title: Assessment of pain, acceptance of illness, adjustment to life with cancer and coping strategies in breast cancer patients.
abstract: BACKGROUND
  Breast cancer is the most common malignant neoplasm in women. Over the past 40 years, the number of patients diagnosed with breast cancer quadrupled. Breast cancer is one of the most frequent causes of death in women aged 65 and more in Poland.
  
  
  OBJECTIVE
  The purpose of the study was to evaluate coping strategies, pain management, disease acceptance and adjustment to cancer in patients diagnosed with breast cancer and to assess the effect of socioeconomic variables on the above mentioned issues.
  
  
  METHODS
  The study included 193 patients diagnosed with breast cancer during outpatient chemotherapy (classical chemotherapy, hormone therapy, molecularly targeted therapies) at the Center of Oncology, Maria Skłodowska-Curie Institute in Warsaw. We applied the Paper and Pencil Interview (PAPI) technique. The questionnaire interview consisted of demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), measuring the influence of factors affecting pain management in patients, CSQ (Coping Strategies Questionnaire), designed to evaluate pain coping strategies, AIS (Acceptance of Illness Scale) questionnaire, measuring disease acceptance, and the mini-MAC (Mental Adjustment to Cancer) scale.
  
  
  RESULTS
  The results of BPCQ show that breast cancer patients mostly believe that doctors control pain; the mean result for the group was 17.09 and test values were differentiated by education and professional status. The top average score in the pain coping strategies questionnaire was recorded in the positive coping self-statement subscale (mean score = 21.81), whereas the lowest, in the catastrophizing subscale (mean score = 10.60). Here, education and income proved most significant in accounting for the differences recorded. The mean score on the AIS was 28.45, and the key factor differentiating the results was income. As far as the mini-MAC is concerned, we reported the highest score in the fighting spirit subscale (23.43). The average results in the scale were slightly differentiated by socioeconomic variables.
  
  
  CONCLUSIONS
  Breast cancer patients mostly believe that those who control pain are doctors. Amongst the strategies of coping with pain, the top average score was recorded in the positive coping self-statement subscale. We found out that the level of disease acceptance depends on respondent's income. The higher the income, the greater the acceptance of illness.
authors.affiliation: Public Health Department, Medical University of Warsaw, Warsaw, Poland. ola_czerw@wp.pl.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Czerw
authors.affiliation: Public Health Department, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Religioni
authors.affiliation: Division of Cancer Prevention, Department of Oncology and Hematology CSK MSW, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Deptała
mesh_terms: D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000209:etiology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D059408:Pain Management / Q000379:methods*; D010820:Physicians; D011044:Poland; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Acceptance of illness; Breast cancer; Pain evaluation; Quality of life