Andrea Cohee1, Shelley A Johns2,3, Jennifer S Alwine1, Tasneem Talib1, Patrick O Monahan4,5, Timothy E Stump4, David Cella6, Victoria L Champion1. 1. School of Nursing, Indiana University School of Nursing, Indianapolis, Indiana, USA. 2. School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. 3. Regenstrief Institute, Inc., Indianapolis, Indiana, USA. 4. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 5. Fairbanks School of Public Health, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA. 6. Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Abstract
OBJECTIVE: Many breast cancer survivors (BCSs) recover from the negative sequelae of cancer treatment. However, some report persistent and disruptive distress well into disease-free survivorship. More information is needed on the predictors of distress in this growing population of BCS, including the role of avoidant coping, or attempts to avoid thoughts, feelings, and reminders of cancer, in mediating the relationship between distress and psychological, physical, and social domains of well-being. METHODS: In a large cross-sectional study, BCS (n = 1,127), who were 3 to 8 years post-diagnosis, completed a survey assessing demographic characteristics, medical history, distress (anxiety and depressive symptoms), avoidant coping, and physical (fatigue), psychological (fear of recurrence, attention, body image), and social (social support from a partner, social constraints from a partner) well-being. Multiple mediation analyses were conducted to determine if avoidant coping mediated the relationship between each distress variable (anxiety and depressive symptoms) and each well-being (fear of recurrence, attention, body image, fatigue, social support, and social constraints) variable. RESULTS: In all six mediation models, avoidant coping significantly (p < 0.001) mediated the relationship between each well-being variable (fear of recurrence, attention, body image, fatigue, social support, and social constraints) and each distress indicator (depression and anxiety). Avoidant coping mediated 19%-54% of the effects of the contributing factors on the distress variables. CONCLUSIONS: Avoidant coping may indicate risk for, or presence of, distress among BCS. Interventions to reduce distress may benefit from addressing avoidant coping styles.
OBJECTIVE: Many breast cancer survivors (BCSs) recover from the negative sequelae of cancer treatment. However, some report persistent and disruptive distress well into disease-free survivorship. More information is needed on the predictors of distress in this growing population of BCS, including the role of avoidant coping, or attempts to avoid thoughts, feelings, and reminders of cancer, in mediating the relationship between distress and psychological, physical, and social domains of well-being. METHODS: In a large cross-sectional study, BCS (n = 1,127), who were 3 to 8 years post-diagnosis, completed a survey assessing demographic characteristics, medical history, distress (anxiety and depressive symptoms), avoidant coping, and physical (fatigue), psychological (fear of recurrence, attention, body image), and social (social support from a partner, social constraints from a partner) well-being. Multiple mediation analyses were conducted to determine if avoidant coping mediated the relationship between each distress variable (anxiety and depressive symptoms) and each well-being (fear of recurrence, attention, body image, fatigue, social support, and social constraints) variable. RESULTS: In all six mediation models, avoidant coping significantly (p < 0.001) mediated the relationship between each well-being variable (fear of recurrence, attention, body image, fatigue, social support, and social constraints) and each distress indicator (depression and anxiety). Avoidant coping mediated 19%-54% of the effects of the contributing factors on the distress variables. CONCLUSIONS: Avoidant coping may indicate risk for, or presence of, distress among BCS. Interventions to reduce distress may benefit from addressing avoidant coping styles.
Authors: Ilaria Durosini; Stefano Triberti; Lucrezia Savioni; Valeria Sebri; Gabriella Pravettoni Journal: Int J Environ Res Public Health Date: 2022-10-04 Impact factor: 4.614