Abstract
Purpose
To examine the roles of both patient symptoms, and subjective appraisals of stress (self-efficacy, symptom barriers, symptom distress), in understanding well-being (anxiety, depression, cancer-specific quality of life, mental health quality of life, and physical health quality of life) in breast cancer patients.
Methods
We examined data from 104 female breast cancer patients. Using a stress process model, we hypothesized that while high levels of patient symptoms would be associated with poorer patient well-being, these effects would be mediated by subjective appraisals, including patient self-efficacy, perceived symptom barriers, and symptom distress.
Results
As expected, higher levels of patient symptoms were associated with poorer well-being on all five indicators. Subjective appraisals of stress added significantly to predictors of well-being, and were mediators of this relationship across all five outcomes.
Conclusions
While patient symptoms are important predictors of patient well-being, subjective appraisals of the stressfulness of symptoms, and of patients’ self-efficacy in managing symptoms, are also key factors. The findings suggest the utility of a stress process model in understanding well-being in breast cancer patients, and point to the potential value of targeting patient appraisals as well as symptoms to improve psychological well-being and quality of life.
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Funding
Research reported in this article was funded in part through a Patient-Centered Outcomes Research Institute (PCORI) Award (CE-12-11-4025). The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.
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The study was approved by the Institutional Review Board at the University of South Florida [Pro00013488].
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Badana, A.N.S., Marino, V.R., Templeman, M.E. et al. Understanding the roles of patient symptoms and subjective appraisals in well-being among breast cancer patients. Support Care Cancer 27, 4245–4252 (2019). https://doi.org/10.1007/s00520-019-04707-2
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DOI: https://doi.org/10.1007/s00520-019-04707-2