Uncertainty Appraisal Coping and Quality of Life in Breast Cancer Survivors

Abstract

Breast cancer survivors increasingly experience long-term side effects that influence their quality of life. They also experience uncertainty of their future due to recurrence of disease. Descriptive design was conducted. Using convenience sampling, 150 breast cancer survivors of more than 3 years from time of diagnosis were recruited from Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. Research instruments included Mishel Uncertainty in Illness Scale, Stress Appraisal Index, Ways of Coping Questionnaire, and Quality of Life: Breast Cancer Version Questionnaire and Demographic Data Questionnaire. Results revealed that breast cancer survivors had moderate levels of uncertainty in their illness. Survivors appraised their illness and found high level of challenges, moderate level of threat, and low level of harm. Overall quality of life was found to be moderate. Among Ways of Coping strategies, seeking social support was used the most and confrontive coping was used the least. Using hierarchical multiple regression, variables influencing quality of life were year of survival, uncertainty in illness, and harm appraisal. All 3 variables explained 21.8% variance of quality of life. Uncertainty and harm appraisal influence quality of life in breast cancer survivors. Suggestions and further implications were included.

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients

“…These aspects may explain the levels of uncertainty in the study participants. Uncertainty has been found among patients with prostate cancer who are undergoing watchful waiting [34,35] or among survivors of breast cancer [15]. Among the latter group, the uncertainty levels (mean = 57.08, SD=10.14) were lower than the ones of our study participants [15].…”

“…Uncertainty has been found among patients with prostate cancer who are undergoing watchful waiting [34,35] or among survivors of breast cancer [15]. Among the latter group, the uncertainty levels (mean = 57.08, SD=10.14) were lower than the ones of our study participants [15]. Undergoing anticancer treatment has been described as being a distressing situation for patients and their families, as the situation is found to be unstable and not predictable [32,33].…”

“…Being confronted with uncertainty can motivate people to attempt to adjust to the changing demands associated with their illness [12,13]. These studies have focused predominantly on cancer survivors, women with breast cancer or men with prostate cancer [14,15]. Cancer patients also experience changes in locus of control [16].…”

Role of Health Locus of Control Between Uncertainty and Uncertainty Appraisal Among Patients With Atrial Fibrillation

“…First, as negative consequences, uncertainty may cause a great deal of psychosocial stress and enhance personal and family hardship (Lazarus & Folkman, 1984;Mishel, 1981;Strauss et al, 1984). Increased uncertainty has been associated with increased stress (Davis, 1990;Lee, 2006;Mishel, 1981;Wonghongkul, Dechaprom, Phumivichuvate, & Losawatkul, 2006), more psychological mood disturbance (Christman et al, 1988;McCain & Cella, 1995;Mishel & Braden, 1987;Mishel, Hostetter, King, & Graham, 1984), increased anxiety (McCormick et al, 2006;Santacroce, 2002), lower level of quality of life (Carroll, Hamilton, & McGovern, 1999), reduced coping effectiveness (Bennett, 1993), and perception of diminished or lower health status (Carroll et al, 1999). Therefore, uncertainty in illness has been identified as one of the single greatest sources of psychosocial stress to patients (Kroocher, 1985).…”

Predictors of psychosocial adjustment during the post-radiation treatment transition

“…No studies were identified that explored the precise relationship between uncertainty and cognitive appraisal during the post-radiation treatment transition. Other studies have found that uncertainty, when coupled with harm or danger appraisal, is predictive of QOL in women with breast cancer three years post-diagnosis (Wonghongkul, Dechaprom, Phumivichuvate, & Losawatkul, 2006), women being treated for gynecologic cancer (Padilla, Mishel, & Grant, 1992), and older men who have opted to practice "watchful waiting" as a treatment option for prostate cancer (Wallace, 2003).…”