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Child maltreatment and breast cancer survivors: Social support makes a difference for

quality of life, fatigue and cancer stress

Christopher P. Fagundes et alEuropean Journal of Cancer

In press, 2011

Drs. H. Prinsen- Onco/NKCVDrs. J. de la Fonteijne - NKCV

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Background Quality of life

• Being diagnosed and treated for cancer is emotionally and physically challenging

• Even when treatment-related problems subside, many breast cancer survivors report quality of life (QOL) difficulties

– Psychological distress– Fatigue– Occupational disruption– Loss of physical functioning

→ Important to understand why some breast cancer survivors are more vulnerable to poorer QOL after treatment than others

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Background

• Women who experienced past traumas ↑ risk for psychological distress when confronted with new traumatic experiences

• Child maltreatment is a common experience; ~50% of adults report experiencing some type of abuse or neglect as children

• Newly diagnosed breast cancer patients, emotionally abused as children, ↑ psychological distress compared to non-abused

→ Child maltreatment has been linked to cancer-related psychological distress

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Background Social support

• Social support important role in the QOL of cancer survivors

• People who were abused or neglected as children reportreceiving ↓ social support as adults

→ Social support may play an important role linking child maltreatment to the QOL of breast cancer survivors

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Vragen

1) Is kindermishandeling ook van invloed op KvL variabelen:moe /werkhervatting / fysiek functioneren

2) Welke mechanismen spelen een rol bij de relatie kindermishandeling en KvL

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Methods Sample

• Clinical trial addressing potential benefits of yoga

• Breast cancer survivors (n=132)

• Stage 0 – 3A

• All women

• Off-treatment at least 2 months, but no more than 2 years

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Methods Measures

• Childhood trauma questionnaire

• Impact of Events Scale

• Multidimensional Fatigue Symptom Investory-Short Form

• Fact-B breast cancer quality of life questionnaire

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Results

• Women who were abused or neglected as children reported:– ↑ cancer-related psychological distress– ↑ fatigue – ↓ physical, emotional, functional, and breast cancer-specific well-being

→ These relations were partially explained by the fact that breast cancer survivors reported receiving less support as adults

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Discussie

• meer survivors• bij mishandeling meer klachten

• bekend: mishandeling -> meer distress na trauma

• nieuw: meer moe / slechter fysiek en emotioneel functioneren

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vervolg

• moe -> meest voorkomende probleem bij survivors

• geen relatie soort kanker en behandeling• verbeteren sociale netwerk ->beter KvL

• sociale steun verklaart belangrijk deel effect

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Discussion Limitations

• vrouwen• witte• bias rapportage

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Discussion Clinical implications

Wat kan de psycholoog hiermee?

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