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Article: Predicting psychological morbidity in Chinese women after surgery for breast carcinoma

TitlePredicting psychological morbidity in Chinese women after surgery for breast carcinoma
Authors
Issue Date2005
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 2005, v. 103 n. 3, p. 637-646 How to Cite?
AbstractBACKGROUND. Between 30% and 70% of western women experience psychological morbidity after undergoing surgery for breast carcinoma; however, the rates and risk factors among Chinese women are unknown. Identifying at-risk women enables preventive intervention. METHODS. Among 430 Chinese women who were approached within 1 week after undergoing surgery for early-stage breast carcinoma (baseline), 405 women (94%) completed measures of self-efficacy and psychological morbidity (the Chinese Health Questionnaire 12-item instrument [CHQ12]) and completed retrospective measures of treatment decision-making (TDM) difficulties, satisfaction with TDM involvement, and satisfaction with consultation and treatment outcome expectations. One-month postsurgery follow-up (follow-up), CHQ12 scores for 367 of 405 women (91%) were adjusted for concurrent physical symptom distress and trait optimism (the revised Chinese Life Orientation Test) and baseline predictors using stepwise multivariate regression. RESULTS. At baseline 28% of women evidenced mild psychological morbidity, and 42% of women evidenced moderate-to-severe psychological morbidity: At follow-up, the respective rates were 32% and 36%. Preferred TDM involvement was associated with lower psychological morbidity (F = 6.702; P < 0.001). Baseline CHQ12 scores were predicted by outcome expectancies and TDM difficulties (adjusted regression coefficient [R2] = 0.192). Baseline CHQ12 scores and follow-up chemotherapy, in turn, predicted physical symptom distress at follow-up. After adjustment, high physical symptom distress, baseline psychological morbidity, low optimism, and no chemotherapy independently predicted follow-up CHQ12 scores (adjusted R2 = 0.585). CONCLUSIONS. Psychological morbidity was linked to women's TDM difficulties, their inability to anticipate treatment effects accurately, and physical symptom distress, possibly exacerbated by symptom misattribution. Optimizing TDM support and helping women accurately determine outcomes in terms of symptom experience and meaning and physical appearance may help to reduce psychological morbidity. Women who have TDM difficulties should be considered to be at high risk for psychological distress. © 2004 American Cancer Society.
Persistent Identifierhttp://hdl.handle.net/10722/151591
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, WWTen_US
dc.contributor.authorFielding, Ren_US
dc.contributor.authorHo, EYYen_US
dc.date.accessioned2012-06-26T06:25:14Z-
dc.date.available2012-06-26T06:25:14Z-
dc.date.issued2005en_US
dc.identifier.citationCancer, 2005, v. 103 n. 3, p. 637-646en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/151591-
dc.description.abstractBACKGROUND. Between 30% and 70% of western women experience psychological morbidity after undergoing surgery for breast carcinoma; however, the rates and risk factors among Chinese women are unknown. Identifying at-risk women enables preventive intervention. METHODS. Among 430 Chinese women who were approached within 1 week after undergoing surgery for early-stage breast carcinoma (baseline), 405 women (94%) completed measures of self-efficacy and psychological morbidity (the Chinese Health Questionnaire 12-item instrument [CHQ12]) and completed retrospective measures of treatment decision-making (TDM) difficulties, satisfaction with TDM involvement, and satisfaction with consultation and treatment outcome expectations. One-month postsurgery follow-up (follow-up), CHQ12 scores for 367 of 405 women (91%) were adjusted for concurrent physical symptom distress and trait optimism (the revised Chinese Life Orientation Test) and baseline predictors using stepwise multivariate regression. RESULTS. At baseline 28% of women evidenced mild psychological morbidity, and 42% of women evidenced moderate-to-severe psychological morbidity: At follow-up, the respective rates were 32% and 36%. Preferred TDM involvement was associated with lower psychological morbidity (F = 6.702; P < 0.001). Baseline CHQ12 scores were predicted by outcome expectancies and TDM difficulties (adjusted regression coefficient [R2] = 0.192). Baseline CHQ12 scores and follow-up chemotherapy, in turn, predicted physical symptom distress at follow-up. After adjustment, high physical symptom distress, baseline psychological morbidity, low optimism, and no chemotherapy independently predicted follow-up CHQ12 scores (adjusted R2 = 0.585). CONCLUSIONS. Psychological morbidity was linked to women's TDM difficulties, their inability to anticipate treatment effects accurately, and physical symptom distress, possibly exacerbated by symptom misattribution. Optimizing TDM support and helping women accurately determine outcomes in terms of symptom experience and meaning and physical appearance may help to reduce psychological morbidity. Women who have TDM difficulties should be considered to be at high risk for psychological distress. © 2004 American Cancer Society.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_US
dc.relation.ispartofCanceren_US
dc.rightsCancer. Copyright © John Wiley & Sons, Inc.-
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBody Imageen_US
dc.subject.meshBreast Neoplasms - Pathology - Psychology - Surgeryen_US
dc.subject.meshChemotherapy, Adjuvanten_US
dc.subject.meshChina - Ethnologyen_US
dc.subject.meshChoice Behavioren_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Ethnologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMastectomy - Psychologyen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshPredictive Value Of Testsen_US
dc.subject.meshQuestionnairesen_US
dc.subject.meshRadiotherapy, Adjuvanten_US
dc.subject.meshSelf Efficacyen_US
dc.subject.meshStress, Psychological - Etiology - Prevention & Controlen_US
dc.titlePredicting psychological morbidity in Chinese women after surgery for breast carcinomaen_US
dc.typeArticleen_US
dc.identifier.emailLam, WWT: wwtlam@hku.hken_US
dc.identifier.emailFielding, R: fielding@hku.hken_US
dc.identifier.authorityLam, WWT=rp00443en_US
dc.identifier.authorityFielding, R=rp00339en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/cncr.20810en_US
dc.identifier.pmid15612024-
dc.identifier.scopuseid_2-s2.0-12744274531en_US
dc.identifier.hkuros97209-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-12744274531&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume103en_US
dc.identifier.issue3en_US
dc.identifier.spage637en_US
dc.identifier.epage646en_US
dc.identifier.isiWOS:000226480100027-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLam, WWT=7203022022en_US
dc.identifier.scopusauthoridFielding, R=7102200484en_US
dc.identifier.scopusauthoridHo, EYY=7102724570en_US

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