Kinesiophobia in Breast Cancer Survivors and its Relationship with Quality of Life, Comorbidity, and other clinical parameters

Abstract

Objectives: This cross-sectional study aims to determine the frequency of kinesiophobia in breast cancer survivors and evaluate its relationship with mainly quality of life and comorbidities, also fatigue, lymphedema, and depression. Material Methods: This study included 54 women with breast cancer who were followed in remission in Aydın Atatürk State Hospital Medical Oncology Clinic between November-December 2020. Clinicopathological characteristics of the patients were recorded. Kinesiophobia was assessed using the Turkish version of Tampa Scale for Kinesiophobia (TSK). Lymphedema was evaluated with bilateral upper extremity measurements. Depressive status and quality of life were determined using the Beck Depression Inventory (BDI) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30 v3). Comorbidities were assessed using the Charlson Comorbidity Index (CCI) while fatigue was evaluated by 10 cm visual analogue scale (VAS). The relationship between the TSK and CCI, BDI, VAS-F, EORTC-30 were investigated. Results: The mean age of patients was 52.11±11.10 years. Of the patients, 36 (66.7%) had kinesiophobia based on having TSK scores above 37. The rate to recieve adjuvant radiotherapy was higher in kinesiophobic group. Kinesiophobic patients had statistically significantly lower global health, physical functioning, and emotional functioning scores, and higher depression and VAS-fatigue scores. Kinesiophobic patients also had higher financial difficulty and higher sypmtom scale scores. Comorbidities and presence of lymphedema did not differ between groups (p>0.05). All EORTC QLQ30 sub-parameter scores except for financial difficulty and symptom severity had negative significant correlations with TSK scores while VAS-fatigue, BDI, EORTC QLQ-30 symptom scale, and financial difficulties showed significant positive correlations. TSK score was not correlated with CCI. Conclusion: Kinesiophobia is rather frequent in breast cancer survivors and has associations with worse quality of life and higher depression and fatigue scores. These patients should be trained and encouraged for an active life style.