Characteristics of positive and negative effects on the quality of life of breast cancer patients.

Abstract

Background: Postoperative and ongoing treatment of breast cancer is traumatic to women with breast cancer and may lead to positive and negative psychological diseases, which can affect the prognosis of patients with breast cancer. Positive affect (PA) and negative affect (NA) significantly impact the prognosis of postoperative breast cancer patients. However, the effects of specific emotions on patient prognosis and the relationships between them are still unclear.

Methods: A case-control study was conducted to investigate the characteristics of PA and NA and their effects on Quality of Life (QoL) in breast cancer patients. 442 postoperative breast cancer patients and 444 healthy women were recruited from November to December 2021. For the observation group, participants were eligible if they (1) were aged between 16 and 80 years and (2) had a confirmed pathological diagnosis of breast cancer and (3) possessed the ability to read text, voluntarily agreed to participate, provided informed consent, and cooperated with the study procedures. The control group consisted of individuals without breast cancer who met all other criteria, as stated above. Patients were excluded from the study if they (1) had severe comorbid conditions causing functional impairment or life-threatening risks or (2) suffered from mental disorders or were unconscious at the time of the study. For the control group, individuals with a pathological diagnosis of breast cancer were also excluded. All other exclusion criteria were consistent with those for the observation group. The demographic information and clinicopathological information of the participants were collected. The Positive Affect and Negative Affect Scale (PANAS) is a scale containing 20 emotional scores related to emotion and is used to assess the level of positive and negative affect. The Quality of Life Questionnaire Core 30 (QLQ-C30) was used to assess the quality of life of cancer patients in 15 domains. SPSS 24.0 was used to analyze and process the data. Independent-sample t-tests, one-way ANOVA and Pearson correlation analysis, were used to analyze PA and NA in different treatment phases. Polynomial regression and response surface analysis were conducted to assess the relationships among PA, NA, and QoL. The results were considered statistically significant at P < 0.05.

Results: Compared with healthy women, breast cancer patients had lower scores on "alert" and "distressed" but higher scores on "inspired," "scared," and "afraid." There were no significant differences in the relationships between PA and NA between patients and healthy women (P > 0.05). During the initial treatment phase, the highest proportion of patients had an NA greater than the PA (PA < NA). In the rehabilitation phase, the highest proportion of patients had PA greater than or equal to the NA (PA ≥ NA). The relationship between PA and QoL was an inverted U-shaped curve (P < 0.05), whereas the relationship between NA and QoL was a positive U-shaped curve (P < 0.05). There was an interaction effect between PA and NA (P < 0.001). The relationships among PA, NA, and QoL varied across treatment phases. In the initial treatment phase, the presence of both positive and negative affect improved QoL. In the endocrine therapy phase, excessive positive effects decrease QoL. During the rehabilitation phase, QoL improved as positive affect increased relative to negative affect.

Conclusion: There are significant differences in the distributions of positive and negative effects in breast cancer patients at different treatment phases. The impact of PA and NA on QoL varies by treatment phase. Our findings have important implications for tailoring emotional interventions for breast cancer patients at different stages of treatment.