title: Correlates of mood disturbance in women with breast cancer: patterns over time.
abstract: OBJECTIVE
  This study examined factors associated with mood disturbance prior to, during and after adjuvant therapy.
  
  
  BACKGROUND
  Breast cancer is the most common cancer in women worldwide. Mood disturbance affects between 20% and 30% of women with breast cancer and is associated with other debilitating symptoms. However, factors associated with mood disturbance across the breast cancer diagnosis-treatment trajectory are not clearly understood.
  
  
  METHODS
  A stress-coping framework guided this longitudinal study. A convenience sample of 49 American women with newly diagnosed breast cancer aged 37-77 years completed questionnaires assessing age, optimism, disease stage, type of adjuvant therapy, lymph node status, emotional support, aid (tangible) support, perceived stress and mood disturbance. Data were collected over an 18-month period in 2002-2003 at three time points: prior to, during and after adjuvant therapy. Descriptive statistics, Pearson's correlation and multiple regression were used.
  
  
  RESULTS
  At all three time points, higher stress was significantly related to greater mood disturbance. Perceived stress mediated the relationship between (1) emotional support and mood disturbance prior to and after adjuvant therapy and between (2) aid support and mood disturbance during adjuvant therapy. In addition, the type of support that was most important to mood disturbance varied over time. Emotional support was related to reduced mood disturbance prior to and after adjuvant therapy, whereas aid support was most important during adjuvant therapy.
  
  
  CONCLUSIONS
  Nurses may use this information to develop interventions that bolster appropriate types of support to reduce stress and ultimately lower mood disturbance. Further research across cultures is needed.
authors.affiliation: Enhancing Quality of Life in Chronic Illness, Indiana University School of Nursing, Indianapolis, USA. dvonah@iupui.edu
authors.forename: Diane
authors.initials: D
authors.lastname: Von Ah
authors.forename: Duck-Hee
authors.initials: DH
authors.lastname: Kang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D019964:Mood Disorders / Q000451:nursing / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological