Abstract
Purpose
Physical symptoms associated with breast cancer and its treatment can substantially interfere with functional outcomes and quality of life. The present study seeks to delineate the relationship between physical symptom burden and cancer-related goal interference in early-stage breast cancer patients.
Methods
Self-report questionnaires were administered to 43 eligible female patients at four time-points in the 6 months following surgery for early-stage breast cancer. Physical symptoms, cancer-related goal interference, and psychological distress were assessed at each time-point. K-means cluster analysis and independent sample t tests evaluated the relationships of interest.
Results
Women with a higher physical symptom burden experienced significantly higher goal interference and psychological distress than those with a lower burden at multiple time-points following surgery.
Conclusions
This study provides preliminary evidence that physical symptom burden can interfere with important goal pursuit in early-stage breast cancer patients. Breast cancer survivors with ongoing challenging symptoms may require targeted psychosocial support to cope with possible goal interference and associated distress.
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References
Ganz PA (2003) Why and how to study the fate of cancer survivors: observations from the clinic and the research laboratory. Eur J Cancer 39:2136–2141
Stein KD, Syrjala KL, Andrykowski MA (2008) Physical and psychological long-term and late effects of cancer. Cancer 112:2577–2592
de Haes JC (1988) Quality of life: Conceptual and theoretical considerations. In: Watson M, Greer S, Thomas C (eds) Psychosocial oncology. Pergamon Press, Oxford, pp 61–70
Calman KC (1984) Quality of life in cancer patients: an hypothesis. J Med Ethics 10:124–127
Carr AJ, Gibson B, Robinson PG (2001) Measuring quality of life: is quality of life determined by expectations or experience? Br Med J 322:1240–1243
Cella DF, Tulsky DS (1990) Measuring quality of life today: methodological aspects. Oncology 4:29–39
WHOQOL, Group (1995) The World Health Organisation quality of life assessment (the WHOQOL): position paper from the World Health Organisation. Soc Sci Med 41:1403–1409
Carver CS, Scheier MF (1998) On the self-regulation of behaviour. Cambridge University Press, Cambridge
Schmuck P, Sheldon KM (2001) Life goals and well-being: Towards a positive psychology of human striving. Hogrefe & Huber Publishers, Seattle
Brunstein JC, Schultheiss O, Maier GW (1999) The pursuit of personal goals: A motivational approach to well-being and life adjustment. In: Brandtstadter J, Lerner RM (eds) Action and self-development: Theory and research through the life span. Sage, Thousand Oaks, pp 169–196
Emmons RA (1986) Personal strivings: an approach to personality and subjective well-being. J Pers Soc Psychol 51:1058–1068
Brandtstadter J, Rothermund K (2002) The life-course dynamics of goal pursuit and goal adjustment: a two-process framework. Dev Rev 22:117–150
Wrosch C, Scheier MF, Carver CS, Schulz R (2003) The importance of goal disengagement in adaptive self-regulation: when giving up is beneficial. Self and Identity 2:1–20
Carver CS (2005) Enhancing adaptation during treatment and the role of individual differences. Cancer 104:2602–2607
Thompson E, Stanton AL, Bower JE (2012) Situational and dispositional goal adjustment in the context of metastatic cancer. J Pers. doi:10.1111/jopy.12025
Lepore SJ, Eton DT (2000) Response shifts in prostate cancer patients: An evaluation of suppressor and buffer models. In: Schwartz CE, Sprangers MAG (eds) Adaptation to changing health: Response shift in quality-of-life research. American Psychological Association, Washington, DC, pp 37–51
Pinquart M, Frohlich C, Silbereisen RK (2008) Testing models of change in life goals after a cancer diagnosis. J Loss Trauma 13:330–351
Offerman MPJ, Schroevers MJ, van der Velden LA, de Boer MF, Pruyn JFA (2010) Goal processes & self-efficacy related to psychological distress in head & neck cancer patients and their partners. Eur J Oncol Nurs 14:231–237
Pinquart M, Nixdorf-Hanchen JC, Silbereisen RK (2005) Associations of age and cancer with individual goal commitment. Appl Dev Sci 9:54–66
Cleeland CS (2007) Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Canc Inst Monogr 37:16–21
Deshields TL, Potter P, Olsen S, Liu J, Dye L (2011) Documenting the symptom experience of cancer patients. J Support Oncol 9:216–223
Dodd MJ, Miaskowski C, Paul SM (2001) Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 28:465–470
Miaskowski C, Aouizerat BE, Dodd M, Cooper B (2007) Conceptual issues in symptom clusters research and their implications for quality-of-life assessment in patients with cancer. J Natl Canc Inst Monogr 37:39–46
Dodd M, Rankin S, Taylor D et al (2001) Advancing the science of symptom management. J Adv Nurs 33:668–676
Miaskowski C, Cooper BA, Paul SM et al (2006) Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: a cluster analysis. Oncol Nurs Forum 33:E79–E89
Pud D, Ben Ami S, Cooper BA et al (2008) The symptom experience of oncology outpatients has a different impact on quality-of-life outcomes. J Pain Symptom Manage 35:162–170
Dodd MJ, Cho MH, Cooper BA, Miaskowski C (2010) The effect of symptom clusters on functional status and quality of life in women with breast cancer. Eur J Oncol Nurs 14:101–110
Zucca AC, Boyes AW, Linden W, Girgis A (2012) All's well that ends well? Quality of life and physical symptom clusters in long-term cancer survivors across cancer types. J Pain Symptom Manage 43:720–731
Burkett VS, Cleeland CS (2007) Symptom burden in cancer survivorship. J Cancer Surviv 1:167–175
Klinger E (1977) Meaning and void: Inner experience and the incentives in people's lives. University of Minnesota Press, Minneapolis
Cimarolli VR, Boerner K, Wang SW (2006) Life goals in vision rehabilitation: are they addressed and how? J Visual Impair Blin 100:343–352
Popivker L, Wang SW, Boerner K (2010) Eyes on the prize: life goals in the context of visual disability in midlife. Clin Rehabil 24:1127–1135
Portenoy RK, Thaler HT, Kornblith AB et al (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30:1326–1336
Gwede CK, Small BJ, Munster PN, Andrykowski MA, Jacobsen PB (2008) Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approach. Support Care Cancer 16:925–933
Lovibond SH, Lovibond PF (1995) The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behav Res Ther 33:335–343
Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K (2012) My changed body: breast cancer, body image, distress and self-compassion. Psychooncology. doi:10.1002/pon.3230
Sharp L, Carsin AE, Timmons A (2013) Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psychooncology 22:745–755
Carelle N, Piotto E, Bellanger A, Germanaud J, Thuillier A, Khayat D (2002) Changing patient perceptions of the side effects of cancer chemotherapy. Cancer 95:155–163
Coates A, Abraham S, Kaye SB et al (1983) On the receiving end-patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19:203–208
Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D (2008) Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional nationwide survey in the U.S. Support Care Cancer 16:791–801
Sanford SD, Wagner LI, Beaumont JL, Butt Z, Sweet JJ, Cella D (2013) Longitudinal prospective assessment of sleep quality: before, during, and after adjuvant chemotherapy for breast cancer. Support Care Cancer 21:959–967
Fortner BV, Stepanski EJ, Wang SC, Kasprowicz S, Durrence HH (2002) Sleep and quality of life in breast cancer patients. J Pain Symptom Manage 24:471–480
Wrosch C, Scheier MF, Miller GE, Schulz R, Carver CS (2003) Adaptive self-regulation of unattainable goals: goal disengagement, goal reengagement, and subjective well-being. Pers Soc Psychol Bull 29:1494–1508
Boerner K, Wang SW (2012) Goals with limited vision: a qualitative study of coping with vision-related goal interference in midlife. Clin Rehabil 26:81–93
de Ridder D, Kuijer R (2007) Reconsidering illness-related goals: is discrepancy resolved by confronting emotions? Psychol Health 22:107–122
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Stefanic, N., Caputi, P. & Iverson, D.C. Investigating physical symptom burden and personal goal interference in early-stage breast cancer patients. Support Care Cancer 22, 713–720 (2014). https://doi.org/10.1007/s00520-013-2026-x
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DOI: https://doi.org/10.1007/s00520-013-2026-x