The Impact of Pain on Breast Cancer Patients’ Quality Life: Pain Associated Psychosocial Factors

Abstract

The onset of cancer disease results in massive lifestyle changes and brings with it overwhelming challenges. Individual psychological features play a crucial role in determining how patients respond and cope with the disease. The main objectives of this research were to study the overall impact of breast cancer [BC] and disease related pain on the patients quality of life [QOL] and to understand the role of selected psychosocial variables [such as anxiety, depression and coping styles] on the perception of pain and QOL. We have studied fifty female BC patients currently undergoing chemotherapy in a tertiary hospital. All our patients were evaluated in a single moment. We have resorted to the use a demographic and clinical questionnaire, the MPQ, the CAD-R, the HADS and the SF-36 questionnaires. We have found that 66% of our patients suffered from pain that could be directly traced to their disease. High intensity of pain was associated to a significant reduction in QOL, expressed both in its physical and mental aspects, and also to higher levels of anxiety and depression. Lower intensity of pain was associated to the use of “Distraction” as a coping strategy. The use of passive coping strategies correlated with a decrease in QO Land with more acute symptoms of anxiety and depression. We conducted two independent regression analyses to determine the relationship between the independent variables [Anxiety and Depression in HADS, PRI and PPI in MPQ, active and passive coping strategies, the condition of having met as t as is or not] and the mental and physical dimensions of QOL and we found that Depression and Anxiety can predict a poor QOL on psychological dimension, whereas for physical dimension, Pain Rating Index and Depression are the variables that best predict low scores in QOL. Conclusions: Pain has a devastating effect on the perception of quality of life as well as on the psychological response irrespective of the stage and severity of the illness.