An In-depth Examination of Psychological Distress in Breast Cancer Survivors

Psychological distress is an important component of cancer care, and can adversely affect treatment compliance, quality of life and survival. Data about psychological distress in breast cancer survivors is sparse. This is an important gap given the adverse impact of psychological distress on breast cancer outcomes. The purpose of the proposed research, “An In-depth Examination of Psychological Distress in Breast Cancer Survivors,” is to gain a detailed understanding of the unique role of multilevel factors on the psychological distress experience of breast cancer survivors, and how survivors cope with breast cancer related psychological distress. This is essential to identify potentially modifiable factors for distress management interventions in breast cancer survivors. A highly qualified multi-disciplinary team has been assembled to support my research and training goals. The predoctoral (F99) research project is a mixed methods study guided by the model of cancer related worries, study aims are to: 1a) examine levels of psychological distress over time by age, and associations between sociodemographic factors, clinical factors, and psychological distress, using an existing longitudinal cohort study controlling for clinical factors; 1b) evaluate the contribution of healthcare delivery and psychosocial factors on psychological distress among breast cancer survivors, using an existing longitudinal cohort study; 1c) determine if healthcare delivery and psychosocial factors mediate and/or moderate the association between non-modifiable factors (age) and psychological distress; 1d) determine if healthcare delivery and psychosocial factors mediate and/or moderate the association between non-modifiable factors (age) and psychological distress. The postdoctoral (K00) research project’s goal is to understand breast cancer survivors’ strategies to cope with psychological distress. Utilizing Strauss and Corbin’s grounded theory methodology and a community engaged approach, study aim is to 2) understand young breast cancer survivors’ strategies for coping with psychological distress, using in-depth interviews. The proposed research aligns with NCI’s key research area of cancer survivorship, which among other issues prioritizes addressing psychological concerns in cancer survivors.