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Assessment of pain, acceptance of illness, adjustment to life with cancer and coping strategies in breast cancer patients

Czerw, A., Religioni, U., Deptała, A.

Breast Cancer, Epub ahead of print 2015 Jun 2, Article in Press,

Abstract

Introduction:
Breast cancer is the most common malignant neoplasm in women. Over the past 40 years, the number of patients diagnosed with breast cancer quadrupled. Breast cancer is one of the most frequent causes of death in women aged 65 and more in Poland. Purpose: The purpose of the study was to evaluate coping strategies, pain management, disease acceptance and adjustment to cancer in patients diagnosed with breast cancer and to assess the effect of socioeconomic variables on the above mentioned issues. Methods: The study included 193 patients diagnosed with breast cancer during outpatient chemotherapy (classical chemotherapy, hormone therapy, molecularly targeted therapies) at the Center of Oncology, Maria Skłodowska-Curie Institute in Warsaw. We applied the Paper and Pencil Interview (PAPI) technique. The questionnaire interview consisted of demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), measuring the influence of factors affecting pain management in patients, CSQ (Coping Strategies Questionnaire), designed to evaluate pain coping strategies, AIS (Acceptance of Illness Scale) questionnaire, measuring disease acceptance, and the mini-MAC (Mental Adjustment to Cancer) scale.

Results:
The results of BPCQ show that breast cancer patients mostly believe that doctors control pain; the mean result for the group was 17.09 and test values were differentiated by education and professional status. The top average score in the pain coping strategies questionnaire was recorded in the positive coping self-statement subscale (mean score = 21.81), whereas the lowest, in the catastrophizing subscale (mean score = 10.60). Here, education and income proved most significant in accounting for the differences recorded. The mean score on the AIS was 28.45, and the key factor differentiating the results was income. As far as the mini-MAC is concerned, we reported the highest score in the fighting spirit subscale (23.43). The average results in the scale were slightly differentiated by socioeconomic variables.

Conclusions:
Breast cancer patients mostly believe that those who control pain are doctors. Amongst the strategies of coping with pain, the top average score was recorded in the positive coping self-statement subscale. We found out that the level of disease acceptance depends on respondent’s income. The higher the income, the greater the acceptance of illness. 


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