Skip to main content

Advertisement

Log in

Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy

Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer.

Methods

One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years).

Results

Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being.

Conclusions

Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Aiken LS, West SG (1991) Multiple regression: testing and interpreting interactions. Sage Publications, Newbury Park

    Google Scholar 

  2. American Cancer Society (2013) Cancer facts and figures 2013. In: Editor (ed)^(eds) Book cancer facts and figures 2013. American Cancer Society, City

  3. Anderson WF, Chu KC, Chatterjee N, Brawley O, Brinton LA (2001) Tumor variants by hormone receptor expression in white patients with node-negative breast cancer from the surveillance, epidemiology, and end results database. J Clin Oncol: Off J Am Soc Clin Oncol 19:18–27

    CAS  Google Scholar 

  4. Ayers B, Hunter MS (2013) Health-related quality of life of women with menopausal hot flushes and night sweats. Climacteric 16:235–239

    Article  CAS  PubMed  Google Scholar 

  5. Bandura A (1998) Health promotion from the perspective of social cognitive theory. Psychol Health 13:623–649

    Article  Google Scholar 

  6. Bartley EJ, Edmond SN, Wren AA, Somers TJ, Teo I, Zhou SS, Rowe KA, Abernethy AA, Keefe FJ, Shelby RA (2013) Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplant. Journal of Pain and Symptom Management in press

  7. Bisschop MI, Kriegsman DM, Beekman AT, Deeg DJ (2004) Chronic diseases and depression: the modifying role of psychosocial resources. Soc Sci Med 59:721–733

    Article  PubMed  Google Scholar 

  8. 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 Coping 20:61–75

    Article  Google Scholar 

  9. Boonstra A, van Zadelhoff J, Timmer-Bonte A, Ottevanger PB, Beurskens CH, van Laarhoven HW (2013) Arthralgia during aromatase inhibitor treatment in early breast cancer patients: prevalence, impact, and recognition by healthcare providers. Cancer Nurs 36:52–59

    Article  PubMed  Google Scholar 

  10. Carpenter KM, Fowler JM, Maxwell GL, Andersen BL (2010) Direct and buffering effects of social support among gynecologic cancer survivors. Ann Beh Med: Publ Soc Beh Med 39:79–90

    Article  Google Scholar 

  11. Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107:167–180

    Article  CAS  PubMed  Google Scholar 

  12. Cella D, Peterman A, Hudgens S, Webster K, Socinski MA (2003) Measuring side effects of taxane therapy in oncology: the Functional Assessment of Cancer Therapy—Taxane (FACT-Taxane). Cancer 98:822–831

    Article  CAS  PubMed  Google Scholar 

  13. Cella DF et al (1993) The Functional Assessment of Cancer Therapy (FACT) scale: development and validation of the general measure. J Clin Oncol 11:570–579

    CAS  PubMed  Google Scholar 

  14. Chu KC, Anderson WF (2002) Rates for breast cancer characteristics by estrogen and progesterone receptor status in the major racial/ethnic groups. Breast Cancer Res Treat 74:199–211

    Article  CAS  PubMed  Google Scholar 

  15. Cleeland CS (1989) Measurement of pain by subjective report. In: Chapman CR, Loeser JD (eds) Issues in measurement. Raven Press, New York, pp 391–403

    Google Scholar 

  16. Collaborative Group on Hormonal Factors in Breast Cancer (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet 365:1687–1717

    Article  Google Scholar 

  17. Crew KD, Greenlee H, Capodice J, Raptis G, Brafman L, Fuentes D, Sierra A, Hershman DL (2007) Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol: Off J Am Soc Clin Oncol 25:3877–3883

    Article  Google Scholar 

  18. Cunningham AJ, Lockwood GA, Cunningham JA (1991) A relationship between perceived self-efficacy and quality of life in cancer patients. Patient Educ Couns 17:71–78

    Article  CAS  PubMed  Google Scholar 

  19. Donnellan PP, Douglas SL, Cameron DA, Leonard RC (2001) Aromatase inhibitors and arthralgia. J Clin Oncol: Off J Am Soc Clin Oncol 19:2767

    CAS  Google Scholar 

  20. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Article  Google Scholar 

  21. Edmond SN, Shelby RA, Kimmick GG, Marcom PK, Peppercorn JM, Keefe FJ (2013) Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment. J Psychosoc Oncol 31:698–711

    Article  PubMed  Google Scholar 

  22. Fallowfield L, Cella D, Cuzick J, Francis S, Locker G, Howell A (2004) Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. J Clin Oncol: Off J Am Soc Clin Oncol 22:4261–4271

    Article  CAS  Google Scholar 

  23. Fenlon D, Addington-Hall JM, O’Callaghan AC, Clough J, Nicholls P, Simmonds P (2013) A survey of joint and muscle aches, pain, and stiffness comparing women with and without breast cancer. J Pain Symptom Manag 46(4):523–535

    Article  Google Scholar 

  24. Garreau JR, Delamelena T, Walts D, Karamlou K, Johnson N (2006) Side effects of aromatase inhibitors versus tamoxifen: the patients’ perspective. Am J Surg 192:496–498

    Article  CAS  PubMed  Google Scholar 

  25. Graves KD (2003) Social cognitive theory and cancer patients’ quality of life: a meta-analysis of psychosocial intervention components. Health Psychol: Off J Div Health Psychol, Am Psychol Assoc 22:210–219

    Article  Google Scholar 

  26. Haas BK (2011) Fatigue, self-efficacy, physical activity, and quality of life in women with breast cancer. Cancer Nurs 34:322–334

    Article  PubMed  Google Scholar 

  27. 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. Psychooncology 11:221–229

