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Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study

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Abstract

Purpose

As many patients experience distress after breast cancer, we investigated whether perceived self-efficacy predicts breast cancer patients’ emotional, physical and social well-being and whether mental adjustment styles mediate this association.

Methods

A sample of 684 women with breast cancer completed a questionnaire including the general self-efficacy scale at baseline, the Mini-MAC at 1-month follow-up and the EORTC QLQ-C30 at 12-month follow-up. Multiple linear regression was used to assess associations between self-efficacy, mental adjustment style and well-being. Disease-related and sociodemographic factors were examined as confounders.

Results

Greater self-efficacy at baseline was associated with emotional well-being after 12 months (β = 0.59; 95% CI, 0.35–0.82). Fighting spirit, anxious preoccupation and helplessness–hopelessness partly mediated the effect of self-efficacy, but self-efficacy also had a direct effect on emotional functioning (β = 0.26; 95% CI, 0.02–0.51). No association was found between self-efficacy and physical and social well-being. Significant associations were observed between self-efficacy and education and time since diagnosis and also between well-being and age, education, relapse and time since diagnosis.

Conclusion

Self-efficacy was a significant predictor of an active adjustment style and emotional well-being in breast cancer patients. Hence, it could be a valuable target of rehabilitation programs.

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References

  1. Montazeri, A. (2008). Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007. Journal of Experimental & Clinical Cancer Research, 27, 32.

    Article  Google Scholar 

  2. Dalton, S. O., Laursen, T. M., Ross, L., Mortensen, P. B., & Johansen, C. (2009). Risk for hospitalization with depression after a cancer diagnosis: A nationwide, population-based study of cancer patients in Denmark from 1973 to 2003. Journal of Clinical Oncology, 27(9), 1440–1445.

    Article  PubMed  Google Scholar 

  3. Mehnert, A., & Koch, U. (2008). Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. Journal of Psychosomatic Research, 64(4), 383–391.

    Article  PubMed  Google Scholar 

  4. Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10(1), 19–28.

    Article  CAS  PubMed  Google Scholar 

  5. Carlson, L. E., Angen, M., Cullum, J., Goodey, E., Koopmans, J., Lamont, L., et al. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90(12), 2297–2304.

    CAS  PubMed  Google Scholar 

  6. Debess, J., Riis, J. O., Pedersen, L., & Ewertz, M. (2009). Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark. Acta Oncologica, 48(4), 532–540.

    Article  PubMed  Google Scholar 

  7. Arndt, V., Stegmaier, C., Ziegler, H., & Brenner, H. (2008). Quality of life over 5 years in women with breast cancer after breast-conserving therapy versus mastectomy: A population-based study. Journal of Cancer Research and Clinical Oncology, 134(12), 1311–1318.

    Article  PubMed  Google Scholar 

  8. Mols, F., Vingerhoets, A. J., Coebergh, J. W., & van de Poll-Franse, L. V. (2005). Quality of life among long-term breast cancer survivors: A systematic review. European Journal of Cancer, 41(17), 2613–2619.

    Article  PubMed  Google Scholar 

  9. Peuckmann, V., Ekholm, O., Rasmussen, N. K., Moller, S., Groenvold, M., Christiansen, P., et al. (2007). Health-related quality of life in long-term breast cancer survivors: Nationwide survey in Denmark. Breast Cancer Research and Treatment, 104(1), 39–46.

    Article  PubMed  Google Scholar 

  10. Ganz, P. A., Guadagnoli, E., Landrum, M. B., Lash, T. L., Rakowski, W., & Silliman, R. A. (2003). Breast cancer in older women: Quality of life and psychosocial adjustment in the 15 months after diagnosis. Journal of Clinical Oncology, 21(21), 4027–4033.

    Article  PubMed  Google Scholar 

  11. Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1(3), 141–169.

    Article  Google Scholar 

  12. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer.

    Google Scholar 

  13. Hobfoll, S. E. (1989). Conservation of resources—a new attempt at conceptualizing stress. American Psychologist, 44(3), 513–524.

    Article  CAS  PubMed  Google Scholar 

  14. Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.

    Google Scholar 

  15. Cunningham, A. J., Lockwood, G. A., & Cunningham, J. A. (1991). A relationship between perceived self-efficacy and quality of life in cancer patients. Patient Education and Counseling, 17(1), 71–78.

    Article  CAS  PubMed  Google Scholar 

  16. Hirai, K., Suzuki, Y., Tsuneto, S., Ikenaga, M., Hosaka, T., & Kashiwagi, T. (2002). A structural model of the relationships among self-efficacy, psychological adjustment, and physical condition in Japanese advanced cancer patients. Psycho-Oncology, 11(3), 221–229.

    Article  PubMed  Google Scholar 

  17. Luszczynska, A., Scholz, U., & Schwarzer, R. (2005). The general self-efficacy scale: Multicultural validation studies. The Journal of Psychology, 139(5), 439–457.

    PubMed  Google Scholar 

  18. Hochhausen, N., Altmaier, E. A., McQuellon, R., Davies, S. M., Papadopoulos, E., Carter, S., et al. (2007). Social support, optimism, and self-efficacy predict physical and emotional well-being after bone marrow transplantation. Journal of Psychosocial Oncology, 25(1), 87–101.

    Article  PubMed  Google Scholar 

  19. Boehmer, S., Luszczynska, A., & Schwarzer, R. (2007). Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping, 20(1), 61–75.

    Article  Google Scholar 

  20. Hoffman, A. J., von Eye, A., Gift, A. G., Given, B. A., Given, C. W., & Rothert, M. (2009). Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research, 58(1), 32–41.

    Article  PubMed  Google Scholar 

  21. Northouse, L. L., Mood, D., Kershaw, T., Schafenacker, A., Mellon, S., Walker, J., et al. (2002). Quality of life of women with recurrent breast cancer and their family members. Journal of Clinical Oncology, 20(19), 4050–4064.

    Article  PubMed  Google Scholar 

  22. Park, C. L., & Gaffey, A. E. (2007). Relationships between psychosocial factors and health behavior change in cancer survivors: An integrative review. Annals of Behavioral Medicine, 34(2), 115–134.

    Article  PubMed  Google Scholar 

  23. Mosher, C. E., Fuemmeler, B. F., Sloane, R., Kraus, W. E., Lobach, D. F., Snyder, D. C., et al. (2008). Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors’ dietary outcomes. Psycho-Oncology, 17(10), 1014–1023.

    Article  PubMed  Google Scholar 

  24. Greer, S., & Watson, M. (1987). Mental adjustment to cancer: Its measurement and prognostic importance. Cancer Surveys, 6(3), 439–453.

    CAS  PubMed  Google Scholar 

  25. Zucca, A. C., Boyes, A. W., Lecathelinais, C., & Girgis, A. (2010). Life is precious and I’m making the best of it: Coping strategies of long-term cancer survivors. Psycho-Oncology. doi:10.1002/pon.1686.

  26. Watson, M., Law, M., dos Santos, M., Greer, S., Baruch, J., & Bliss, J. (1994). The mini-MAC: Further development of the Mental Adjustment to Cancer Scale. Journal of Psychosocial Oncology, 12(3), 33–46.

    Article  Google Scholar 

  27. Grassi, L., Buda, P., Cavana, L., Annunziata, M. A., Torta, R., & Varetto, A. (2005). Styles of coping with cancer: The Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale. Psycho-Oncology, 14(2), 115–124.

    Article  PubMed  Google Scholar 

  28. Ho, S. M., Fung, W. K., Chan, C. L., Watson, M., & Tsui, Y. K. (2003). Psychometric properties of the Chinese version of the Mini-Mental Adjustment to Cancer (MINI-MAC) scale. Psycho-Oncology, 12(6), 547–556.

    Article  PubMed  Google Scholar 

  29. Barez, M., Blasco, T., Fernandez-Castro, J., & Viladrich, C. (2009). Perceived control and psychological distress in women with breast cancer: A longitudinal study. Journal of Behavioral Medicine, 32(2), 187–196.

    Article  PubMed  Google Scholar 

  30. Watson, M., Haviland, J. S., Greer, S., Davidson, J., & Bliss, J. M. (1999). Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet, 354(9187), 1331–1336.

    Article  CAS  PubMed  Google Scholar 

  31. Hack, T. F., & Degner, L. F. (2004). Coping responses following breast cancer diagnosis predict psychological adjustment three years later. Psycho-Oncology, 13(4), 235–247.

    Article  PubMed  Google Scholar 

  32. Kang, J. I., Chung, H. C., Kim, S. J., Choi, H. J., Ahn, J. B., Jeung, H. C., et al. (2008). Standardization of the Korean version of Mini-Mental Adjustment to Cancer (K-Mini-MAC) scale: Factor structure, reliability and validity. Psycho-Oncology, 17(6), 592–597.

    Article  PubMed  Google Scholar 

  33. Cotton, S. P., Levine, E. G., Fitzpatrick, C. M., Dold, K. H., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8(5), 429–438.

