Symptom-Management Self-efficacy Mediates the Effects of Symptom Distress on the Quality of Life Among Taiwanese Oncology Outpatients With Breast Cancer

2016 ◽  
Vol 39 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Shu-Yuan Liang ◽  
Ta-Chung Chao ◽  
Ling-Ming Tseng ◽  
Shiow-Luan Tsay ◽  
Kuan-Chia Lin ◽  
...  
PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246430
Author(s):  
Chia-Hui Chin ◽  
Ling-Ming Tseng ◽  
Ta-Chung Chao ◽  
Tsae-Jyy Wang ◽  
Shu-Fang Wu ◽  
...  

Background The important role of self-efficacy in facilitating health behavior and, in turn, promoting health outcomes has been widely presumed in the theoretical literature. However, little research has focused on the mechanism by which self-care mediates the relationship between symptom-management self-efficacy and quality of life (QOL) in breast cancer patients. Objective The purpose of this study was to examine the relationship between symptom-management self-efficacy and quality of life in Taiwanese oncology outpatients with breast cancer and then proposes self-care as a mediator between these two factors. Methods This cross-sectional study enrolled 201 oncology outpatients at one teaching hospital in metropolitan Taipei City, Taiwan. The research instruments included the Symptom-Management Self-Efficacy Scale—Cancer (SMSES-Breast Ca.), the Self-Care Scale, and the European Organization for Research & Treatment of Cancer Quality of Life Group Questionnaire (EORTC-QLQ-C30). Results Symptom-management self-efficacy (SMSE) was directly associated with the QOL of the participants (β = 5.94, p < .001). Moreover, SMSE was indirectly associated with QOL through self-care. Self-care was found to mediate the relationship between symptom-management self-efficacy and global QOL (indirect effect = 0.54, 95% CI 0.12 to 1.18). The level of 95% CI was significant. Conclusions The present study supports that self-efficacy beliefs and self-care both significantly and positively influence the quality of life of patients.


2003 ◽  
Vol 21 (24) ◽  
pp. 4510-4516 ◽  
Author(s):  
H. de Haes ◽  
M. Olschewski ◽  
M. Kaufmann ◽  
M. Schumacher ◽  
W. Jonat ◽  
...  

Purpose: To compare quality of life (QoL) in premenopausal and perimenopausal patients with node-positive, early breast cancer treated with the endocrine agent goserelin (Zoladex; AstraZeneca Pharmaceuticals LP, Wilmington, DE) or cyclophosphamide + methotrexate + fluorouracil (CMF). Patients and Methods: Patients from 86 centers worldwide were randomly assigned to receive either goserelin (3.6 mg every 28 days for 2 years; n = 514) or CMF (six 28-day cycles; n = 496), and were included in the QoL study. QoL was assessed using a self-administered patient questionnaire that consisted of 39 items from the Rotterdam Symptom Checklist, including dimensions evaluating physical and psychological symptom distress, activities of daily living, hormonal effects, and an assessment of overall QoL. Results: Early benefits were noted during months 3 to 6 of treatment, for goserelin compared with CMF. Significant differences were found for changes in overall QoL (eg, 6.96 ± 0.88 v 0.69 ± 0.92 at 6 months; P < .0001) and for physical symptom distress, activity levels, and “effort to cope with illness” dimensions. At 1, 2, and 3 years, there were no significant differences in overall QoL or specific QoL dimensions. Scores for hormonal symptoms were worse with goserelin during the 2-year goserelin treatment period; however, this trend was reversed at 3 years. Conclusion: Goserelin offers improved overall QoL during the first 6 months of therapy compared with CMF chemotherapy in premenopausal and perimenopausal patients with early breast cancer. Coupled with equivalent efficacy in estrogen receptor-positive patients, these data support the use of goserelin as an alternative to CMF in premenopausal and perimenopausal patients with estrogen receptor-positive, node-positive early breast cancer.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 163-163
Author(s):  
Jeanne M. Ferrante ◽  
Michelle Doose ◽  
Alicja Bator ◽  
Katie Devine ◽  
Pamela Ohman Strickland ◽  
...  