    Article  PubMed  Google Scholar 

  28. Hochhausen N, Altmaier EM, McQuellon R, Davies SM, Papadopolous E, Carter S, Henslee-Downey J (2007) Social support, optimism, and self-efficacy predict physical and emotional well-being after bone marrow transplantation. J Psychosoc Oncol 25:87–101

    Article  PubMed  Google Scholar 

  29. Hunter MS, Grunfeld EA, Mittal S, Sikka P, Ramirez AJ, Fentiman I, Hamed H (2004) Menopausal symptoms in women with breast cancer: prevalence and treatment preferences. Psycho-Oncology 13:769–778

    Article  PubMed  Google Scholar 

  30. Kahn KL, Schneider EC, Malin JL, Adams JL, Epstein AM (2007) Patient centered experiences in breast cancer—predicting long-term adherence to tamoxifen use. Med Care 45:431–439

    Article  PubMed  Google Scholar 

  31. Lewis JE, Hilditch JR, Wong CJ (2005) Further psychometric property development of the Menopause-Specific Quality of Life questionnaire and development of a modified version, MENQOL-Intervention questionnaire. Maturitas 50:209–221

    Article  PubMed  Google Scholar 

  32. Loprinzi PD, Cardinal BJ (2013) Self-efficacy mediates the relationship between behavioral processes of change and physical activity in older breast cancer survivors. Breast Cancer 20:47–52

    Article  PubMed  Google Scholar 

  33. Lorig K, Chastain RL, Ung E, Shoor S, Holman HR (1989) Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 32:37–44

    Article  CAS  PubMed  Google Scholar 

  34. Manne SL, Ostroff JS, Norton TR, Fox K, Grana G, Goldstein L (2006) Cancer-specific self-efficacy and psychosocial and functional adaptation to early stage breast cancer. Ann Beh Med : Publ Soc Beh Med 31:145–154

    Article  Google Scholar 

  35. Melchior H, Buscher C, Thorenz A, Grochocka A, Koch U, Watzke B (2013) Self-efficacy and fear of cancer progression during the year following diagnosis of breast cancer. Psychooncology 22:39–45

    Article  PubMed  Google Scholar 

  36. Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, Huber SL (1999) The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer 85(5):1186–1196

    Article  CAS  PubMed  Google Scholar 

  37. Mikkelsen EG, 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. Scand J Psychol 43:397–405

    Article  PubMed  Google Scholar 

  38. Molino A, Giovannini M, Auriemma A, Fiorio E, Mercanti A, Mandara M, Caldara A, Micciolo R, Pavarana M, Cetto GL (2006) Pathological, biological and clinical characteristics, and surgical management, of elderly women with breast cancer. Crit Rev Oncol/Hematol 59:226–233

    Article  Google Scholar 

  39. Mystakidou K, Parpa E, Tsilika E, Gogou P, Panagiotou I, Galanos A, Kouvaris I, Gouliamos A (2010) Self-efficacy, depression, and physical distress in males and females with cancer. Am J Hosp Palliat Care 27:518–525

    Article  PubMed  Google Scholar 

  40. Namkoong K, Shah DV, Han JY, Kim SC, Yoo W, Fan D, McTavish FM, Gustafson DH (2010) Expression and reception of treatment information in breast cancer support groups: how health self-efficacy moderates effects on emotional well-being. Patient Educ Couns 81(Suppl):S41–S47

    Article  PubMed  Google Scholar 

  41. Niravath P (2013) Aromatase inhibitor-induced arthralgia: a review. Ann Oncol: Off J Eur Soc Med Oncol / ESMO 24:1443–1449

    Article  CAS  Google Scholar 

  42. Northouse LL, Mood D, Kershaw T, Schafenacker A, Mellon S, Walker J, Galvin E, Decker V (2002) Quality of life of women with recurrent breast cancer and their family members. J Clinical Oncol: Off J Am Soc Clin Oncol 20:4050–4064

    Article  Google Scholar 

  43. Park H, Yoon HG (2013) Menopausal symptoms, sexual function, depression, and quality of life in Korean patients with breast cancer receiving chemotherapy. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

  44. Phillips SM, McAuley E (2013) Physical activity and fatigue in breast cancer survivors: a panel model examining the role of self-efficacy and depression. Cancer Epidemiol Biomark Prev: Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 22:773–781

    Article  Google Scholar 

  45. Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr (2004) Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA :J Am Med Assoc 291:2441–2447

    Article  CAS  Google Scholar 

  46. Porter LS, Keefe FJ, Garst J, McBride CM, Baucom D (2008) Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress. Pain 137:306–315

    Article  PubMed Central  PubMed  Google Scholar 

  47. Porter LS, Keefe FJ, McBride CM, Pollak K, Fish L, Garst J (2002) Perceptions of patients’ self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers. Pain 98:169–178

    Article  PubMed  Google Scholar 

  48. Preacher KJ, Curran PJ, Bauer DJ (2006) Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. J Educ Behav Stat 31:437–448

    Article  Google Scholar 

  49. Rottmann N, Dalton SO, Christensen J, Frederiksen K, Johansen C (2010) Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study. Qual Life Res: Int J Qual Life Asp Treat, Care Rehabil 19:827–836

    Article  Google Scholar 

  50. Stanton AL, Luecken LJ, MacKinnon DP, Thompson EH (2013) Mechanisms in psychosocial interventions for adults living with cancer: opportunity for integration of theory, research, and practice. J Consult Clin Psychol 81:318–335

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflicts of interest to report. We have full control of all primary data and agree to allow the journal to review the data if requested.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rebecca A. Shelby.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shelby, R.A., Edmond, S.N., Wren, A.A. et al. Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy. Support Care Cancer 22, 2851–2859 (2014). https://doi.org/10.1007/s00520-014-2269-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-014-2269-1

Keywords

Navigation