Quality of Life in Breast Cancer Patients: The Moderator Role of Family Stress
Abstract
In breast cancer patients, quality of life has been associated with treatment response and overall survival. One hundred women undergoing chemotherapy treatment for breast cancer completed questionnaires including demographic and clinical information, the EORTC-Quality of Life Questionnaire, Hospital Anxiety and Depression Scales, Body Image Scale, Index of Family Relations and the Life Orientation Test. The results showed that higher optimism and better body image were associated with improved quality of life. Distress significantly predicted physical and emotional quality of life, but recurrence only predicted physical quality of life. Family stress was a moderator in the relationship between psychological distress and emotional quality of life, showing the need to screen and intervene on family stress in patients with breast cancer. The results may help in designing interventions for women with breast cancer in order to promote quality of life.
Downloads
References
Aaronson, N., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., & Duez, N. 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. JNCI Journal Of The National Cancer Institute, 85(5), 365-376. http://dx.doi.org/10.1093/jnci/85.5.365
Al-Ghazal, S., Fallowfield, L., & Blamey, R. (1999). Does cosmetic outcome from treatment of primary breast cancer influence psychosocial morbidity?. European Journal Of Surgical Oncology (EJSO), 25(6), 571-573. http://dx.doi.org/10.1053/ejso.1999.0708
Allisson, P., Guichard, C., & Gilain, L. (2000). A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients. Quality Of Life Research, 9(8), 951-960.
Applebaum, A., Stein, E., Lord-Bessen, J., Pessin, H., Rosenfeld, B., & Breitbart, W. (2013). Optimism, social support, and mental health outcomes in patients with advanced cancer. Psycho-Oncology, 23(3), 299-306. http://dx.doi.org/10.1002/pon.3418
Ardebil, M., Bouzari, Z., Shenas, M., Zeinalzadeh, M., & Barat, S. (2011). Depression and Health Related Quality of Life in Breast Cancer Patients. Academic Journal Of Cancer Research, 4(2), 43-46.
Avis, N., Crawford, S., & Manuel, J. (2005). Quality of Life Among Younger Women With Breast Cancer. Journal Of Clinical Oncology, 23(15), 3322-3330. http://dx.doi.org/10.1200/jco.2005.05.130
Badger, T., Braden, C., Mishel, M., & Longman, A. (2004). Depression burden, psychological adjustment, and quality of life in women with breast cancer: Patterns over time. Research In Nursing & Health, 27(1), 19-28. http://dx.doi.org/10.1002/nur.20002
Baron, R., & Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal Of Personality And Social Psychology, 51(6), 1173-1182. http://dx.doi.org/10.1037//0022-3514.51.6.1173
Braun, D., Gupta, D., Grutsch, J., & Staren, E. (2011). Can changes in health related quality of life scores predict survival in stages III and IV colorectal cancer?. Health And Quality Of Life Outcomes, 9(1), 62. http://dx.doi.org/10.1186/1477-7525-9-62
Breast Cancer Treatment Option Overview. (2012). National Cancer Institute. Retrieved 22 August 2017, from http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page5#Keypoint23
Browall, M., Ahlberg, K., Karlsson, P., Danielson, E., Persson, L., & Gaston-Johansson, F. (2008). Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. European Journal Of Oncology Nursing, 12(3), 180-189. http://dx.doi.org/10.1016/j.ejon.2008.01.005
