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Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey

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Abstract

Purpose

The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health.

Methods

Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2.

Results

In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51–0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47–0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44–0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32–4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32–18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption.

Conclusion

This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

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Acknowledgments

The research was undertaken as a holder of a University of Queensland Graduate School International Travel Award. We acknowledge The University of Queensland Graduate School for providing funding to enable this research. The funder had no role in the study design, collection, analysis, and interpretation of data. We also acknowledge the assistance of Information and Statistics Division Scotland who carried out the linkage of the Scottish Health Survey data to Scottish Cancer Registry data and who provided the data for this study.

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Correspondence to Janni Leung.

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Leung, J., Atherton, I., Kyle, R.G. et al. Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey. Support Care Cancer 24, 1755–1761 (2016). https://doi.org/10.1007/s00520-015-2968-2

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  • DOI: https://doi.org/10.1007/s00520-015-2968-2

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