Kemoterapi Alan İleri Evre Meme Kanserli Hastalarda Semptom Yükü, Fonksiyonel Durum ve Öz-etkililik Arasındaki İlişki

Abstract

This descriptive and cross-sectional study aimed to investigate the relationship between symptom burden, functional status, and self-efficacy in advanced breast cancer patients receiving chemotherapy. The study was conducted in two different hospitals with 122 patients diagnosed with stage IV breast cancer who received outpatient chemotherapy, between 10 April 2021 and 29 April 2022. Patient Information Form, MD Anderson Symptom Inventory (MDASI), Functional Living Index-Cancer (FLIC), and Symptom Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy (SMSES-BC) were used to collect research data. The data were analysed with Mann-Whitney U, Kruskal Wallis, and Spearman correlation tests and path analysis. The median age was 54 years, 42.6% were primary school graduates, and 64.8% defined their income as equal to income-expenditure. The median scores of the MDASI for symptom severity, MDASI symptom interference, FLIC, and SMSES-BC were 4.54 (moderate), 6.5 (moderate), 96.5 (moderate), and 176 (moderate), respectively. The symptom burden was higher and self-efficacy and functional status were lower in patients with lower education (p<0.05). Functional status deteriorated as the income level decreased (p<0.05). A negative and moderate correlation was found between MDASI symptom severity, FLIC, and SMSES-BC scores; and a very strong negative correlation was found between the FLIC and MDASE symptom interference (p<0.001). There was a moderate and positive correlation between FLIC and SMSES-BC scores (p<0.001). The hypothesized path model showed that symptom severity has a direct effect on self-efficacy and an indirect effect on functional status, and self-efficacy directly affects functional status (p<0.001). This study concluded that as symptom burden increased, self-efficacy decreased, and functional status worsened in patients with advanced breast cancer. In line with the study findings, evaluating symptom burden, functional status, and self-efficacy simultaneously in advanced breast cancer patients receiving chemotherapy and planning interventions to support the self-efficacy of patients to alleviate the symptom burden and improve functional status are recommended.