Carver, C., Smith, R., Antoni, M., Petronis, V., Weiss, S., & Derhagopian, R. (2005). Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer. Health Psychology, 24(5), 508-516. http://dx.doi.org/10.1037/0278-6133.24.5.508
Carver, C., Smith, R., Petronis, V., & Antoni, M. (2006). Quality of life among long-term survivors of breast cancer: different types of antecedents predict different classes of outcomes. Psycho-Oncology, 15(9), 749-758. http://dx.doi.org/10.1002/pon.1006
Colby, D., & Shifren, K. (2013). Optimism, mental health, and quality of life: A study among breast cancer patients. Psychology, Health & Medicine, 18(1), 10-20. http://dx.doi.org/10.1080/13548506.2012.686619
Collins, K., Liu, Y., Schootman, M., Aft, R., Yan, Y., & Dean, G. et al. (2010). Effects of breast cancer surgery and surgical side effects on body image over time. Breast Cancer Research And Treatment, 126(1), 167-176. http://dx.doi.org/10.1007/s10549-010-1077-7
Edwards, B., & Clarke, V. (2004). The psychological impact of a cancer diagnosis on families: The influence of family functioning and patients' illness characteristics on depression and anxiety. Psycho-Oncology, 13(8), 562-576. http://dx.doi.org/10.1002/pon.773
Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J., & Comber, H. et al. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal Of Cancer, 49(6), 1374-1403. http://dx.doi.org/10.1016/j.ejca.2012.12.027
Fobair, P., Stewart, S., Chang, S., D'Onofrio, C., Banks, P., & Bloom, J. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology, 15(7), 579-594. http://dx.doi.org/10.1002/pon.991
Gupta, D., Granick, J., Grutsch, J., & Lis, C. (2006). The prognostic association of health-related quality of life scores with survival in breast cancer. Supportive Care In Cancer, 15(4), 387-393. http://dx.doi.org/10.1007/s00520-006-0165-z
Härtl, K., Engel, J., Herschbach, P., Reinecker, H., Sommer, H., & Friese, K. (2010). Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psycho-Oncology, 19(2), 160-169. http://dx.doi.org/10.1002/pon.1536
Helms, R., O'Hea, E., & Corso, M. (2008). Body image issues in women with breast cancer. Psychology, Health & Medicine, 13(3), 313-325. http://dx.doi.org/10.1080/13548500701405509
Ho, S., So, W., Leung, D., Lai, E., & Chan, C. (2013). Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: A comparative evaluation. European Journal Of Oncology Nursing, 17(6), 877-882. http://dx.doi.org/10.1016/j.ejon.2013.04.005
Holzner, B., Kemmler, G., Kopp, M., Moschen, R., Rd Schweigkofler, H., & Du Nser, M. et al. (2001). Quality of Life in Breast Cancer Patients—Not Enough Attention for Long-Term Survivors?. Psychosomatics, 42(2), 117-123. http://dx.doi.org/10.1176/appi.psy.42.2.117
Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal Of Cancer, 37(2), 189-197. http://dx.doi.org/10.1016/s0959-8049(00)00353-1
Hudson, W. (1993). Index of Family Relations. In W. Hudson, The Walmyr Assessment Scales Scoring Manual. Tempe: Walmyr Publishing Company.
Kissane, D., Bloch, S., Dowe, D., Snyder, R., Onghena, P., McKenzie, D., & Wallace, C. (1996). The Melbourne Family Grief Study, I: Perceptions of family functioning in bereavement. American Journal Of Psychiatry, 153(5), 650-658. http://dx.doi.org/10.1176/ajp.153.5.650
Laranjeira, C. (2008). Tradução e validação portuguesa do Revised Life Orientation test (LOT-R). Universitas Psychologica, 7(2), 469-476.
