Abstract CN36
Background
Receiving a breast cancer diagnosis is accompanied by emotional responses to both the diagnosis and the treatment, and women must adapt their coping strategies to handle this stress. Coping strategies are individual management acts to cope with with illness. Discontinuation of endocrine therapy (ET) occurs most frequently during the first three months of treatment, indicating that this period may be very stressful. Thus, research should examine several consecutive days after starting ET to understand how treatment can create stressful events and experienced problems over time.
Methods
A mixed-methods (qualitative and quantitative) design was used. The Daily Coping Assessment (DCA) was used. A consecutive sample of 39 women newly diagnosed with breast cancer were included at the start of their adjuvant endocrine therapy. A daily coping assessment was used to create daily reports about stressful events or experienced problems and coping strategies.
Results
The most reported problem, related to ET, was physical problems, reported by 94% the first month. The most frequently reported physical problems were sleeping difficulties reported by 68%. Patients reported a variety of problems such as sleeping difficulties, pain, cramps, stiffness and hot flashes. Although hot flashes were expected, they were associated with the lowest level of control. Anxiety, irritation and pre-knowledge were categorized as emotional problems. Anxiety was the most reported emotional problem, and reported by 29%. Patients used both emotion-and problem-focused coping, and sleeping difficulties were coped by relaxing, and anxiety was coped by thinking about something else. Over the three months, the most frequently used coping strategy was accepting the problem. The overall reported distress level was somewhat higher in the second month.
Conclusions
Patients experienced a variety of stressful events or problems during the first three months of endocrine therapy. They also used several coping strategies to endure the treatment. Our results highlight the importance of exploring individuals’ experiences of stressful events or experienced problems during ET. The results stress that support needs to be based on individualized experiences of ET.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Susanne Ahlstedt Karlsson has received honoraria from R&D Council in Gothenburg and Bohuslän (VGFOUGSB-703271) and the foundation of Wilhelm and Martina Lundgren's science fund (2018-2036). Ingela Henoch is currently receiving a grant from the Assar Gabrielsson Foundation (FB 17-14). For the remaining authors, no sources of funding were declared.
Disclosure
All authors have declared no conflicts of interest.