and it may mediate health outcomes. The reference instrument in the research on emotional suppression is the Courtauld Emotional Control Scale (CECS). The present study analysed construct validity of a new Spanish adaptation of the CECS in a sample of 175 breast cancer patients. The results confirmed the proposal by Watson and Greer claiming that the CECS is composed of three subscales that measure different dimensions, but not independent, from emotional control. The present Spanish version of the CECS showed high internal consistency in each subseale as well as the total score. According to Derogatis (BSI-18) criteria, emotional suppression predicts clinically significant distress. In short, our results support the reliability, validity and utility of this Spanish adaptation of the CECS in clinical and research settings.
Subject(s)
Adaptation, Psychological , Breast Neoplasms/psychology , Carcinoma, Ductal/psychology , Cross-Cultural Comparison , Emotions , Internal-External Control , Personality Inventory/statistics & numerical data , Psychophysiologic Disorders/psychology , Repression, Psychology , Stress Disorders, Post-Traumatic/psychology , Adult , Aged , Anxiety/diagnosis , Anxiety/psychology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Ductal/pathology , Carcinoma, Ductal/surgery , Depression/diagnosis , Depression/psychology , Humans , Longitudinal Studies , Middle Aged , Neoplasm Staging , Psychometrics/statistics & numerical data , Psychophysiologic Disorders/diagnosis , Reproducibility of Results , Spain , Stress Disorders, Post-Traumatic/diagnosis , TranslatingABSTRACT
OBJECTIVES: This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. DESIGN: Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. METHOD: Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. RESULTS: Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. CONCLUSION: With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.
Subject(s)
Body Image , Breast Neoplasms/psychology , Breast Neoplasms/surgery , Carcinoma, Ductal/psychology , Carcinoma, Ductal/surgery , Carcinoma, Intraductal, Noninfiltrating/psychology , Carcinoma, Intraductal, Noninfiltrating/surgery , Carcinoma, Lobular/psychology , Carcinoma, Lobular/surgery , Gender Identity , Identity Crisis , Mammaplasty/psychology , Mastectomy, Segmental/psychology , Mastectomy/psychology , Adaptation, Psychological , Adult , Female , Grief , Humans , Interview, Psychological , Middle Aged , Qualitative Research , Reoperation/psychologyABSTRACT
The purpose of this study was to explore the symptom experience and predictors of distress and quality of life over time in women with recurrent breast cancer. Fifty-six women completed questionnaires at the diagnosis of recurrence, 1 month, 3 and 6 months after recurrence. A majority of women reported multiple, concurrent and distressing symptoms such as lack of energy, difficulty sleeping, pain, worry and problems with sexual interest or activity during the recurrent breast cancer trajectory. The highest level of symptom burden and distress and decreased quality of life was reported 3 months after recurrence. Although distress declined and quality of life improved over time, patients reported persistent symptoms. Of the patients at increased risk of vulnerability to distress were women who experienced multiple and concurrent symptoms. Other risk factors were co-morbidity, prehistory of anxiety and depression and progressive or terminal disease. Fatigue, pain and depression explained 68-72% of the variance in distress. Distress explained 44-46% of the variance in quality of life. These findings suggest that symptoms are important contributors to the distress experience, and that distress has a severe impact on quality of life. The care of women with recurrent breast cancer must be based upon the awareness of critical factors that exacerbate the vulnerability to distress throughout the disease trajectory.
Subject(s)
Breast Neoplasms/psychology , Carcinoma, Ductal/psychology , Carcinoma, Lobular/psychology , Neoplasm Recurrence, Local/psychology , Postmenopause/psychology , Quality of Life/psychology , Sick Role , Adaptation, Psychological , Aged , Anxiety/diagnosis , Anxiety/psychology , Breast Neoplasms/therapy , Carcinoma, Ductal/therapy , Carcinoma, Lobular/therapy , Comorbidity , Depression/diagnosis , Depression/psychology , Disease Progression , Fatigue/psychology , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local/therapy , Pain/psychology , Prognosis , Retreatment , Risk Factors , Surveys and QuestionnairesSubject(s)
Education, Medical, Undergraduate , Faculty, Medical , Neoplasms/psychology , Physician-Patient Relations , Truth Disclosure , Adult , Breast Neoplasms/genetics , Breast Neoplasms/psychology , Carcinoma, Ductal/genetics , Carcinoma, Ductal/psychology , Empathy , Female , Humans , MinnesotaABSTRACT
Hot flashes are a significant problem for many breast cancer survivors and can cause discomfort, insomnia, anxiety, and decreased quality of life. In the past, the standard treatment for hot flashes has been hormone replacement therapy. However, recent research has found an increased risk of breast cancer in women receiving hormone replacement therapy. As a result, many menopausal women and breast cancer survivors reject hormone replacement therapy and many women want non-pharmacological treatment. In this critical review we assess the potential use of hypnosis in reducing the frequency and intensity of hot flashes. We conclude that hypnosis is a mind-body intervention that may be of significant benefit in treatment of hot flashes and other benefits may include reduced anxiety and improved sleep. Further, hypnosis may be a preferred treatment because of the few side-effects and the preference of many women for a non-hormonal therapy. Two case studies are included to illustrate hypnosis for hot flashes. However this intervention has not been adequately studied. We discuss an NIH-funded randomized clinical trial of hypnosis for hot flashes in breast cancer survivors that is presently being conducted.
