학술논문

Early postoperative psychological distress as a mediator of subsequent persistent postsurgical pain outcomes among younger breast cancer patients
Document Type
Clinical report
Source
Breast Cancer Research and Treatment. November, 2022, Vol. 196 Issue 2, p363, 8 p.
Subject
Cancer patients -- Care and treatment -- Patient outcomes
Depression, Mental -- Care and treatment -- Patient outcomes
Mediation
Sleep disorders -- Care and treatment -- Patient outcomes
Breast cancer -- Care and treatment -- Patient outcomes
Sleep
Stress (Psychology) -- Care and treatment -- Patient outcomes
Language
English
ISSN
0167-6806
Abstract
Purpose Younger age is a risk factor for worse pain outcomes following breast cancer surgery, yet little is known about how younger women's psychological state may contribute to their pain experience. Using prospectively collected longitudinal data from a surgical cohort, we examined whether early postoperative psychological distress at 2 weeks mediated the association between younger age and subsequent worse pain-related functioning 3 months after surgery. Methods Patients (N = 159) were recruited before breast cancer surgery into this longitudinal cohort study. Age at time of surgery, psychological distress (anxiety, depression, and sleep disturbance) assessed 2 weeks postoperatively, and impact of surgical pain on cognitive/emotional functioning and physical functioning assessed 3 months postoperatively were used for analysis. Results Younger age was associated with greater depression, anxiety, and sleep disturbance 2 weeks postoperatively. Younger age was also associated with greater ratings of pain impacting cognitive/emotional functioning and physical functioning 3 months postoperatively. The association between younger age and worse cognitive/emotional impact of pain was mediated by greater anxiety and sleep disturbance. Similarly, the association between younger age and worse physical impact of pain was mediated by greater sleep disturbance. Conclusion The degree of anxiety and sleep disturbance that occur early after breast surgery may contribute to greater chronic pain-related functional disability among younger patients. Anxiety and sleep disturbance are modifiable with behavioral interventions, making them potential perioperative targets to improve long-term outcomes in young breast cancer survivors.
Author(s): Jenna M. Wilson [sup.1], Carin A. Colebaugh [sup.1], K. Mikayla Flowers [sup.1], Robert R. Edwards [sup.1], Ann H. Partridge [sup.2], Laura S. Dominici [sup.3] [sup.4], Kristin L. Schreiber [sup.1] [...]