title: Job stress and physical activity related to elevated symptom clusters in breast cancer survivors at work.
abstract: OBJECTIVE
  To identify whether clusters of symptoms (depression, anxiety, fatigue, cognitive limitations) appear in employed breast cancer survivors, and whether clusters are related to job stress and aerobic activity.
  
  
  METHODS
  Employed breast cancer survivors (n = 94) and women without a history of cancer (n = 100) completed questionnaires online in a cross-sectional study.
  
  
  RESULTS
  A two-cluster solution of high or low symptom severity groups was observed. High symptom cluster was associated with breast cancer (odds ratio [OR] = 2.46; 95% confidence interval [CI], 1.22 to 4.93), more frequent job stress (OR = 1.78; 95% CI, 1.12 to 2.83), and lower levels of aerobic activity (OR = 0.55; 95% CI, 0.36 to 0.83).
  
  
  CONCLUSIONS
  Levels of anxiety, depression, cognitive limitations, and fatigue are expressed as clusters with varying severity. Clusters are related to job stress and aerobic activity in breast cancer survivors at work. Findings suggest avenues for clinical management and research.
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
authors.forename: Michal C
authors.initials: MC
authors.lastname: Moskowitz
authors.forename: Michael
authors.initials: M
authors.lastname: Feuerstein
authors.forename: Briana L
authors.initials: BL
authors.lastname: Todd
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D016000:Cluster Analysis; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D016272:Occupational Health; D016017:Odds Ratio; D012016:Reference Values; D018570:Risk Assessment; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D017741:Survivors; D013577:Syndrome; D014481:United States; D055815:Young Adult