163 Background: Obesity is associated with higher breast cancer recurrence and death, and poorer health and quality of life. African-American (AA) women have the highest prevalence of obesity, obesity-related comorbidities, and breast cancer mortality compared with other racial/ethnic groups. Weight loss after breast cancer diagnosis may lower rates of recurrence and improve fitness, fatigue, and quality of life. Methods: This 6-month randomized controlled trial pilot-tests the use of a Fitbit activity tracker (Fitbit only group) versus Fitbit plus SparkPeople, a free web-based weight loss program (combined group) among 70 AA breast cancer survivors. Paired t-tests assess changes from baseline to 6-months among each participant in primary (weight, body mass index [BMI], percent body fat) and secondary (24-hour caloric intake, daily number of steps, quality of life, self-monitoring strategies, self-efficacy) outcomes. Two-group t-tests assess differences in outcomes between the two groups. Results: Currently, 36 of 46 (78.3%) eligible participants have enrolled and completed baseline assessments. Mean age of participants is 61.7 years (SD 8.7) and mean BMI is 36.9 (SD 7.0). Analyses of the first 25 participants who completed 3-month assessments (Fitbit only N = 12; combined group N = 13) show significant weight loss in both groups; Fitbit only: mean weight change -6.73 pounds, SD 4.61, p < 0.001; mean BMI change -0.96 kg/m2, SD 0.84, p = 0.002; combined group: mean weight change -5.95 pounds, SD 5.84, p = 0.003; mean BMI change -1.03 kg/m2, SD 0.77, p < 0.001. All participants significantly increased tracking of diet (Fitbit only p = 0.016; combined group p < 0.001) and physical activity (Fitbit only p < 0.001; combined group p = 0.001). Though not significant, combined group participants showed greater increases in self-efficacy for eating healthy and reducing fat and calories, and increases in daily steps (+1308 vs. +285 for Fitbit only group). Preliminary analyses show no statistically significant difference in changes in outcomes from baseline to 3 months between the two groups. Conclusions: Both programs show potential as convenient and efficient weight loss methods for African-American breast cancer survivors. Clinical trial information: NCT02699983.


2014 ◽  
Author(s):  
Margaret LG Darling ◽  
Claudia Campos ◽  
Larisa Caicedo ◽  
Karlynn BrintzenhofeSzoc ◽  
James R. Zabora ◽  
...  

2017 ◽  
Author(s):  
Jiemin Zhu ◽  
Lyn Ebert ◽  
Xiangyu Liu ◽  
Di Wei ◽  
Sally Wai-Chi Chan

BACKGROUND Women undergoing chemotherapy for the treatment of breast cancer have frequently reported unmet supportive care needs. Moreover, easily accessible and innovative support is lacking. OBJECTIVE The purpose of this trial was to determine the effectiveness of an app-based breast cancer e-support program to address women’s self-efficacy (primary outcome), social support, symptom distress, quality of life, anxiety, and depression. Secondary objectives included exploring the association between women’s health outcomes and the breast cancer e-support usage data. METHODS A multicenter, single-blinded, randomized controlled trial was conducted. A total of 114 women with breast cancer, who were commencing chemotherapy and were able to access internet through a mobile phone, were recruited in the clinics from 2 university-affiliated hospitals in China. Women were randomized either to the intervention group (n=57) receiving breast cancer e-support plus care as usual or the control group (n=57) receiving care as usual alone. The health care team and research assistants collecting data were blinded to the women’s group allocation. Bandura’s self-efficacy theory and the social exchange theory guided the development of the breast cancer e-support program, which has 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. Moderated by an experienced health care professional, the breast cancer e-support program supported women for 12 weeks covering 4 cycles of chemotherapy. Health outcomes were self-assessed through paper questionnaires in clinics at baseline before randomization (T0), after 3 (T1), and 6 months (T2) of follow-ups. RESULTS Fifty-five participants in the intervention group and 49 in the control group completed the follow-up assessments (response rate: 91.2%). During the 12-week intervention, the log-in frequency ranged from 0 to 774 times (mean 54.7; SD 131.4; median 11; interquartile range, IQR 5-27), and the total usage duration ranged from 0 to 9371 min (mean 1072.3; SD 2359.5; median 100; IQR 27-279). Repeated measures multivariate analysis of covariance (intention-to-treat) found that breast cancer e-support + care as usual participants had significant better health outcomes at 3 months regarding self-efficacy (21.05; 95% CI 1.87-40.22; P=.03; d=0.53), symptom interference (−0.73; 95% CI −1.35 to −.11; P=.02; d=−0.51), and quality of life (6.64; 95% CI 0.77-12.50; P=.03, d=0.46) but not regarding social support, symptom severity, anxiety, and depression compared with care as usual participants. These beneficial effects were not sustained at 6 months. Spearman rank-order correlation showed that the breast cancer e-support usage duration was positively correlated with self-efficacy (r=.290, P=.03), social support (r=.320, P=.02), and quality of life (r=.273, P=.04) at 3 months. CONCLUSIONS The breast cancer e-support program demonstrated its potential as an effective and easily accessible intervention to promote women’s self-efficacy, symptom interference, and quality of life during chemotherapy. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000639426; www.ANZCTR.org.au/ACTRN12616000639426.aspx (Archived by Webcite at http://www.webcitation.org/6v1n9hGZq)


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