Event-correlated trajectories of bio-psycho-social distress in breast cancer and its predictors

Objective: The treatment pathway of breast cancer (BC) patients is increasingly complex, multidisciplinary and intersectoral. The aim of the study was to identify the trajectory of psychological distress as well as symptom burden and its impact on daily life of BC patients in dependence of the treat...

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Bibliographic Details
Published in:Journal of psychosomatic research 2021-06, Vol.145, p.110456, Article 110456
Main Authors: Czisch, Agnieszka, Kant, Janina, Schott, Sarah, Keller, Monika
Format: Article
Language:English
Subjects:
Activities of daily living
Breast cancer
Cancer therapies
Chemotherapy
Diagnosis
Medical diagnosis
Newly diagnosed
Patients
Psychological distress
Short term
Survival
Temporal patterns
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Summary:Objective: The treatment pathway of breast cancer (BC) patients is increasingly complex, multidisciplinary and intersectoral. The aim of the study was to identify the trajectory of psychological distress as well as symptom burden and its impact on daily life of BC patients in dependence of the treatment modality and their individual treatment path. Second aim was to identify predictors of increased bio-psycho-social distress of BC patients. Methods: In a prospective study bio-psycho-social distress was investigated in 160 newly diagnosed BC patients over four event-correlated time points, from diagnosis to short-term survival. Psychological distress, symptom burden and impairment of daily life were assessed using the GHQand MDASI I&II, respectively. Results: Psychological distress shows a regressive course in all therapy modalities; however, continuously above the clinically relevant limit. The percentage of patients with elevated distress levels were 62.5%, 57.5%. 48.1% and 45.0% for time points T1-T4, respectively. Patients with (neo-)adjuvant chemotherapy show an increase to maximum perceived symptom burden right after treatment with a subsequent decline to baseline level Patient-related factors were identified as predictors of bio-psycho-social distress, as well as a treatment path involving chemotherapy for perceived symptom burden. Conclusion: A substantial proportion of BC patients show persistent elevated distress levels. Temporal patterns for the course of perceived symptom burden and impairment of daily life were identified. Patient-related factors influence bio-psycho-social distress of BC patients more than cancer/treatment-related factors. The results underline the need for psycho-oncological care of patients beyond the time of diagnosis into short-term survival.
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2021.110456