Pain, psychological distress, health status, and coping in patients with breast cancer scheduled for autotransplantation

F Gaston-Johansson, K V Ohly, J M Fall-Dickson, J P Nanda, M J Kennedy
Oncology Nursing Forum 1999, 26 (8): 1337-45

PURPOSE/OBJECTIVES: To describe pain, psychological distress, health status, and coping that patients with breast cancer who were scheduled for autotransplantation experienced; the strength and direction of relationships among pain, psychological distress, health status, and coping; and the percentage of variance within the concept of health status that age, pain, psychological distress, and coping.

DESIGN: Descriptive, correlational.

SETTING: An urban, National Cancer Institute-designated comprehensive cancer center located in the eastern United States.

SAMPLE: A convenience sample of 83 female patients with breast cancer scheduled for autotransplantation. The population age ranged from 22-59 years (X = 44.47 years) and was comprised of 72 (88%) Caucasians, 6 (7%) African Americans, and 4 (5%) from other minorities.

METHODS: An oncology clinical nurse specialist in the outpatient medical oncology clinic collected the data during a regularly scheduled visit approximately 20 days prehospitalization for high-dose chemotherapy and autotransplantation. Data were collected using a demographic data from and self-report instruments (Gaston-Johansson Painometer, State-Trait Anxiety Inventory, Beck Depression Inventory, Medical Outcomes Study Short-Form General Health Survey, and Coping Strategies Questionnaire).

MAIN RESEARCH VARIABLES: Pain, psychological distress, health status, and coping.

FINDINGS: Although the subjects experienced low pain intensity, the range of reported pain intensity ratings was wide. Pain locations varied but were reported mainly in the vagina, chest, shoulder, and arm. Although subjects reported primarily mild depression and mild state anxiety, the range of depression and state anxiety scores was wide. Coping strategies used most frequently to deal with pain included positive coping statements, diverting attention, praying and hoping, increasing activity level, and ability to control and decrease pain. Subjects reported moderate total health status and low role functioning. Moderate, positive correlations were seen between state anxiety and depression and physical functioning and role functioning. Sixty-five percent of the variance in health status was explained by sensory pain depression, and catastrophizing.

CONCLUSIONS: Patients with breast cancer who are scheduled for autotransplantation may experience pain, psychological distress, and alterations in coping and perceived health status. Total pain intensity, sensory pain, depression, and catastrophizing appear to be important variables related to the patient's perceived health status.

IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to include assessment of pain, psychological distress, health status, and coping in their routine patient assessment prior to autotransplantation to provide appropriate care and make necessary multidisciplinary referrals. Future nursing research should be directed toward the implementation and evaluation of interventions that promote the use of comprehensive coping strategies to decrease pain, anxiety, and depression.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"