Patient-Reported Self-Efficacy, Anxiety, and Health-Related Quality of Life During Chemotherapy: Results From a Longitudinal Study

Purpose/Objectives: To explore changes over time in self-efficacy and the predictive ability of changes in state anxiety and health-related quality of life during chemotherapy.

Design: Secondary analysis of a longitudinal dataset derived from a larger, multicenter study.

Setting: Outpatient oncology clinics across eight general hospitals in England, Scotland, and Northern Ireland.

Sample: 137 patients scheduled to receive adjuvant chemotherapy for breast or colorectal cancer.

Methods: At the beginning of each of six chemotherapy cycles, participants completed the Strategies Used by People to Promote Health questionnaire, the State-Trait Anxiety Inventory, and the Functional Assessment of Cancer Therapy–Breast or –Colorectal questionnaire. Multilevel model analysis was used to analyze longitudinal data, adjusted for demographic and clinical variables.

Main Research Variables: Self-efficacy, anxiety, and health-related quality of life.

Findings: No significant time effects were found for patients’ overall perceived self-efficacy or self-efficacy parameters. A trend toward greater self-efficacy was evident as chemotherapy progressed. Self-efficacy was significantly associated with decreased state anxiety throughout chemotherapy. Increases in overall self-efficacy and perceived ability to maintain a positive attitude were significantly associated with over-time increases in physical, emotional, and functional well-being, as well as with fewer cancer-related concerns.

Conclusions: Findings highlight the importance of clinical assessments throughout treatment that focus on patients’ perceived self-efficacy as a positive regulator of mood and well-being.

Implications for Nursing: The current study suggests self-efficacy enhancement should be a key component of psycho-behavioral programs designed to support patients with cancer throughout chemotherapy.