Pre-surgery supportive and goal-oriented strategies are associated with lower post-surgery perceived distress in women diagnosed with breast cancer

Abstract

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.

Impact of a Biopsychosocial Screening Program on Clinical and Hospital-Based Outcomes in Cancer

“…Previous studies have noted that biopsychosocial support can improve clinical outcomes in the postoperative setting, including reducing the number and severity of complications and improving patients' recovery and prognosis. 12,13 The other reasons for hospital admission (fever/infection/neutropenia, functional status, and respiratory) were significantly higher among patients who did not participate in the BSP. It is possible that the program could affect patients' recovery during the treatment period, suggesting that screening and referrals increase the ability of an integrated model of care to manage patients' unmet needs.…”

Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study

“…After experiencing diferent degrees of psychological distress, patients choose to accept the fact of having cancer, including the acts of embracing the diagnoses and resigning themselves to it. A study has shown that patients who experience presurgery psychological distress can infuence postoperative functional recovery and prognosis [46]. Ohkura et al longitudinally tracked changes in the psychological status of patients undergoing esophagectomy at fve time points and showed that changes in patients' psychological status were signifcantly associated with changes in symptom experience and quality of life brought about by esophagectomy [47,48].…”

Are Diagnostic Delays Associated with Distress in Breast Cancer Patients?

“…Identification of patients with high distress allows providers the opportunity to offer interventions aimed to decrease distress. A recent study by Taurisano et al [37] demonstrated that a pre-surgery intervention reduced post-op distress in patients with breast cancer. Similar interventions exist to reduce distress in breast cancer survivors [38].…”