title: Factors associated with long-term functional outcomes and psychological sequelae in women after breast cancer.
abstract: The objective of this study was to examine factors impacting long-term functional outcomes and psychological sequelae in survivors of breast cancer (BC). A clinical assessment and structured interview assessed the impact of BC on participants' (n=85) current activity and restriction in participation, using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact Problem Profile (PIPP) and Depression Anxiety Stress Scale (DASS). Participants showed good functional recovery (median motor FIM score=78). Three-quarters (74%) reported pain, 32% reported upper limb weakness, 31% pain limiting shoulder movement and 29% lymphoedema. One third (32%) reported greatest impact on psychological wellbeing. A substantial number of participants reported high levels of depression (22%), anxiety and stress (19% each). Factors associated with poorer current level of functioning and wellbeing included: younger participants, recent diagnoses, aggressive tumour types, receiving chemotherapy, shoulder limitation due to pain, and lymphoedema. BC survivors require long-term management of psychological sequelae impacting activity and participation.
authors.affiliation: Department of Medicine, Dentistry & Health Sciences, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia. fary.khan@mh.org.au
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
authors.forename: Ishani
authors.initials: I
authors.lastname: Rajapaksa
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult