Influence of breast cancer patient's distress and advice

Abstract

This study explored the influence of Index Patient distress and advice giving regarding breast-health information on first-degree female relatives of newly diagnosed breast cancer patients. Participants were 306 newly diagnosed breast cancer patients (IPs) and 624 of their first-degree female relatives (FDFRs) (daughter, sisters, and mothers).;A correlational analysis showed that IP levels of emotional distress were predictive of levels of cancer-specific distress among FDFRs (r = .19, p < .001), though accounting for a small proportion of the variance. Contrary to prediction, the relationship was not mediated by age of the IP, education level of FDFR, emotional closeness, the perception that the IP's lifespan may be shortened, and perceived risk. However, the relative's proximity to the index patient after the diagnosis did fully medicate the relationship between IP distress and FDFR distress. In an exploratory multivariate model (using backward stepwise regression) predicting cancer-specific distress in FDFRs, significant predictors were: (1) having an increased perception that the IP's lifespan will be shortened, (2) reporting a higher level of emotional closeness, (3) having an increased perception that the IP was emotionally upset, (4) having a greater amount of perceived risk, (5) having more contact with the IP, (6) being less educated, and (7) having a relative with breast cancer who was younger in age (model R2 = 0.23, p < .001). IP distress did not remain significant in this multivariate model. Though not tested in the multivariate model, FDFR distress was significantly different between those women who were the mothers, sisters, and daughters of the IP, with the mothers reporting the highest distress, followed by sisters, then daughters (F = 8.9, p < .001). Thus, bivariate correlations between the independent variables were computed within each relationship group to see if there were similar relationships among the predictor variables and distress. The magnitude of the correlations between the variables and distress were often similar in the three groups, though with the small number of mothers (n = 38) in this sample, none of the correlations were significant for the mothers. In general, the individual differences such as contact with the IP and emotional closeness were more closely related to distress in the sisters (and to a lesser extent in the daughters) than in the mothers.;100% of FDFRs who were given advice on breast-health information reported receiving that advice. The majority of FDFRs did not act upon the advice that was given, specifically in reference to screening advice such as getting a mammogram or performing self-breast exams. Interestingly, advice was apparently selectively given to FDFRs who were not already participating in screening. Results of this study may help inform the development of appropriate psychoeducational interventions for this population of women at increased risk for breast cancer.