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Problem-solving style and adaptation in breast cancer survivors: a prospective analysis

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Abstract

Introduction

Emotional care of the breast cancer patient is not well understood; this lack of understanding results in both a high cost to the patient, as well as the health care system. This study examined the role of problem-solving style as a predictor of emotional distress, adjustment to breast cancer, and physical function immediately post-surgery and 12 months later.

Methods

The sample consisted of 121 women diagnosed with breast cancer and undergoing surgery as a primary treatment. The survivors completed a measure of problem-solving style and three outcome measures immediately post-surgery, as well as at 1 year later. There was a 95.6% retention rate at 1 year.

Results

Multiple hierarchical regressions revealed, after controlling for patient demographics and stage of cancer, that problem-solving style (particularly personal control) was associated with emotional distress, adjustment to chronic illness, and physical function immediately following surgical intervention. In addition, a more positive problem-solving style was associated with less emotional distress, but not a better adaptation to a chronic illness or physical functioning 12 months later; the Personal Control again was the best single predictor of the emotional distress, adding 10% of the variance in predicting this outcome.

Conclusions

The utility of post-surgery assessment may help identify those in need for problem-solving training to improve these outcomes at 1 year. Future studies need to determine the impact of interventions tailored to levels of problem-solving styles in cancer survivors over time.

Implications for Cancer Survivors

Understanding the role of problem solving style in breast cancer survivors deserves attention as it is associated with emotional distress immediately and one year after medical intervention. Problem-solving style should be evaluated early, and interventions established for those most at risk for emotional distress.

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Acknowledgements

Research Supported by NIH R01 NR05342 and MU PRIME C2720047 (Armer, PI), as well as Ellis Fischel Cancer Center research funds. The authors wish to thank Dr. Richard Madsen, Ashley Sherman, and Isabella Zaniletti for biostatistical assistance, Dr. Bob R. Stewart for editorial review, the other members of the Lymphedema Research Team including research nurses, research assistants, and clinical collaborators at Ellis Fischel Cancer Center and, most importantly, the breast cancer survivors participating in the study.

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Author notes

  1. Brent Mallinckrodt

    Present address: Department of Psychology, University of Tennessee, Knoxville, TN, 37996-0900, USA

Authors and Affiliations

  1. Department of Educational, School and Counseling Psychology, University of Missouri, 16 Hill Hall, Columbia, MO, 65211, USA

    P. Paul Heppner & Brent Mallinckrodt

  2. Sinclair School of Nursing, University of Missouri, Columbia, MO, 65211, USA

    Jane M. Armer

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  1. P. Paul Heppner
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Correspondence to P. Paul Heppner.

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Paul Heppner, P., Armer, J.M. & Mallinckrodt, B. Problem-solving style and adaptation in breast cancer survivors: a prospective analysis. J Cancer Surviv 3, 128–136 (2009). https://doi.org/10.1007/s11764-009-0085-2

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