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Prevalence of psychological distress and its associated factors among breast cancer patients in China:a systematic review and meta-analysis

October 24, 2022 2:57 PM | Anonymous

Authors: Jia Hui Liu, MS, RN, Hunan Cancer Hospital; Xu Ying Li, PhD, RN, Hunan Cancer Hospital


Breast cancer(BC)is a common cancer type in women, ranking the first in in the incidence, and the fourth in the mortality, among female cancers in China. Treatment of BC was reported to lead to a repertoire of psychological symptoms and health problems, such as depression, anxiety and fatigue (de Ligt et al., 2019; Götze et al., 2020), and the psychological symptoms were suggested to be caused by psychological distress among patients receiving treatment. (Loewenstein 2018). Such psychological distress may hinder treatment compliance, increase the risk of suicide and mortality, and affect the prognosis of the disease. In light of the detrimental effect of cancer treatment on the psychological well-being on patients, a better understanding on the factors that may increase their risk of experiencing psychological distress is needed. Therefore, we conducted a systematic review that aims to provide an overview on the prevalence of psychological distress with breast cancer patients in China, and the factors that may affect their experience of psychological distress. These identified factors may help provide useful clues in the identification of patients at higher risk of psychological distress, where additional psychological interventions may be given to these patients to facilitate personalized care.

Our findings showed that breast cancer patients in China had a high prevalence of psychological distress of 55.4%. We also found that patients with moderate distress, those who were about to receive chemotherapy, those living in western regions in China, and those whose cancer was at the pathological stages Ⅱ to Ⅲ had a higher prevalence of psychological distress.

With our data showing the relatively high prevalence of psychological distress among breast cancer patients in China, more resources should be allocated in the implementation of psychological interventions shown to be effective in alleviating psychological issues, such as training more psychological care professionals, and constructing psychological intervention plans based on the level of psychological distress. Psychological interventions of potential for implementation among the patients include relaxation training, physical activity, and couples therapy. Patients at stages II or III of Cancer who have their chemotherapy scheduled to start and those living in western China are in higher need of these interventions. Meanwhile, there is a great need to further improve the ability of healthcare professionals to screen for or detect psychological distress in cancer patients, where those having psychological distress can be identified for referrals to receive the psychological interventions. The Government may consider the allocation of more resources for training healthcare professionals to implement these interventions.


de Ligt, K. M., Heins, M., Verloop, J., Smorenburg, C. H., Korevaar, J. C., Siesling, S. (2019). Patient-reported health problems and healthcare use after treatment for early-stage  breast cancer. Breast, 46, 4-11. doi: 10.1016/j.breast.2019.03.010

Götze, H., Friedrich, M., Taubenheim, S., Dietz, A., Lordick, F., Mehnert, A. (2020). Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Support Care Cancer, 28(1), 211-220. doi: 10.1007/s00520-019-04805-1

Loewenstein, K. (2018). Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context  of the Social Ecological Model: A Scoping Review. J Am Psychiatr Nurses Assoc, 24(6), 495-509. doi: 10.1177/1078390318765205

This study was presented at ICCN2022 virtual conference.
Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

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