The Effects of Fatigue and Distress on Self-efficacy among Breast Cancer Survivors

Abstract

Purpose:The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy. Methods: A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions. Results: The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance. Conclusion: Fatigue should be managed to improve self-efficacy of breast cancer survivors. Therefore, nursing programs designed to decrease fatigue may be helpful.

Does the Association Between Fatigue and Fatigue Self-management Preference Vary by Breast Cancer Stage?

“…In addition, a previous study involving BCS reported a lower fatigue score (3.83) among subjects who were either undergoing active treatment or receiving follow-up care 27 ; however, that study's participants were an average of approximately 1 year post diagnosis, compared with 2.14 ± 1.77 years in our study. The observed differences in fatigue level may have been due to differences among studies in the number of participants in treatment as opposed to having completed treatment, but because cancer stage was not analyzed in 2 of the studies, 25,27 it is difficult to reach conclusions regarding the role of cancer stage. In addition, differences in the fatigue level could be related to survivorship phase (acute, extended, or permanent) 28 as well as to the cumulative effects of CRF over time.…”

“…Another study of Korean BCS showed that patients undergoing RT had higher fatigue (5.04) than those receiving chemotherapy (4.03), but cancer stage was not significantly related to fatigue level 26 . In addition, a previous study involving BCS reported a lower fatigue score (3.83) among subjects who were either undergoing active treatment or receiving follow-up care 27 ; however, that study's participants were an average of approximately 1 year post diagnosis, compared with 2.14 ± 1.77 years in our study. The observed differences in fatigue level may have been due to differences among studies in the number of participants in treatment as opposed to having completed treatment, but because cancer stage was not analyzed in 2 of the studies, 25,27 it is difficult to reach conclusions regarding the role of cancer stage.…”

Improving the quality of life in a breast cancer patient and caregiver: Protocol for the application of the integrative medical service model

“…(2) Distress Thermometer (Korean Edition-NCCN Guidelines for Distress Management) Distress was measured using the Korean version of the national comprehensive cancer network (NCCN) distress thermometer (DT), [9] Korean Edition-NCCN Guidelines for Distress Management Version 2.2013. [10] The DT expresses the degree of distress felt in the past week, including the current day, on a rating scale from 0 (no distress) to 10 (excessive stress). The cutoff score is 4 points: mild distress < 4, moderate-to-severe distress ≥ 4.…”

“…(3) Inventory of Functional Status-Cancer (IFS-CA) Functional status was measured using the inventory of functional status-cancer (IFS-CA) developed by Tulman et al (1991) [9] and adapted to the Korean context by Seo and Lee (1997). [10] The IFS-CA is a 39-item questionnaire designed to measure the functional status of women with cancer, and consists of 4 subscales: household and family activities (15 items), social activities (6 items), self-care activities (10 items), and occupational activities (8 items). Each item is rated on a 4-point scale (1 = never, 4 = always).…”

“…Cronbach's α was .82 across the subscales and .74 in household and family activities, .82 in social activities, .56 in self-care activities, and .72 in occupational activities at the time of instrument development, and .74, .66, .52, and .82, respectively, in the study of Seo and Lee (1997). [10] (4) Menopause Rating Scale (MRS) Menopausal symptoms were measured using the Korean version of the menopause rating scale (MRS) developed by Heinemann et al (2003). [11] The MRS is an 11-item tool designed to assess the menopausal symptoms in 3 areas: somato-vegetative symptoms (4 items), psychological symptoms (4 items), and urogenital symptoms (3 items).…”