Anxiety and Quality of Life of Women Who Receive Radiation or Chemotherapy for Breast Cancer
Purpose/Objectives: To examine quality of life (QOL) and anxiety in a sample of women receiving radiation or chemotherapy for breast cancer.
Design: Longitudinal, descriptive.
Setting: A cancer center in the southeastern United States.
Sample: 48 women participated; 17 received radiation and 31 received chemotherapy.
Methods: The Ferrans and Powers Quality of Life Index (QLI) and Speilberger's State-Trait Anxiety Inventory (STAI) were administered. The QLI was administered at the start of treatment and one year later. The STAI was administered at the start of treatment. The state portion of the STAI also was administered 4 weeks and 12 weeks after the start of treatment.
Main Research Variables: QOL and anxiety.
Findings: Total QOL improved significantly over time for the entire sample, as did scores on the health/functioning, psychological/spiritual, and family subscales of the QLI. No significant differences existed for total QOL or any subscales by treatment. Trait anxiety was significantly higher for women receiving chemotherapy, and state anxiety was significantly higher at all three measurement times for the women. State anxiety did not decrease significantly over the course of the treatment for either group. Trait anxiety and state anxiety at the start of treatment were significantly negatively correlated with total QLI score and the psychological/spiritual subscale. State anxiety at the start of treatment also was significantly negatively correlated with total QOL and the health/functioning and psychological/spiritual QLI subscales both at the start of treatment and one year later.
Conclusions: QOL improves over time for women who have received radiation or chemotherapy. Women receiving chemotherapy have higher anxiety scores, and higher anxiety at the start of treatment is associated with decreased QOL at the start of treatment and postdiagnosis.
Implications for Nursing: Nursing interventions to reduce anxiety at the start of treatment, especially for chemotherapy recipients, are indicated. Research also should target methods to reduce anxiety at the start of treatment.
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References
Berglund, G., Bolund, C., Fornander, T., Rutqvist, L.E., & Sjoden, P.O. (1991). Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. European Journal of Cancer, 27, 1075-1081.
Fallowfield, L.J., Hall, A., Maguire, P., Baum, M., & A'Hern, R.P. (1994). Psychological effects of being offered choice of surgery for breast cancer. BMJ, 309, 448.
Ferrans, C.E. (1990). Development of a quality of life index for patients with cancer. Oncology Nursing Forum, 17(Suppl. 3), 15-21.
Ferrans, C.E., & Powers, M. (1985). Quality of Life Index: Development and psychometric properties. Advances in Nursing Science, 8(1), 15-24.
Ferrell, B.R., Grant, M., Funk, B., Otis-Green, S., & Garcia, N. (1997). Quality of life in breast cancer. Part I: Physical and social well-being. Cancer Nursing, 20, 398-408.
Ferrell, B.R., Grant, M., Funk, B., Otis-Green, S., & Garcia, N. (1998). Quality of life in breast cancer. Part II: Psychological and spiritual well being. Cancer Nursing, 21, 1-9.
Ganz, P.A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M.L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183-199.
Graydon, J.E. (1994). Women with breast cancer: Their quality of life following a course of radiation therapy. Journal of Advanced Nursing, 19, 617-622.
Hoskins, C.N. (1997). Breast cancer treatment-related patterns in side effects, psychological distress, and perceived health status. Oncology Nursing Forum, 24, 1575-1583.
King, C., & Hinds, P. (1998). Quality of life from nursing and patient perspectives: Theory, research, practice. Sudbury, MA: Jones and Bartlett.
Longman, A.J., Braden, C.J., & Mishel, M.H. (1999). Side-effects burden, psychological adjustment, and life quality in women with breast cancer: Pattern of association over time. Oncology Nursing Forum, 26, 909-915.
Ritz, L.J., Nissen, M.J., Swenson, K.K., Farrell, J.B., Sperduto, P.W., Sladek, M.L., et al. (2000). Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. Oncology Nursing Forum, 27, 923-932.
Rustoen, T., Moum, T., Wiklund, I., & Hanestad, B. (1999). Quality of life in newly diagnosed cancer patients. Journal of Advanced Nursing, 29, 490-498.
Speilberger, C.D. (1983). Manual for the Strait-Trait Anxiety Inventory (form Y). Palo Alto, CA: Consulting Psychologists Press.
Wyatt, G.K., & Friedman, L.L. (1998). Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer. Oncology Nursing Forum, 25, 761-768.