title: Appraisal of illness, symptom distress, self-care burden, and mood states in patients receiving chemotherapy for initial and recurrent cancer.
abstract: Cancer recurrence may present unique stressors for patients receiving chemotherapy. The objectives of this exploratory study were to (1) describe perceptions of symptom distress, self-care burden, appraisal of illness, and mood in patients undergoing chemotherapy, (2) identify differences in these perceptions according to stage of illness (new versus recurrent cancer), and (3) test a theoretical model of the mediating effects of appraisal. Subjects completed a modified Symptom Distress Scale, the Self-Care Burden Scale, the Family Hardiness Index, the Appraisal of Illness Scale, the short form of the Profile of Mood States, and a self-report form that included personal and illness characteristics and questions about the subjects' current situation. The 60 subjects were outpatients being treated for initial cancer (n = 28) or recurrent cancer (n = 32). Those with recurrence had higher symptom distress and health deviation self-care burden scores and more stressful appraisals; mood scores were low and did not differ between groups. Appraisal, symptom distress, and perceived seriousness predicted 36% of variance in affective mood, with appraisal partially mediating the effects of symptom distress. Somatic mood (36%) was best predicted by symptom distress and universal self-care burden (USCB). Economic status, symptom distress, and recurrence status predicted 49% of appraisal variance. Symptom distress was predicted best by recurrence and symptom control; USCB was predicted best by economic status and perceived dependency. Results suggest the need for different nursing interventions for the two groups. Further model testing is recommended.
authors.affiliation: University of Wisconsin Hospitals and Clinics, Madison.
authors.forename: A
authors.initials: A
authors.lastname: Munkres
authors.forename: M T
authors.initials: MT
authors.lastname: Oberst
authors.forename: S H
authors.initials: SH
authors.lastname: Hughes
mesh_terms: D000339:Affect; D001294:Attitude to Health; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009364:Neoplasm Recurrence, Local / Q000451:nursing / Q000503:physiopathology / Q000523:psychology*; D012648:Self Care; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology