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Determinants of emotional distress in breast cancer survivors with lymphedema
Descriptive
TitleInfo
Title
Determinants of emotional distress in breast cancer survivors with lymphedema
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Chu
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Kayoung Hee
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1960-
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Kayoung Hee Chu
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author
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Thomas-Hawkins
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Charlotte
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Charlotte Thomas-Hawkins
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Advisory Committee
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chair
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Flynn
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Linda
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Linda Flynn
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internal member
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Musanti
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Rita
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Rita Musanti
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Advisory Committee
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internal member
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Fu
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Mei R
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Mei R Fu
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Advisory Committee
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outside member
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Yu
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Gary
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Gary Yu
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Advisory Committee
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Rutgers University
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Graduate School - Newark
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theses
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2020
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2020-01
Language
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English
Abstract
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Background: 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.
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.
Subject
(authority = local)
Topic
Emotional distress in breast cancer
Subject
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Topic
Breast -- Cancer -- Patients -- Psychology
Subject
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Topic
Nursing
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Rutgers University Electronic Theses and Dissertations
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ETD_10422
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1 online resource (viii, 98 pages) : illustrations
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Ph.D.
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Includes bibliographical references
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Graduate School - Newark Electronic Theses and Dissertations
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rucore10002600001
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doi:10.7282/t3-5xb6-7b75
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Chu
GivenName
Kyung
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Permission or license
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2019-11-24 21:44:52
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Kyung Chu
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Rutgers University. Graduate School - Newark
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2020-01-14T17:07:46
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2020-01-14T17:07:46
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