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Determinants of emotional distress in breast cancer survivors with lymphedema
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Chu, Kayoung Hee. Determinants of emotional distress in breast cancer survivors with lymphedema. Retrieved from https://doi.org/doi:10.7282/t3-5xb6-7b75

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TitleDeterminants of emotional distress in breast cancer survivors with lymphedema
NameChu, Kayoung Hee (author); Thomas-Hawkins, Charlotte (chair); Flynn, Linda (internal member); Musanti, Rita (internal member); Fu, Mei R (outside member); Yu, Gary (outside member); Rutgers University; Graduate School - Newark
Date Created2020
Other Date2020-01 (degree)
SubjectEmotional distress in breast cancer, Breast -- Cancer -- Patients -- Psychology, Nursing
Extent1 online resource (viii, 98 pages) : illustrations
DescriptionBackground: There is no consensus regarding the definition and quantification of lymphedema. Moreover, most studies in breast cancer related lymphedema (BCRL) did not include lymphedema symptoms on its effect on outcome. Therefore, the results from the studies in BCRL have presented a wide gap in the findings. Moreover, despite its importance for health outcomes, there is a paucity of studies that have examined emotional distress (ED) over time in women with BCRL and little is known of the pattern of ED over time who experience symptoms of lymphedema and who are at risk for lymphedema following treatment for breast cancer.

Study Purpose: This study aimed to identify and further understand the determinants of ED in breast cancer survivors with lymphedema.

Methods: This is a secondary analysis of de-identified data collected prospectively from 140 women who were diagnosed with breast cancer between December 2011 and April 2014.The inclusion criteria were women aged 21 years and over who were diagnosed with a first-time diagnosis of stage 1-III breast cancer and were scheduled for surgical treatment. Lymph volume was measured by the perometer, and 26 lymphedema symptoms and 12 ED symptoms collected on Breast Cancer & Lymphedema Symptom Experience (BCLE-SEI) at pre surgery, four to eight weeks and 12 months post surgery. Using the framework of the theory of unpleasant symptoms, physiological factors (i.e., age, BMI and lymph fluid volume), situational factors (i.e., level of education, marital status, type of surgery, type of therapy) and lymphedema symptoms were examined.

Results: The level of ED over time did not decline spontaneously, but increased 12 months after surgical treatment. Situational factors examined were not associated. Two physiological factors, BMI and lymph volume were significantly associated with ED post-surgery. Lymphedema symptom intensity was significantly associated with ED post-surgery. A lymph volume increase of ≥ 5 % (OR= 3.9, 95 % CI; 1.469-10.452) and a high level of lymphedema symptom intensity score ≥ 9 (OR=8.7, 95 % CI; 3.362-22.356) were independently associated with a likelihood of high ED 12 months post-surgery in an adjusted model.

Implication: Our findings offer clinically relevant evidence- based knowledge regarding lymphedema, lymphedema symptoms and ED symptoms to inform the health care professionals to improve of the care in breast cancer survivors. Our results can be used to assist in the early detection and assessment of ED and lymphedema symptoms in either the absence or presence of lymphedema in breast cancer survivors.
NotePh.D.
NoteIncludes bibliographical references
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/t3-5xb6-7b75
LanguageEnglish
CollectionGraduate School - Newark Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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