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Trajectories of psychological distress among Chinese women diagnosed with breast cancer
Author(s) -
Lam Wendy W. T.,
Bonanno George A.,
Mancini Anthony D.,
Ho Samuel,
Chan Miranda,
Hung Wai Ka,
Or Amy,
Fielding Richard
Publication year - 2010
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1658
Subject(s) - distress , optimism , psychological intervention , medicine , clinical psychology , psychological resilience , breast cancer , disappointment , rehabilitation , psychiatry , psychology , physical therapy , cancer , psychotherapist
Background : The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods : 285 of 405 Chinese women receiving surgery for BC were assessed at 5‐day, 1‐month, 4‐month, and 8‐month post‐surgery on measures of psychological distress, optimism, treatment decision‐making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results : Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed‐recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post‐surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed‐recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion : Optimism and better early post‐operative treatment outcomes predicted resilience to distress. Pre‐operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post‐operative rehabilitation should focus on symptom management. Copyright © 2009 John Wiley & Sons, Ltd.