Symptom-Management Self-efficacy Mediates the Effects of Symptom Distress on the Quality of Life Among Taiwanese Oncology Outpatients With Breast Cancer.
BACKGROUND
Theory has suggested that self-efficacy plays an important role in facilitating health behaviors and, in turn, promoting healthy outcomes. However, limited research has focused on the mechanisms through which symptom-management self-efficacy acts as a mediator between symptom distress and quality of life (QOL) for patients with breast cancer who have undergone chemotherapy.


OBJECTIVE
The purpose of this study is to examine the association between symptom distress and QOL among Taiwanese oncology outpatients with breast cancer and proposed symptom-management self-efficacy as a mediator between symptom distress and QOL.


METHODS
This cross-sectional study included 201 oncology outpatients in 1 teaching hospital in the Taipei area of Taiwan. The research instruments included the Symptom-Management Self-Efficacy Scale-Breast Cancer, the symptom distress scale, and the European Organization for Research and Treatment of Cancer Quality of Life Group Questionnaire. Bootstrapping was used to statistically assess the possible mediating effects of self-efficacy on QOL.


RESULTS
Symptom-management self-efficacy mediated the association between symptom distress and global QOL (indirect effect, -6.33; 95% confidence interval [CI], -9.63 to -3.74), functional QOL (indirect effect, -4.47; 95% CI, -7.05 to -2.36), and symptom QOL (indirect effect, 2.59; 95% CI, 1.07-4.83). All of the 95% CIs were significant. The lower symptom distress that patients experienced was indirectly associated with better QOL through higher self-efficacy.


CONCLUSIONS
Symptom management self-efficacy may be a crucial mechanism through which symptom distress influences patients' QOL.


CONCLUSIONS
Clinicians may incorporate strategies focused on improving patients' self-efficacy in relation to managing their symptoms caused by chemotherapy to improve patients' QOL.
Author Affiliations: College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei (Drs Liang, Lin, and Tung); Department of Medicine, Taipei Veterans General Hospital, Taipei (Drs Chao and Tseng); College of Nursing, Dayeh University, Changhua, Taiwan (Dr Tsay).
Shu-Yuan
SY
Liang
Ta-Chung
TC
Chao
Ling-Ming
LM
Tseng
Shiow-Luan
SL
Tsay
Kuan-Chia
KC
Lin
Heng-Hsin
HH
Tung
D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D013315:Stress, Psychological / Q000523:psychology; D013624:Taiwan