Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Sense-of-Coherence in breast cancer: is it protective of psychological morbidity? (#510)

Luzia Travado 1 , Cidalia Ventura , Cristina Martins
  1. Central Lisbon Hospital Centre-Hospital S. José, Lisbon, Portugal

PURPOSE. A diagnose of breast cancer (BC) is still considered for many a “death sentence” in Portugal. Evidence shows that 25-50% of cancer patients will develop psychological morbidity as a consequence of having cancer. We conducted the present study with the purpose of characterizing the psychosocial consequences of BC in Portuguese patients after active treatment. METHODS. A convenience sample of BC treated outpatients from Multidisciplinary Breast Surgery Consultation at Hospital S. Jose, Lisbon were assessed to evaluate anxiety and depression (HADS), QoL (SEPOS-VAS), coping style (Mini-MAC), concerns (CWI) and Sense-of-Coherence (SOC). The protocol used was adapted from the SEPOStudy (Grassi et al,2004). RESULTS. We assessed 110 women (mean age=58.1 yrs; level of education=5.8 yrs). Psychosocial morbidity was found in about ¼ of the women (16.1%-24.5%) with anxiety in 39.1% and depression in 29.1%. Predominant use of Fatalism, Avoidance and Fighting Spirit as coping styles; support from faith and from others as most relevant for our population. Concerns were low and mainly about emotional issues, the future and the illness. Meaningfulness is the highest SOC component. Concerns were significantly correlated to psychosocial morbidity and maladaptive coping (Hopelessness, r=.48; Anxious Preoccupation r=.51), and negatively with QoL variables and SOC/meaningfulness (r=-.41). Faith is significantly correlated with psychosocial morbidity (r=-.26), Hopelessness (r=-.27), Avoidance (r=-.42) and support from others with depression (r=-.21). SOC is negatively correlated with hopelessness, psychological morbidity and concerns. CONCLUSIONS. Portuguese BC survivors’ psychosocial profile allows us to better understand their needs and to develop psycho-oncology programs accordingly to address them at an early phase as part of standard patient care. Our study also emphasizes the patients’ need to find meaning in their cancer experience and its important value in building resilience, which helps them facing stressful circumstances and maintain well-being. The interesting results with SOC components in this population suggests that the introduction of a sense-of-coherence model in an early psychological intervention aimed at preventing psychological morbidity may have important value in providing patients complementary resources in dealing with the distressing episodes of their cancer journey.