title: Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study.
abstract: OBJECTIVE
  As many patients experience distress after breast cancer, we investigated whether perceived self-efficacy predicts breast cancer patients' emotional, physical and social well-being and whether mental adjustment styles mediate this association.
  
  
  METHODS
  A sample of 684 women with breast cancer completed a questionnaire including the general self-efficacy scale at baseline, the Mini-MAC at 1-month follow-up and the EORTC QLQ-C30 at 12-month follow-up. Multiple linear regression was used to assess associations between self-efficacy, mental adjustment style and well-being. Disease-related and sociodemographic factors were examined as confounders.
  
  
  RESULTS
  Greater self-efficacy at baseline was associated with emotional well-being after 12 months (beta = 0.59; 95% CI, 0.35-0.82). Fighting spirit, anxious preoccupation and helplessness-hopelessness partly mediated the effect of self-efficacy, but self-efficacy also had a direct effect on emotional functioning (beta = 0.26; 95% CI, 0.02-0.51). No association was found between self-efficacy and physical and social well-being. Significant associations were observed between self-efficacy and education and time since diagnosis and also between well-being and age, education, relapse and time since diagnosis.
  
  
  CONCLUSIONS
  Self-efficacy was a significant predictor of an active adjustment style and emotional well-being in breast cancer patients. Hence, it could be a valuable target of rehabilitation programs.
authors.affiliation: Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark. rottmann@cancer.dk
authors.forename: Nina
authors.initials: N
authors.lastname: Rottmann
authors.forename: Susanne O
authors.initials: SO
authors.lastname: Dalton
authors.forename: Jane
authors.initials: J
authors.lastname: Christensen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011788:Quality of Life; D020377:Self Efficacy; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
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