Stress and well-being in breast cancer survivors : the influence of personality, socio-demographics, cancer-related characteristics, and physical activity levels

Cancer is now considered to be one of the most prevalent chronic diseases in Canada, with breast cancer emerging as the most common type of cancer diagnosed in Canadian women (Canadian-Cancer-Society, 2009). As breast cancer patients move to long-term survivorship, they face new challenges that extend beyond end of treatment (Deimling et al, 2003) which can have direct influences on quality of life (Ferrell et al., 1995). Previous research has often failed to use stress frameworks to examine stress relationships faced by breast cancer survivors (BCS) and has seldom investigated the effect of specific cancer-related stressors and their meaning on quality of life. To address these limitations, the current study investigated the influence of stress-related variables on quality of life of BCS post-treatment using Lazarus’ framework. Moreover, the direct and indirect effects of individual characteristics, including physical activity and personality trait, as well as cancer-related characteristics on stress-related variables were investigated. The final sample included 365 women who had been diagnosed with breast cancer, had completed treatment, and were between the age of 29 and 90 years (Mage = 61.58, SD = 11.36). Structural equation modeling techniques were used to test a hypothesized model based on Lazarus’ framework. The measurement and structural models testing the most global hypothesized model showed good model fit (RMSEA .90, TLI > .90), whereby direct and indirect effects of stressors, physical activity, and optimism on quality of life were shown. Together, these constructs explained 61% and 70% of the variance in physical and mental health respectively, highlighting the direct effect of stressors on quality of life above and beyond the role of cognitive appraisal. Experiencing more stressors was significantly associated with reporting lower levels of quality of life. Furthermore, personality had a direct effect on mental health whereas being physically active was positively associated with physical health. Overall, findings provided partial support for Lazarus’ model and highlighted some of the potential benefits of physical activity for cancer survivors. These results could be used to guide the design of interventions aimed at increasing physical and mental health in breast cancer survivors.Education, Faculty ofKinesiology, School ofGraduat