Relationships between psychosocial factors and health behavior change in cancer survivors: an integrative review.

BACKGROUND: Adaptive health behavior changes following cancer diagnosis and treatment are associated with better psychological and physical well-being. However, little is known about the roles that psychosocial factors play in facilitating or inhibiting these changes. A better understanding of health behavior change will allow the development of more effective interventions.
PURPOSE: Our goal was to conduct a systematic and exhaustive review of research examining relationships among psychosocial factors and health behavior change in cancer survivors.
METHOD: We searched electronic databases and reference sections of relevant article and chapters to locate all studies that met our criteria (i.e., examined at least one psychosocial variable and one health behavior change in a sample of cancer survivors).
RESULTS: We located 30 studies that met criteria. Social support, locus of control, and distress were the focus of most of this literature. Although findings are inconsistent, social support appears to be helpful in making adaptive changes, particularly in exercise; internal locus of control facilitates positive health behavior changes but may depend on survivors' perceptions of links between behaviors and cancer or recurrence, and cancer-related distress may facilitate adaptive changes although more general distress may impede them. Studies based on theoretical models of health behavior change have demonstrated that stage of readiness to change, intentions, and self-efficacy may be powerful determinants of improvements in health behaviors.
CONCLUSIONS: Much remains to be learned about the influence of psychosocial factors in survivors' health behavior change. We describe the limitations of the current state of the research and conclude with suggestions for future research and intervention.