School of Psychology
Stefanic, Natalie Alise, Investigating psychological resilience in early-stage breast cancer patients: a contextual goal-based approach, thesis, School of Psychology, University of Wollongong, 2014. http://ro.uow.edu.au/theses/4245
The diagnosis and treatment of breast cancer imposes substantial demands and limitations on multiple domains of life and functioning. Research evidence suggests that the psychosocial impact of breast cancer can vary widely across individuals over the months and years following diagnosis. However, the majority of breast cancer patients maintain relatively stable levels of low psychological distress across the cancer continuum. Greater insight into the adaptive factors and processes theorised to underpin the manifestation of psychological resilience in breast cancer patients has the potential to inform psychosocial care. There are a paucity of studies investigating these issues in cancer patients.
The overall aim of this doctoral thesis is to better understand the phenomenon of psychological resilience in breast cancer patients. Specifically, this thesis examines the nature of goal-related risk factors and adaptive coping processes conceptually linked to psychological resilience in a sample of early-stage breast cancer patients across the short-term treatment and recovery period. The three studies comprising this doctoral thesis are grounded in the life-span developmental perspective on resilience and, moreover, the dual-process model of developmental regulation central to this perspective. The first study investigates how the experience of physical symptom burden influences cancer-related goal interference at multiple time-points within the six months following surgery. The findings of this study indicate that physical symptom burden is an important source of personal goal interference during adjuvant treatment, and that clinicians may benefit from targeting goal-based psychosocial strategies towards those breast cancer patients experiencing high symptom burden.
The second study examines the relationship of cancer-related goal interference and perceived goal attainability with indicators of psychological functioning across two broad time-points following surgery. It also investigates the nature of personal goals held by patients across this time period. Study findings indicate that perceived goal attainability plays an important role inchanging psychological distress symptoms over time, and moreover, that patients holding onto important goals with poor attainability may require support with adaptive goal adjustment during the short-term treatment and recovery period.
The third study explores the nature of adaptive goal-based coping processes (i.e., assimilation and accommodation) in response to personal goal interference encountered across the six months following surgery. The findings suggest that the utilisation of goal-based coping strategies differs across goals and over time. Additionally, findings indicate that breast cancer patients exhibit different patterns of response to interference, with perceived interference primarily responded to with one or both types of adaptive goal-based coping. Other forms of response may also be activated, in combination with goal-based coping or independently.
Broadly, the findings from this doctoral thesis provide support for the application of the life-span developmental resilience framework to the study of resilience in breast cancer patients. The thesis findings have the potential to inform psychosocial cancer care by helping oncology clinicians to identify patients at high risk of poor psychological functioning, and moreover, support adaptive goal-based coping and psychological resilience in breast cancer patients across the cancer continuum.