Lemieux, J., Maunsell, E., & Provencher, L. (2008). Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: a literature review. Psycho-Oncology, 17(4), 317-328. http://dx.doi.org/10.1002/pon.1245
Leung, J., Atherton, I., Kyle, R., Hubbard, G., & McLaughlin, D. (2015). Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey. Supportive Care In Cancer, 24(4), 1755-1761. http://dx.doi.org/10.1007/s00520-015-2968-2
Livneh, H., & Antonak, R. (2005). Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors. Journal Of Counseling & Development, 83(1), 12-20. http://dx.doi.org/10.1002/j.1556-6678.2005.tb00575.x
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(1), 32. http://dx.doi.org/10.1186/1756-9966-27-32
Moreira, C.B., Fernandes, A.F., Gomes, A.M.; Silva A.M. & Santos, M.C... (2013). Educational Strategy Experimented with Mastectomized Women: Experience Report. Journal of Nursing UFPE On Line, 7 (1), 302-305, 2013. doi: 10.5205/r euol.3049-24704-1-LE.0701201339
Moreira, H., Silva, S., Marques, A., & Canavarro, M. (2010). The Portuguese version of the Body Image Scale (BIS) – psychometric properties in a sample of breast cancer patients. European Journal Of Oncology Nursing, 14(2), 111-118. http://dx.doi.org/10.1016/j.ejon.2009.09.007
Northouse, L., Kershaw, T., Mood, D., & Schafenacker, A. (2005). Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers. Psycho-Oncology, 14(6), 478-491. http://dx.doi.org/10.1002/pon.871
Northouse, 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. http://dx.doi.org/10.1200/jco.2002.02.054
Ogden, J. (2004). Understanding Breast Cancer. Lisboa: Climepsi Editores.
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health and Medicine, 12, 225-237. doi: 10.1080/13548500500524088
Pais-Ribeiro, J., Pinto, C., & Santos, C. (2008). Validation study of the Portuguese Version of The QLC-C30-V.3. Psicologia, Saúde e Doenças, 9 (1), 89-102. http://hdl.handle.net/10400.12/1077
Penttinen, H., Saarto, T., Kellokumpu-Lehtinen, P., Blomqvist, C., Huovinen, R., & Kautiainen, H. et al. (2010). Quality of life and physical performance and activity of breast cancer patients after adjuvant treatments. Psycho-Oncology, 20(11), 1211-1220. http://dx.doi.org/10.1002/pon.1837
Pereira, M., & Roncon, J. (2010). Relacionamento familiar em pessoas idosas: Adaptação do Índice de Relações Familiares (IFR). Psicologia, Saúde & Doenças, 11(1), 41-53.
Petersen, L., Clark, M., Novotny, P., Kung, S., Sloan, J., & Patten, C. et al. (2008). Relationship of Optimism–Pessimism and Health-Related Quality of Life in Breast Cancer Survivors. Journal Of Psychosocial Oncology, 26(4), 15-32. http://dx.doi.org/10.1080/07347330802359578
Rabin, E., Heldt, E., Hirakata, V., & Fleck, M. (2008). Quality of life predictors in breast cancer women. European Journal Of Oncology Nursing, 12(1), 53-57. http://dx.doi.org/10.1016/j.ejon.2007.06.003
Rasmussen, H., Scheier, M., & Greenhouse, J. (2009). Optimism and Physical Health: A Meta-analytic Review. Annals Of Behavioral Medicine, 37(3), 239-256. http://dx.doi.org/10.1007/s12160-009-9111-x
Reece, J., Chan, Y., Herbert, J., Gralow, J., & Fann, J. (2013). Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer. General Hospital Psychiatry, 35(4), 376-381. http://dx.doi.org/10.1016/j.genhosppsych.2013.03.017
Reich, M., Lesur, A., & Perdrizet-Chevallier, C. (2007). Depression, quality of life and breast cancer: a review of the literature. Breast Cancer Research And Treatment, 110(1), 9-17. http://dx.doi.org/10.1007/s10549-007-9706-5
Rosenberg, S., Tamimi, R., Gelber, S., Ruddy, K., Kereakoglow, S., & Borges, V. et al. (2012). Body image in recently diagnosed young women with early breast cancer. Psycho-Oncology, 22(8), 1849-1855. http://dx.doi.org/10.1002/pon.3221
Scheier, M., & Carver, C. (1985). Optimism, coping ad health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4(3), 219-247.
