Survivors of breast cancer: illness uncertainty, positive reappraisal, and emotional distress.

PURPOSE/OBJECTIVES: To explore variables associated with illness uncertainty and emotional distress for disease-free survivors of breast cancer.

DESIGN

Cross-sectional, descriptive, and correlational.

SETTING

Regional cancer center in the southeastern United States.

SAMPLE

109 women one to six years post-treatment for stage I-III nonmetastatic breast cancer.

METHODS

Face-to-face data gathering using five questionnaires with established reliability.

MAIN RESEARCH VARIABLES

Symptom distress, concurrent illness, fear of recurrence, illness uncertainty, positive reappraisal, and emotional distress.

FINDINGS

The antecedent variables symptom distress, fear of recurrence, and concurrent illness problems were positively related to illness uncertainty. Illness uncertainty and the antecedent variables were positively related to emotional distress. The antecedent variables explained 40% of the variance in uncertainty. Uncertainty, its antecedents, and positive reappraisal collectively explained 51% of the variance in emotional distress.

CONCLUSIONS

Illness uncertainty related to symptoms and fear of recurrence was linked with emotional distress for some women, even years after treatment. Positive reappraisal may help to reduce this distress.

IMPLICATIONS FOR NURSING PRACTICE

Nurses need to identify, monitor, and assist women who are at risk for illness uncertainty and emotional distress after breast cancer treatment. They also should explore with women positive, growth-promoting aspects of breast cancer, as well as aspects of the disease that are threatening.