Background Psycho-oncology literature pointed out that individual health outcomes may depend on patients’ propensity to adopt approach or, conversely, avoidant coping strategies. Nevertheless, coping factors associated with postoperative distress remain unclear, unfolding the lack of tailored procedures to help breast cancer patients manage the psychological burden of scheduled surgery. In view of this, the present study aimed at investigating: 1. pre-/post-surgery distress variations occurring among women diagnosed with breast cancer; 2. the predictivity of approach and avoidant coping strategies and factors in affecting post-surgery perceived distress. Methods N = 150 patients (mean age = 59.37; SD = ± 13.23) scheduled for breast cancer surgery were administered a screening protocol consisting of the Distress Thermometer (DT) and the Brief-COPE. The DT was used to monitor patients’ distress levels before and after surgery (± 7 days), whereas the Brief-COPE was adopted only preoperatively to evaluate patients’ coping responses to the forthcoming surgical intervention. Non-parametric tests allowed for the detection of pre-/post-surgery variations in patients’ perceived distress. Factor analysis involved the extraction and rotation of principal components derived from the Brief-COPE strategies. The predictivity of such coping factors was investigated through multiple regression (Backward Elimination). Results The Wilcoxon Signed-Rank Test yielded a significant variation in DT mean scores (TW = -5,68 < -zα/2 = -1,96; p < .001) indicative of lower perceived distress following surgery. The four coping factors extracted and Varimax-rotated were, respectively: 1. cognitive processing (i.e., planning + acceptance + active coping + positive reframing); 2. support provision (i.e., instrumental + emotional support); 3. emotion-oriented detachment (i.e., self-blame + behavioral disengagement + humor + denial); 4. goal-oriented detachment (i.e., self-distraction). Among these factors, support provision (B = .458; β = − .174; t = − 2.03; p = .045), encompassing two approach coping strategies, and goal-oriented detachment (B = .446; β = − .176; t = − 2.06; p = .042), consisting of one avoidant strategy, were strongly related to post-surgery distress reduction. Conclusion The present investigation revealed that the pre-surgery adoption of supportive and goal-oriented strategies led to postoperative distress reduction among breast cancer patients. These findings highlight the importance of timely psychosocial screening and proactive interventions in order to improve patients’ recovery and prognosis.
Gli studi volti all'analisi del disagio psicologico delle pazienti con tumore al seno sono sempre più frequenti. Tuttavia, i correlati psicologici e psicosociali dei sintomi ansioso-depressivi (SAD) nel carcinoma mammario richiedono ulteriori approfondimenti, alla luce dell'eterogeneità dei protocolli impiegati per l'assessment psiconcologico. La presente rassegna sistematica, condotta mediante la banca dati Scopus, si è posta il duplice obiettivo di identificare e classificare i principali correlati dei SAD nelle pazienti oncologiche, e indagare il ruolo svolto da tali correlati verso l'insorgenza, il mantenimento e/o la severità dei SAD. La rassegna, basata su criteri di eleggibilità prestabiliti e procedure sistematiche di screening e valutazione, ha preso in esame 64 studi osservazionali (trasversali e longitudinali) pubblicati nel decennio 2012-2022. Dagli studi è emerso un legame fra SAD (rilevati con strumenti di screening), ansia e/o depressione (valutati con questionari specifici), e tre macro-categorie di costrutti: 1. altri sintomi di disagio psicologico, positivamente correlati ai SAD; 2. il capitale psicologico e psicosociale delle pazienti, inversamente correlato ai SAD; 3. ulteriori fattori che influenzano la salute e l'aderenza terapeutica. Le implicazioni della presente rassegna della let-teratura si realizzano nell'opportunità di adottare protocolli valutativi e di intervento integrati, orientando studi futuri verso un'analisi ed una maggiore comprensione della variabilità delle procedure di assessment e delle diverse risposte delle pazienti al disagio cancro-correlato.
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