Trajectory Patterns and Factors Influencing Self-management Behaviors in Chinese Patients With Breast Cancer.

Abstract

Self-management plays an important role in improving quality of life among patients with breast cancer. Self-management behaviors change with treatment periods, and the trajectory varies in patients with different demographic and psychosocial characteristics. However, the trajectory patterns and the predictive factors have not been fully studied. The aim of this study was to identify the trajectory patterns of self-management behaviors in Chinese patients with breast cancer and their predictive factors. A total of 128 patients with breast cancer were recruited. Demographic and disease-related information, self-management behaviors, self-efficacy, coping modes, emotional distress, and social support were investigated across 5 time points. Growth mixture modeling was used to identify the trajectory patterns of self-management behaviors. Logistic regression was used to determine the predictors for membership. The best-fit growth mixture modeling revealed a 2-class model; model fit indices were all in acceptable ranges. Class 1 and 2 were named as the group of "stable" (34.38%) and the group of "sharply decreased" (65.62%), respectively, based on the tendency of change. Modified radical mastectomy, avoidance coping mode, anxiety, and low self-efficacy level were predictors of the patients' membership to the sharply decreased group. Our study proved the heterogeneity of self-management behaviors and the influencing effect of treatment and psychosocial factors on the development of self-management behaviors in Chinese patients with breast cancer. Health professionals should pay more attention to patients who are at higher risk of developing a poor self-management pattern. Targeted interventions should be developed across subpopulations and treatment periods accordingly.