title: Assessment of psychosocial factors and distress in women having adjuvant endocrine therapy for breast cancer: the relationship among emotional distress and patient and treatment-related factors.
abstract: OBJECTIVE
  The aims of this study were to comprehensively describe the psychosocial and medical characteristics of women who initiated tamoxifen or aromatase inhibitors for breast cancer and to compare levels of emotional distress according to their medical (tumor demographics, treatment type, treatment duration) and psychosocial (self-esteem, perceived social support, sociodemographic) characteristics.
  
  
  METHODS
  A total of 104 women currently receiving tamoxifen or aromatase inhibitors was recruited from outpatient clinics and they were asked to complete self-report questionnaires including the Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support and the Hospital Anxiety and Depression Scale during their routine follow-up. Psychosocial and medical characteristics of the patients were first described and subsequently the score of emotional distress was compared with these.
  
  
  RESULTS
  The patients' mean age was 52.49 ± 10.30 and they were being treated for an average of 24.3 months. Out of the patients' characteristics, educational and marital status, level of perceived social support and self-esteem were all significantly related with emotional distress. As for medical variables, the score of distress was relatively higher among patients in the first 2 years of their treatment than the patients who were in the second to fifth years of treatment, but this was not statistically significant.
  
  
  CONCLUSIONS
  Given the results of this study, it appeared that patient variables, rather than the medical or treatment characteristics, were related with emotional distress in women undergoing endocrine treatment. For that reason it is critical that medical staff are aware of patient factors that relate to distress during a long period of adjuvant endocrine therapy.
authors.affiliation: Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sihhiye, Ankara, Turkey.
authors.forename: Ozturk
authors.initials: O
authors.lastname: Ates
authors.affiliation: Department of Psychology, Beytepe Campus, Hacettepe University, Ankara, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Soylu
authors.affiliation: Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sihhiye, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Babacan
authors.affiliation: Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sihhiye, Ankara, Turkey.
authors.forename: Furkan
authors.initials: F
authors.lastname: Sarici
authors.affiliation: Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sihhiye, Ankara, Turkey.
authors.forename: Neyran
authors.initials: N
authors.lastname: Kertmen
authors.affiliation: Department of Radiology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Allen
authors.affiliation: Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Sever
authors.affiliation: Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sihhiye, Ankara, Turkey.
authors.forename: Kadri
authors.initials: K
authors.lastname: Altundag
keywords: Breast cancer; Emotional distress; Endocrine therapy; Psychosocial factors; Self-esteem; Social support