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.
References
Aiken LS, West SG (1991) Multiple regression: testing and interpreting interactions. Sage Publications, Newbury Park
American Cancer Society (2013) Cancer facts and figures 2013. In: Editor (ed)^(eds) Book cancer facts and figures 2013. American Cancer Society, City
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
Ayers B, Hunter MS (2013) Health-related quality of life of women with menopausal hot flushes and night sweats. Climacteric 16:235–239
Bandura A (1998) Health promotion from the perspective of social cognitive theory. Psychol Health 13:623–649
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
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
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
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
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
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
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
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
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
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
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
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
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
Donnellan PP, Douglas SL, Cameron DA, Leonard RC (2001) Aromatase inhibitors and arthralgia. J Clin Oncol: Off J Am Soc Clin Oncol 19:2767
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
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
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
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
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
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
Haas BK (2011) Fatigue, self-efficacy, physical activity, and quality of life in women with breast cancer. Cancer Nurs 34:322–334
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Niravath P (2013) Aromatase inhibitor-induced arthralgia: a review. Ann Oncol: Off J Eur Soc Med Oncol / ESMO 24:1443–1449
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
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
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
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
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
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
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
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
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
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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.
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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
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DOI: https://doi.org/10.1007/s00520-014-2269-1