Quality of life, survivorship, and psychosocial adjustment of young women with breast cancer after breast-conserving surgery and radiation therapy.

PURPOSE/
OBJECTIVES: To examine changes in quality of life (QOL), psychosocial adjustment, and survivorship issues over time of women younger than 45 years who underwent breast-conserving surgery and radiation therapy (RT) for breast cancer.
DESIGN: Repeated measures, longitudinal design.
METHODS: Data were collected at four time points: start of RT, midpoint of RT, end of RT, and six months after RT. Three instruments were used to collect data: Quality-of-Life Index, Psychosocial Adjustment to Illness Scale, and the newly developed Adaptation to Survivorship Experience. Subjects also participated in an indepth interview at the start of RT.
SETTING: A large radiation oncology department located in an urban teaching hospital in the Northeast United States. SAMPLE: 23 women with newly diagnosed stage I or II breast cancer who were starting RT following breast-conserving surgery, with a mean age of 37.8 years (range = 25-45 years). MAIN RESEARCH VARIABLES: QOL, psychosocial adjustment, and adaptation to survivorship experience.
FINDINGS: Although subjects adjusted their lives to accommodate RT, QOL declined from the start of RT to midpoint, with gradual improvement reported six months later. Social and sexual adjustment declined from start of RT to six months later. Negative perceptions of the survivorship experience and worry about cancer increased from the start of RT to six months later.
CONCLUSIONS: Young women with breast cancer experience changes in QOL, psychosocial adjustment, and adaptation to survivorship issues during RT. Changes may not reflect what is observed in clinical practice. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to be aware of changes in QOL, psychosocial adjustment, and survivorship to better understand and support young women during RT.