References
Quality of life and personal resilience in the first two years after breast cancer diagnosis: systematic integrative review
Abstract
The aim of this systematic integrative review was to examine the early impacts of a breast cancer diagnosis (up to 2 years after diagnosis) in relation to quality of life and personal resilience. The bibliographic databases of Medline, CINAHL, Cochrane, and Psychology and Behavioral Science Collection were searched using predetermined search criteria. Research studies published up to February 2019 were considered and following appraisal 36 articles were included in the review. Younger age, disease progression at first presentation, personality factors such as optimism, and moderators such as social support, clinical interventions and development of self-management abilities predicted better quality of life and personal resilience. Not recovering from the physical and psychological impacts of a new diagnosis has implications for future mental and physical health. This systematic, integrative review highlighted that building resilience and working with women's strengths should be the focus for contemporary clinical interventions for women in the early period after diagnosis of breast cancer.
Breast cancer is the most common cancer site in women in all countries of Europe (Ferlay et al, 2018). Treatment may include surgery, therapies (eg radiation, chemotherapy, hormonal) and drug trial treatment, or a combination of these (World Health Organization, 2007). Improvements in survival rates also relate to advances in prevention and early detection (Youlden et al, 2012; Plevritis et al, 2018). Some women diagnosed with breast cancer can experience substantial physical and psychological pain even before their treatment begins; furthermore evidence suggests that pre-existing anxiety and depression can influence the degree of physical pain experienced (Galloway et al, 2012; Johannsen et al, 2017).
Diagnosis-related depression and anxiety can also impact recovery in the biological, social, psychological and emotional domains. Because depression and/or anxiety are common in the 12 months following a diagnosis of breast cancer there is a need for psychological clinical interventions in breast cancer care (Burgess et al, 2005; Kelly et al, 2018). The impact of psychological sequelae following diagnosis includes a poorer prognosis, poor satisfaction with life and poor health-related quality of life (QoL), and subsequent poor personal adjustment or resilience. Depression can manifest as symptoms such as poor sleep, poor appetite and lowered activity levels (Fiorentino et al, 2011). There is evidence to suggest that younger women suffer more psychological distress compared with older women with breast cancer, having implications for QoL, recovery, survival and use of clinical services (Avis et al, 2012).
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