Scheier, M., & Carver, C. (1992). Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update. Cognitive Therapy And Research, 16(2), 201-228. http://dx.doi.org/10.1007/bf01173489
Scheier, M., Carver, C., & Bridges, M. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal Of Personality And Social Psychology, 67(6), 1063-1078. http://dx.doi.org/10.1037/0022-3514.67.6.1063
Schou, I., Ekeberg, Ø., Sandvik, L., Hjermstad, M., & Ruland, C. (2005). Multiple Predictors of Health-Related Quality of Life in Early Stage Breast Cancer. Data from a Year Follow-up Study Compared with the General Population. Quality Of Life Research, 14(8), 1813-1823. http://dx.doi.org/10.1007/s11136-005-4344-z
Seidl, E., & Zannon, C. (2004). Qualidade de vida e saúde: aspectos conceituais e metodológicos. Cadernos De Saúde Pública, 20(2), 580-588. http://dx.doi.org/10.1590/s0102-311x2004000200027
Silva, S., Bettencourt, D., Moreira, H., & Canavarro, M. C. (2011). Qualidade de vida de mulheres com cancro da mama nas diversas fases da doença: O papel de variáveis sociodemográficas, clínicas e das estratégias de coping enquanto fatores de risco/proteção. Revista Portuguesa de Saúde Pública, 29, 64-67.
So, W., Marsh, G., Ling, W., Leung, F., Lo, J., Yeung, M., & Li, G. (2010). Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. European Journal Of Oncology Nursing, 14(1), 17-22. http://dx.doi.org/10.1016/j.ejon.2009.07.005
Stanton, A., Revenson, T., & Tennen, H. (2007). Health Psychology: Psychological Adjustment to Chronic Disease. Annual Review Of Psychology, 58(1), 565-592. http://dx.doi.org/10.1146/annurev.psych.58.110405.085615
Thomas, C., Morris, S., & Harman, J. (2002). Companions through cancer:. Social Science & Medicine, 54(4), 529-544. http://dx.doi.org/10.1016/s0277-9536(01)00048-x
Vilhena, E., Pais-Ribeiro, J., Silva, I., Pedro, L., Meneses, R., & Cardoso, H. et al. (2014). Optimism on quality of life in Portuguese chronic patients: moderator/mediator?. Revista Da Associação Médica Brasileira, 60(4), 373-380. http://dx.doi.org/10.1590/1806-9282.60.04.017
White, C. (2000). Body image dimensions and cancer: a heuristic cognitive behavioural model. Psycho-Oncology, 9(3), 183-192.doi: 10.1002/1099-1611(200005/06)9:3<183::aid-pon446>3.0.co;2-l
White, C. A., & Hood, C. (2011). Body image issues in oncology. In T. F. Cash & L. Smolak (Eds.), Body image: A handbook of science, practice and prevention (pp. 333-341). Guilford Press.
Zenger, M., Brix, C., Borowski, J., Stolzenburg, J., & Hinz, A. (2009). The impact of optimism on anxiety, depression and quality of life in urogenital cancer patients. Psycho-Oncology, 19(8), 879-886. http://dx.doi.org/10.1002/pon.1635
Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x
The works published in this journal are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) retains the property rights (copyright) of published works, and encourages and enables the reuse of the same under the license specified in paragraph 2.
© Servicio de Publicaciones, Universidad de Murcia, 2022
2. The works are published in the online edition of the journal under a Creative Commons Reconocimiento-CompartirIgual 4.0 (legal text). You can copy, use, distribute, transmit and publicly display, provided that: i) you cite the author and the original source of publication (journal, editorial and URL of the work), ii) are not used for commercial purposes, iii ) mentions the existence and specifications of this license.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
3. Conditions of self-archiving. Is allowed and encouraged the authors to disseminate electronically pre-print versions (version before being evaluated and sent to the journal) and / or post-print (version reviewed and accepted for publication) of their works before publication, as it encourages its earliest circulation and diffusion and thus a possible increase in its citation and scope between the academic community. RoMEO Color: Green.