title: Change and predictors of symptom distress in breast cancer patients following the first 4 months after diagnosis.
abstract: OBJECTIVE
  Breast cancer patients may encounter a wide range of physical and psychosocial distress symptoms during diagnosis, while awaiting treatment, and during treatment. This study of newly diagnosed breast cancer patients explores: (1) changes in symptom distress over 4 months; and (2) factors predicting changes in symptom distress.
  
  
  METHODS
  A prospective longitudinal design was used to collect data from breast cancer patients in northern Taiwan. A set of questionnaires was used to measure anxiety, symptom distress, social support, and demographic and treatment-related characteristics. Repeated measures analysis of variance (RM-ANOVA) with least significant difference (LSD) was used to examine differences in symptom distress, state anxiety, and social-support levels across four time-points. Generalized estimating equation (GEE) is used to determine predictors for the change in symptom distress.
  
  
  RESULTS
  Participants showed mild overall symptom distress during treatment that increased from cancer diagnosis to treatment phases, with a peak at 4 months after diagnosis. Insomnia was the most commonly identified distressful symptom over time. Changes in overall symptom distress were significantly predicted by state anxiety, health professional support, and time since cancer diagnosis.
  
  
  CONCLUSIONS
  Change in symptom distress following the first 4 months after diagnosis was predicted by state anxiety, health professional support, and time. Patients should receive social support and be trained in problem-solving skills to relieve distressful symptoms from diagnosis through treatment.
authors.affiliation: Administration Center of Medical Research Department, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Mei-Nan
authors.initials: MN
authors.lastname: Liao
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Shin-Cheh
authors.initials: SC
authors.lastname: Chen
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Hsueh-Chih
authors.initials: HC
authors.lastname: Hung
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. Electronic address: swjane@gw.cgust.edu.tw.
authors.forename: Sui-Whi
authors.initials: SW
authors.lastname: Jane
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013624:Taiwan
keywords: anxiety; breast cancer; social support; symptom distress