“Waiting for the other shoe to drop:” distress and coping during and after treatment for breast cancer.

This study explored distress and coping strategies during and after breast cancer treatment. Open ended interview questions were used to explore stress and coping across the illness trajectory and during continuing care. With permission, 49 of the 50 interviews were audiotaped. Interviews also involved the use of the Impact of Events Scale-Revised (IES-R), the Ways of Coping (WAYS) and the Lubben Social Support Network Scale (LSNS-6). Data analysis involved a sequential quantitative (dominant)-qualitative (non-dominant) design.A mean-split procedure was used to compare lower and higher distress. The overall IES-R score as well as the Avoidance, Intrusions, and Hyperarousal subscales were all statistically significant between the higher-lower distress groups. Fourteen of the 22 individual IES-R items were significantly different between groups.WAYS subscale scores were not significantly different but 21% of the individual items were. Stress involves (1) physical stressors and(2) psychosocial stressors: (fear of recurrence and family-focused concerns). Coping involves (1) activity-based strategies, (2) cognitive strategies, and (3) spiritual strategies. Breast cancer survivors experience persistent concern about recurrence and uncertainty about the future. Understanding the nature of distress and how women cope during and after treatment are key to improved care for women who have breast cancer.