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Abstract
This study aimed to identify the changes in the illness perceptions and depression of women with breast cancer, undergoing AET, at three time points (i.e., before initiating AET, 3 months follow-up, and 12 months follow-up). We investigated the interaction effects of their demographic and clinical characteristics on illness perception changes over time. Furthermore, factors including the patient’s characteristics and illness perceptions associated with depressive symptoms 1 year after starting AET were explored. Illness perception and depressive symptoms were assessed with the brief illness perception questionnaire and the Center for Epidemiologic Studies Depression Scale, in a prospective study of 150 women. The changes in illness perceptions and depression between the three time points were analyzed using repeated measures ANOVA. The factors associated with depressive symptoms were identified using regression analysis. Illness perception improved overall over the 12 months. However, more patients perceived their illness as chronic, experienced more symptoms, and developed negative beliefs that treatment could not control their disease. Patients’ depressive symptoms decreased significantly. Depression at the baseline, cancer stage, and the perception of personal control were highly associated with depression after 12 months. These findings suggest that healthcare providers should offer appropriate interventions to patients, for managing symptoms, having a positive belief that treatment can control their disease, and preventing long-term depressive symptoms.
Highlights
Breast cancer is the most prevalent type of cancer, and the leading cause of mortality among women, with 2,090,000 new cases and 627,000 deaths in 2018 [1]
adjuvant endocrine therapy (AET) can reduce the risk of recurrence and death from breast cancer in women, it is associated with several physical and psychological side effects, such as hot flushes, night sweating, joint pain, and depression [5,6]
This study examined the changes in illness perception and depression among patients with breast cancer, over 12 months after starting AET, and explored factors associated with depressive symptoms
Summary
Breast cancer is the most prevalent type of cancer, and the leading cause of mortality among women, with 2,090,000 new cases and 627,000 deaths in 2018 [1]. 50–78% of breast cancer patients in Korea are hormone receptor-positive [2], and they often receive long-term (i.e., 5 or more years) adjuvant endocrine therapy (AET) upon completion of primary therapy (e.g., surgery, radiation, or chemotherapy), to further reduce their cancer recurrence risk and increase their overall survival [3,4]. AET can reduce the risk of recurrence and death from breast cancer in women, it is associated with several physical and psychological side effects, such as hot flushes, night sweating, joint pain, and depression [5,6]. It is known that depression is associated with several other factors, including the patient’s socio-demographic (e.g., age, socio-economic status) and clinical characteristics (e.g., cancer stage, treatments) [12,13,14], and their perception of the illness [15,16]
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