Trajectories of psychological distress among Chinese women diagnosed with breast cancer

  • Lam W
  • Bonanno G
  • Mancini A
 et al. 
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Background: The distinct trajectories of psychological distress over
the first year of the diagnosis with breast cancer {(BC)} and its
determinants have not been {explored.Methods:} 285 of 405 Chinese
women receiving surgery for {BC} were assessed at 5-day, 1-month,
4-month, and 8-month post-surgery on measures of psychological distress,
optimism, treatment decision-making {(TDM)} difficulties, satisfaction
with treatment outcome, satisfaction with medical consultation, and
physical symptom distress. Latent growth mixture modelling identified
trajectories of psychological response to {BC.} Multinominal logistic
regression compared {TDM} difficulties, satisfaction with treatment
outcome, satisfaction with medical consultation, optimism, and physical
symptom distress, by distress pattern adjusted for age, education,
employment status, and stage of {disease.Results:} Four distinct
trajectories of distress were identified, namely, resilience (66%),
chronic distress (15%), recovered (12%), and delayed-recovery (7%).
{TDM} difficulties, optimism, satisfaction with consultation, and
physical symptom distress predicted distress trajectories. Psychologically
resilient women had less physical symptom distress at early post-surgery
compared with women with other distress patterns. Compared with the
resilient group, women in the recovered or chronic distress groups
experienced greater {TDM} difficulties, whereas women in the delayed-recovery
group reported greater dissatisfaction with the initial medical consultation.
Women in the chronic distress group reported greater pessimistic
{outlook.Conclusion:} Optimism and better early post-operative treatment
outcomes predicted resilience to distress. Pre-operative interventions
helping women to establish a realistic expectation of treatment outcome
may minimize disappointment with treatment outcome and resultant
distress, whereas post-operative rehabilitation should focus on symptom
management. Copyright � 2009 John Wiley & Sons, Ltd.

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  • Wendy W. T. Lam

  • George A. Bonanno

  • Anthony D. Mancini

  • Samuel Ho

  • Miranda Chan

  • Wai Ka Hung

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