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Emotional state and psychological flexibility in breast cancer survivors

European Journal of Oncology Nursing, October 2017, Volume 30, Pages 75-83



This study analyses the premise that less time spent carrying out valuable activities and inflexible avoidance of thoughts, feelings and memories related to the oncological process may play an important role in the emotional problems of cancer survivors.


Emotional state was evaluated, as was quality of life and psychological flexibility in a sample of 122 breast cancer survivors ( M age = 52.40; SD age = 7.26). The analysis was carried out using a cross-sectional predictive study.


Approximately half of those in the sample suffered from clinically significant emotional distress. The predictor variables selected explained a high percentage of the variability in emotional problems and quality of life (51.10–77.10%).


Avoidance explained a high percentage of the variance in anxiety, depression and general distress. A lower degree of participation in valuable activities contributed, more specifically, to explaining variability in depression. The quantity and availability of environmental reinforcement was closely related to quality of life. A decisive contribution towards promoting emotional well-being and quality of life can be made by nursing action aimed at diminishing those avoidance strategies related to the oncological experience which may distance patients from daily activities which are gratifying and congruent with their values.



  • The study show that emotional distress in cancer survivors is related to a response pattern based on experiential avoidance.

  • Involvement in valuable life activities showed a negative relationship with emotional distress.

  • It would be important to take experiential avoidance when preventing/treating emotional distress in survivors.


Keywords: Cancer, Psychological flexibility, Depression, Anxiety, Quality of life.