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Abstract
Purpose
The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy.
Methods
A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions.
Results
The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance.
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Table 1.
General and Clinical Characteristics of Participants (N=158)
Table 2.
Degree of Fatigue, Distress, and Self-efficacy (N=158)
Table 3.
Differences in Fatigue, Distress, and Self-efficacy by Participants' Characteristics (N=158)
| Characteristics | Categories | Fatigue | Distress | Self-efficacy | |||
|---|---|---|---|---|---|---|---|
| M±SD | t or F (p) | M±SD | t or F (p) | M±SD | t or F (p) | ||
| Age (year) | ≤40a | 3.81±1.90 | 1.75 | 4.55±1.99 | 0.70 | 3.96±0.44 | 4.56 |
| 41~50b | 3.45±2.01 | (.160) | 4.05±2.35 | (.556) | 3.88±0.52 | (.004) | |
| 51~60c | 4.32±2.30 | 4.60±2.39 | 3.60±0.55 | a, b＞c† | |||
| ≥61d | 3.68±1.88 | 4.06±2.44 | 3.64±0.43 | ||||
| Educational level | ≤Junior high school | 4.57±2.04 | 2.26 | 4.50±2.30 | 0.52 | 3.56±0.55 | -2.60 |
| ≥High school | 3.64±2.09 | (.025) | 4.26±2.34 | (.606) | 3.82±0.51 | (.010) | |
| Residence area | Metropolitan city | 3.70±1.98 | .81 | 4.42±2.37 | 0.52 | 3.82±0.54 | 1.95 |
| Small & medium-sized city | 3.89±2.55 | (.449) | 3.94±2.08 | (.598) | 3.73±0.54 | (.146) | |
| Countryside | 4.33±2.05 | 4.32±2.46 | 3.58±0.42 | ||||
| Marital status | Singlea | 4.13±2.50 | 2.24 | 4.47±2.50 | 0.52 | 3.77±0.34 | 3.64 |
| Marriedb | 3.68±1.99 | (.110) | 4.36±2.34 | (.597) | 3.81±0.55 | (.028) | |
| Divorce, separate, bereavec | 4.87±2.51 | 3.71±2.02 | 3.41±0.33 | b＞c† | |||
| Occupation | Housewife | 4.03±2.12 | 1.71 | 4.25±2.36 | 0.92 | 3.75±0.57 | 0.35 |
| Self-employed | 3.10±2.12 | (.151) | 4.82±2.75 | (.454) | 3.72±0.41 | (.841) | |
| Professionals | 3.31±1.97 | 4.23±1.99 | 3.87±0.44 | ||||
| Service | 4.80±2.11 | 5.44±2.55 | 3.67±0.51 | ||||
| Other | 3.23±2.02 | 3.67±2.15 | 3.79±0.45 | ||||
| Religion | Yes | 4.30±2.35 | 0.05 | 4.30±2.35 | 0.05 | 3.76±0.53 | 0.17 |
| No | 4.33±2.28 | (.959) | 4.33±2.28 | (.959) | 3.78±0.53 | (.866) | |
| Monthly household income (10,000 won) | ＜100a | 4.15±2.42 | 2.09 | 4.21±2.39 | 2.57 | 3.47±0.37 | 4.18 |
| 100~199b | 4.52±1.74 | (.104) | 5.26±2.05 | (.056) | 3.66±0.36 | (.007) | |
| 200~299c | 3.79±2.09 | 4.34±2.45 | 3.77±0.57 | a＜d† | |||
| ≥300d | 3.43±2.13 | 3.88±2.27 | 3.90±0.57 | ||||
| Time since diagnosis was made (month) | 6~12 | 4.10±2.09 | 1.16 | 4.55±2.24 | 0.90 | 3.74±0.56 | 0.18 |
| 13~18 | 3.65±2.17 | (.316) | 3.98±2.42 | (.411) | 3.79±0.59 | (.832) | |
| 19~24 | 3.51±2.04 | 4.29±2.36 | 3.79±0.33 | ||||
| Current treatment modality | Chemotherapy radiation | 4.63±1.73 | 2.19 | 4.41±2.15 | 0.24 | 3.64±0.53 | -1.35 |
| therapy | (.030) | (.812) | (.179) | ||||
| Others, follow up | 3.66±0.53 | 4.29±2.36 | 3.79±0.53 | ||||
| Perceived health condition | Good | 4.00±2.24 | -3.44 | 4.00±2.24 | -3.44 | 3.83±0.53 | 3.20 |
| Not good | 5.53±2.29 | (.001) | 5.53±2.29 | (.001) | 3.51±0.45 | (.002) | |
| Medical expense payer | Owna | 4.21±2.28 | 2.33 | 4.53±2.17 | 0.81 | 3.74±0.49 | 3.81 |
| Spouseb | 3.46±1.95 | (.100) | 4.07±2.37 | (.447) | 3.85±0.56 | (.024) | |
| Othersc | 3.99±1.87 | 4.56±2.73 | 3.47±0.38 | b＞c† | |||
| Economic burden | Higha | 4.32±2.19 | 3.16 | 4.60±2.44 | 1.43 | 3.63±0.55 | 2.97 |
| Moderateb | 3.41±1.91 | (.045) | 3.99±2.13 | (.243) | 3.86±0.53 | (.054) | |
| Lowc | 4.02±2.30 | a＞b† | 4.63±2.55 | 3.77±0.43 | |||
| Cancer pain level | Mild | 4.19±2.28 | -1.31 | 4.19±2.28 | -1.80 | 3.79±0.52 | 1.69 |
| Severe | 5.22±2.49 | (.192) | 5.38±2.53 | (.090) | 3.56±0.55 | (.092) | |
Table 4.
Correlation among Fatigue, Distress, and Self efficacy (N=158
| Variables | Fatigue | Distress | Self-efficacy |
|---|---|---|---|
| r (p) | r (p) | r (p) | |
| Fatigue | 1 | ||
| Distress | .56 (＜.001) | 1 | |
| Self-efficacy | -.33 (＜.001) | -.28 (＜.001) | 1 |
Table 5.
Influencing Factors on Self-efficacy of the Breast Cancer Survivors (N=158)
| Step | Variables | Adjusted R2 | F | p | B | SE | β | t | p |
|---|---|---|---|---|---|---|---|---|---|
| Step 1 | Fatigue | .11 | 19.60 | ＜.001 | -.08 | .02 | -.33 | -4.43 | ＜.001 |
| Step 2 | Fatigue | .15 | 15.15 | ＜.001 | -.08 | .02 | -.33 | -4.43 | ＜.001 |
| Age | -.01 | .01 | -.23 | -3.10 | .002 | ||||
| Step 3 | Fatigue | .17 | 12.00 | ＜.001 | -.08 | .02 | -.32 | -4.37 | ＜.001 |
| Age | -.01 | .01 | -.20 | -2.76 | .006 | ||||
| One million won† | -.26 | .12 | -.16 | -2.20 | .028 |
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