| Learning Objective #1: Identify women with breast cancer who are at risk for the development of symptom distress | |||
| Learning Objective #2: Develop a more holistic approach when clinically dealing with patients who have early stage breast cancer |
Cancer evokes considerable stress from diagnosis through treatment, with each patient’s trek unique. This unique response is known as “symptom distress” and refers to the perception of discomfort as experienced by the individual. Identification and management of patients at risk for high levels of symptom distress is essential because higher levels of distress have been equated with diminished self-care, altered social relationships and decreased adherence to treatment protocols, curtailing survival. The purpose of this study was to examine instrument sensitivity in symptom distress measurement and investigate the relationships of personal characteristics, resources and coping on symptom distress levels experienced by women with early stage breast cancer undergoing adjunct chemotherapy. This descriptive, correlational, longitudinal study used convenience sampling to recruit 120 women with Stage I and II breast cancer from six socioeconomically diverse oncology settings in Buffalo, NY. Analysis determined that the McCorkle and Rhodes symptom distress scales were highly correlated for all data collection points (r = .90; r = .84; r = .77 respectively), however, anecdotal comments from women suggest that the instruments might not be sensitive measures. Hierarchical regressions correlated optimism and locus of control with lower levels of symptom distress at the nadir and end of the first cycle of chemotherapy (p<.00; p<.00). Mediation testing (Baron & Kenny,1986) found no relationship between family hardiness and/or coping, personal characteristics and symptom distress levels. Results of this study suggest that higher levels of symptom distress experienced by women with breast cancer occur at the nadir and consist of fatigue, insomnia, body image and diminished concentration. Interventions should be initiated early during the chemotherapy cycle. Optimism and externality are correlated with lower symptom distress levels and should be evaluated by clinicians.
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