Relationships of Mood Disturbance, Symptom Experience, and Attentional Function in Women with Breast Cancer Based upon the Theory of Unpleasant Symptoms

  • Lee Eun-Hyun (Ajou University, Graduate School of Public Health)
  • Published : 2005.06.01

Abstract

Purpose. The purpose of this study was to identify direct, mediating, and moderating relationships of mood disturbance, symptom experience, and attentional function in Korean women with breast cancer based upon a middle-range theory of unpleasant symptoms. Methods. This study used a cross-sectional, correlational design. A convenience sample of 125 women receiving chemotherapy for breast cancer was recruited from a university hospital in South Korea. The women completed questionnaires on mood disturbance, symptom experience, and attentional function using the Linear Analogue Self-Assessment Scale, the Symptom Experience Scale, and the Attentional Function Index, respectively. Results. Each mood disturbance and symptom experience showed a significant relationship with attentional function. Symptom experience did not act as a mediator between mood disturbance and attentional function, but it did act as a moderator: patients with a higher level of mood disturbance exhibited a lower level of attentional function when their symptoms were at the level of medium, but not when their symptoms were either high or low. Conclusion. This suggests that clinical interventions for attenuating the influence of mood disturbance on attentional function may be effective only in women experiencing medium level of symptoms.

Keywords

References

  1. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filibert,i A., Flechtner, H., Fleishman, S. B., De, H. J. C. J. M., Kaasa, S., Klee, M., Osoba, D., Ranzavi, D., Rofe, P. B., Schraub, S., Sneeuw, K., Sullivan, M., & Takeda, F. (1993). The EORTC QLQ-C30: A quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 85, 365-377 https://doi.org/10.1093/jnci/85.5.365
  2. Aiken, L. S., & West, S. G. (1999). Multiple regression. Newbury Park, CA: Sage
  3. Aldwin, C. M. (1994). Stress, coping, and development: An integrative perspective. New York: Guilford Press
  4. Atkinson, A., Barsevick, A., & Cella, D., et al. (2000). NCCN Practice guidelines for cancer-related fatigue. Oneol New York, 14(11A suppl 10), 151-161
  5. Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical consideration. J Pers Soc Psychol, 51, 1173-1182 https://doi.org/10.1037/0022-3514.51.6.1173
  6. Brezden, C. B., Phillips, K-A., Abdolell, M., Bunston, T., & Tannock, F. (2000). Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oneal, 18, 2695-2701
  7. Burger, A. M. (1998). Patterns of fatigue, activity and rest during adjuvant breast cancer chemotherapy. Oncol Nurs Forum, 25, 51-62
  8. Cimprich, B. (1992). Attentional fatigue following breast cancer surgery. Res Nur Health, 15, 199-207 https://doi.org/10.1002/nur.4770150306
  9. Cimprich, B. (1993). Development of an intervention to restore attention in cancer patients. Cancer Nurs, 16(2), 83-92
  10. Cimprich, B. (1999). Pretretment symptom distress in women newly diagnosed with breast cancer. Cancer Nurs, 23(3), 185-194
  11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates
  12. Cohen, J, & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Association
  13. Cull, A., Stewart, M., & Altman, D. G. (1995). Assessment of and intervention for psychosocial problems in routine oncology practice. Br J Cancer, 72, 229-235 https://doi.org/10.1038/bjc.1995.308
  14. Cunningham, R. S. (2003). Anemia in oncology patient: Cognitive function and cancer. Cancer Nurs, 26, 38S-42S
  15. de Jong, N., Courtens, A. M., Abu-Saad, H. H., & Schouten, H. C. (2002). Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Cancer Nurs, 25, 283-297 https://doi.org/10.1097/00002820-200208000-00004
  16. Dow, K. H. (1996). Contemporary issues in breast cancer. Sudbury, Massachusetts: Jones and Bartlett
  17. Early Breast Cancer Trialists' Collaborative Group (1998). Polychemotherapy for early breast cancer: An overview of the randomized trials-Early Breast Cancer Trialists' Collaborative Group. Lancet, 352, 930-942 https://doi.org/10.1016/S0140-6736(98)03301-7