    Article  CAS  PubMed  Google Scholar 

  34. Schulz, U., & Mohamed, N. E. (2004). Turning the tide: Benefit finding after cancer surgery. Social Science and Medicine, 59(3), 653–662.

    Article  PubMed  Google Scholar 

  35. Schnoll, R. A., Harlow, L. L., Stolbach, L. L., & Brandt, U. (1998). A structural model of the relationships among stage of disease, age, coping, and psychological adjustment in women with breast cancer. Psycho-Oncology, 7(2), 69–77.

    Article  CAS  PubMed  Google Scholar 

  36. Schou, I., Ekeberg, O., Ruland, C. M., Sandvik, L., & Karesen, R. (2004). Pessimism as a predictor of emotional morbidity one year following breast cancer surgery. Psycho-Oncology, 13(5), 309–320.

    Article  CAS  PubMed  Google Scholar 

  37. Høybye, M. T., Dalton, S. O., Christensen, J., Ross Larsen, L., Kuhn, K. G., Nygaard Jensen, J., et al. (2008). Research in Danish cancer rehabilitation: Social characteristics and late effects of cancer among participants in the FOCARE research project. Acta Oncologica, 47, 47–55.

    Article  PubMed  Google Scholar 

  38. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor, England: NFER-NELSON.

    Google Scholar 

  39. Mikkelsen, E. G., & Einarsen, S. (2002). Relationships between exposure to bullying at work and psychological and psychosomatic health complaints: The role of state negative affectivity and generalized self-efficacy. Scandinavian Journal of Psychology, 43(5), 397–405.

    Article  PubMed  Google Scholar 

  40. Watson, M., Greer, S., Young, J., Inayat, Q., Burgess, C., & Robertson, B. (1988). Development of a questionnaire measure of adjustment to cancer: The MAC scale. Psychological Medicine, 18(1), 203–209.

    Article  CAS  PubMed  Google Scholar 

  41. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376.

    Article  CAS  PubMed  Google Scholar 

  42. Osoba, D., Aaronson, N., Zee, B., Sprangers, M. A., & Te Velde, A. (1997). Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. Quality of Life Research, 6(2), 103–108.

    Article  CAS  PubMed  Google Scholar 

  43. Moller, S., Jensen, M. B., Ejlertsen, B., Bjerre, K. D., Larsen, M., Hansen, H. B., et al. (2008). The clinical database and the treatment guidelines of the Danish Breast Cancer Cooperative Group (DBCG); its 30-years experience and future promise. Acta Oncologica, 47(4), 506–524.

    Article  PubMed  Google Scholar 

  44. Barez, M., Blasco, T., Fernandez-Castro, J., & Viladrich, C. (2007). A structural model of the relationships between perceived control and adaptation to illness in women with breast cancer. Journal of Psychosocial Oncology, 25(1), 21–43.

    Article  CAS  PubMed  Google Scholar 

  45. Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.

    CAS  PubMed  Google Scholar 

  46. Bredal, I. S. (2010). The Norwegian version of the Mini-Mental Adjustment to Cancer Scale: Factor structure and psychometric properties. Psycho-Oncology, 19(2), 216–221.

    Article  PubMed  Google Scholar 

  47. Anagnostopoulos, F., Kolokotroni, P., Spanea, E., & Chryssochoou, M. (2006). The Mini-Mental Adjustment to Cancer (Mini-MAC) scale: Construct validation with a Greek sample of breast cancer patients. Psycho-Oncology, 15(1), 79–89.

    Article  PubMed  Google Scholar 

  48. Anderson, R. M., & Funnell, M. M. (2009). Patient empowerment: Myths and misconceptions. Patient Education and Counseling. doi:10.1016/j.pec.2009.07.025.

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Acknowledgments

The study was funded by the Danish Cancer Society. The authors wish to acknowledge the excellent collaboration of the staff at the Dallund Rehabilitation Centre, Denmark.

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Authors and Affiliations

  1. Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Nina Rottmann, Susanne O. Dalton & Christoffer Johansen

  2. Department of Statistics and Epidemiology, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Jane Christensen & Kirsten Frederiksen

  3. National Centre for Cancer Rehabilitation Research, Institute of Public Health, University of Southern Denmark, Odense, Denmark

    Christoffer Johansen

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  1. Nina Rottmann
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  2. Susanne O. Dalton
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Correspondence to Nina Rottmann.

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Rottmann, N., Dalton, S.O., Christensen, J. et al. Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study. Qual Life Res 19, 827–836 (2010). https://doi.org/10.1007/s11136-010-9653-1

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