Symptoms and uncertainty in breast cancer survivors in Korea: differences by treatment trajectory

J Clin Nurs. 2012 Apr;21(7-8):1014-23. doi: 10.1111/j.1365-2702.2011.03896.x. Epub 2011 Nov 15.

Abstract

Aims: The study compared the levels of symptoms and uncertainty, their associated factors, relationships between them and predictors of uncertainty by treatment trajectory among breast cancer survivors.

Background: Little is known with regard to how uncertainty and symptoms are related to treatment trajectory among breast cancer survivors.

Design: A cross-sectional descriptive design was used.

Method: A total of 252 women with breast cancer, receiving cancer therapy, or having completed their therapy were recruited from the National Cancer Center in Korea. Measurements used included symptom subscales of the European Organization of Research and Therapy for Cancer QLQ-C30 and Breast Cancer Module BR23 and the Mishel Uncertainty in Illness Scale.

Results: Women in treatment reported more severe symptoms and higher levels of uncertainty than women having completed treatment. During treatment, most symptoms were positively correlated with the level of uncertainty, whereas, in women who had completed treatment, only dyspnoea, insomnia, systemic therapy side effects and arm symptoms positively correlated with uncertainty. There were also differences in predictors of uncertainty by treatment trajectory. Age, marital status and pain were significant predictors of uncertainty during treatment, while monthly income, dyspnoea and insomnia were predictors of uncertainty after treatment.

Conclusions: Among breast cancer survivors, levels of symptoms and uncertainty, associated factors, relationships between them and predictors of uncertainty differed depending on treatment trajectory.

Relevance to clinical practice: To provide trajectory-sensitive nursing intervention for uncertainty among breast cancer survivors, age, marital status and pain should be considered during treatment, while factors such as economic status, dyspnoea and insomnia should be taken into account after treatment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Breast Neoplasms / nursing
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Fatigue / epidemiology*
  • Fatigue / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Korea
  • Linear Models
  • Marital Status
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Pain / epidemiology
  • Pain / physiopathology
  • Predictive Value of Tests
  • Quality of Life*
  • Sickness Impact Profile
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / physiopathology
  • Socioeconomic Factors
  • Stress, Psychological
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Time Factors
  • Uncertainty*