  18. Hoopwood, P., Howell, A., & Maguire, P. (1991). Psychiatric morbidity in patients with advanced cancer of the breast: Prevalence measured by two self-rating questionnaires. Br J Cancer, 64, 349-352 https://doi.org/10.1038/bjc.1991.304
  19. Hur, H. K., Lee, E-H, Lee, W. H., So, H. S., Chung, B. Y., & Kang, E. S. (2002). Symptom occurrence related to disease characteristics of adults with cancer. J Korean Acad Adult Nurs, 14, 411-417
  20. Irvine, D. M., Vincent, L., Grydon, J. E., & Bubela, N. (1998). Fatigue in women with breast cancer receiving radiation therapy. Cancer Nurs, 21, 127-135 https://doi.org/10.1097/00002820-199804000-00006
  21. Jaccard, J., Turris, R, & Wan, C. (1990). Interaction effects in multiple regression. Newbury Park, CA: Sage
  22. Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative network. J Environ Psychol, 15, 169-182 https://doi.org/10.1016/0272-4944(95)90001-2
  23. Korean Ministry of Health and Welfare (2003). Report on the analysis of the Korean cancer enrollment. Seoul: Korean Ministry of Health Welfare
  24. Lehto, R. H. , & Cimprich, B. (1999). Anxiety and directed attention in women awaiting breast cancer surgery. Oneal Nurs Forum, 26(4), 767-772
  25. Lenz, E. R., Pugh, L. C., Milligan, R. A., Gift, A., & Suppe, F. (1997). The middle-range theory of unpleasant symptoms: An update. Adv Nurs Sci, 19(3), 14-27
  26. Lewis, H., & Kliewer, W. (1996). Hope, coping and adjustment among child with sickle cell disease: Testing of mediator and moderator model. J Ped Psychol, 21, 25-41 https://doi.org/10.1093/jpepsy/21.1.25
  27. McMair, D. M., Lorr, M., & Droppleman, L. F. (1971). Profile of mood states. San Diego, CA: Education and Institutional Testing Service
  28. Molassiotis, A., Mok, T. S. K., Yam, B. M. C., & Yung, H. (2002). An analysis of the antiemetic protection of metoclopramide plus dexamethasone in Chinese patients receiving moderately high emetogenic chemotherapy. Euro J Cancer Care, 11, 108-113 https://doi.org/10.1046/j.1365-2354.2002.00300.x
  29. Nam, G. S. (1987). The relationship between spouse' support and body-image in patients underwent mastectomy and hysterectomy. Unpublished master's thesis, Ewha Women's University of Korea, Seoul
  30. Olin, J. J. (2001). Cognitive function after systemic therapy for breast cancer. Oncol, 15, 613-624
  31. Olivitto, I., Gelmon, K., & Kuusk, U. (1996). Breast cancer. Vancouver: Intelligent Patient Guide
  32. Pinder, K. L., Ramirez, A. J., Black, M. E., Richards, M. A., Greggory, W. M., & Rubens, R. D. (1993). Psychiatric disorder in patients with advanced breast cancer: Prevalence and associ-ated factors. Eur J Cancer, 29A, 524-527
  33. Samarel, N., Leddy, S. K., Greco, K., Cooley, M. E., Torres, S. c., Tulmanm, L., & Torres, A. (1996). Development and testing of the symptom experience scale. J Pain Symptom Manage, 12, 221-228 https://doi.org/10.1016/0885-3924(96)00150-9
  34. Schagen, S. B., van Dam. F. S. A. M., Muller, M. J., Boogerd, W., Lindeboom, J., & Bruning, P. F. (1999). Cognitive deficits after postoperative adjuvant chemotherapy for breast cancer. Cancer, 85, 640-650 https://doi.org/10.1002/(SICI)1097-0142(19990201)85:3<640::AID-CNCR14>3.0.CO;2-G
  35. Sutherland, H. J., Lockwood, G. A., & Cunningham, A. J. (1989). A simple, rapid method for assessing psychological distress in cancer patients: Evaluation of validity for Linear Analogue Scales. J Psycho Oncol, 7, 31-43
  36. Tannock, I. F., Ahles, T. A., Ganz, P. A., & van, Dam F. S. A. M. (2004). Cognitive impairment associated with chemotherapy for cancer: Report of a workshop. J Clin Oncol, 22, 2233-2239 https://doi.org/10.1200/JCO.2004.08.094
  37. van Dam, F. S. A. M., Schagen, S. B., Muller, M. J, Boogerd, W., Wall, E., Fortuyn, M. E. D., & Rodenhuis, S. (1998). Impairment of cognitive function in women receiving adjuvant chemotherapy for high-risk breast cancer: High-dose versus standard-dose chemotherapy. J Natl Cancer Inst, 90, 210-218 https://doi.org/10.1093/jnci/90.3.210