PREDICTORS OF QUALITY OF LIFE DURING CHEMOTHERAPY FOR BREAST CANCER. INVESTIGATING THE ROLE OF MULTIDIMENSIONAL SYMPTOMS AND DYSFUNCTIONAL BELIEFS
Mădălina SUCALĂ* Patriciu ACHIMAŞ-CADARIU3, Daniel DAVID2,1 1,2, Cristina PETRIŞOR2, 1 Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 2 Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania 3 Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj, Romania
Abstract Background: Breast cancer is the most frequently diagnosed cancer and is one of the leading cause of cancer death among women in Europe. Although breast cancer chemotherapy increases disease-free survival and life expectancy, it bears adverse side-effects. Breast cancer patients undergoing chemotherapy experience multiple physical and psychological symptoms that can impact their quality of life. Aims: The aims of this study were to investigate: 1) the multidimensional symptom experience (i.e., symptom prevalence, frequency, severity, and burden) in breast cancer patients undergoing chemotherapy; 2) the breast cancer patients’ quality of life during chemotherapy, exploring not only the general quality of life, but also its multidimensional components (physical wellbeing, emotional wellbeing, functional wellbeing and social wellbeing); and, 3) the relationship between symptom experience, dysfunctional beliefs and quality of life of breast cancer patients undergoing chemotherapy. Methods: 145 breast cancer patients undergoing chemotherapy were included in the study (Age=52.15, SD=10.51; 97.2% Romanian, 2.8% Hungarian; 33.8% college education; 77.2% married). Wellbeing was measured with the Functional Assessment of Cancer Therapy – GP (FACT-GP) and chemotherapy side effects and symptoms were measured using the Memorial Symptom Assessment Scale – Short Form (MSAS-SF). Dysfunctional beliefs were measured with the Attitudes and Beliefs Scale (ABSs). Results: 56.6% of the patients reported dry mouth as they most prevalent and frequent physical symptom, while the most severe and bothersome symptom was difficulty sleeping. Quality of life was predicted by physical symptoms and dysfunctional beliefs. Using bootstrapping procedures to obtain estimates and confidence intervals for indirect effects, results showed that physical symptoms effects on quality of life were mediated by dysfunctional beliefs, as indicated by the 95% CI (-.089 to -.005). Conclusion: The results highlight the importance of assessing the symptom experience in a multidimensional manner, and, at the same time, they point to the important role of addressing patients’ dysfunctional beliefs in addition to direct symptom management when offering psychosocial interventions aimed at increasing their quality of life.
Keywords: chemotherapy, quality of life, dysfunctional beliefs.