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Leo CSY, Cheng LJ, Lam XR, He H. Global prevalence and factors associated with preoperative depression in women undergoing breast surgery: a meta-analysis and meta-regression. Breast Cancer Res Treat 2024; 205:425-438. [PMID: 38492162 DOI: 10.1007/s10549-023-07216-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/05/2023] [Indexed: 03/18/2024]
Abstract
PURPOSE Depression is one of the main psychological responses experienced by patients with breast cancer perioperatively. Therefore, this review aimed to synthesize the prevalence rate of depression preoperatively among patients with breast cancer. METHODS Six databases were searched for published articles, which recruited female patients aged 18 years and above, diagnosed with breast cancer and planned for breast surgery. Grey literatures were searched from ProQuest Theses and Dissertations, Science.gov and CogPrints. Studies published in English from the inception of databases to January 2023 were considered. Two reviewers screened, extracted, and appraised the data independently. Joanna Briggs Institute data collection form was used for data collection. Hoy's Risk of Bias Tool was utilized to assess the individual study's quality. Review Manager 5.4 software was utilized for meta-analysis. Subgroup analyses were conducted to explore the reasons for any heterogeneity. Publication bias was evaluated by Egger's test and funnel plot. RESULTS Twenty studies involving 32,143 patients with breast cancer were included. Meta-analyses revealed an overall preoperative prevalence of 30% among all studies. Subgroup analyses showed that studies conducted in the Middle East and North Africa used purposive sampling, with patients undergoing mastectomy and lumpectomy and with moderate risk of bias reported higher prevalence of preoperative depression (54%, 44%, 40%, and 49%, respectively) as compared to other respective subgroups. CONCLUSION The high prevalence of preoperative depression among women with breast cancer indicated the need for health care professionals to provide more psychological support to them.
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Affiliation(s)
- Celest Su Yi Leo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
- National University Health System, Singapore, Singapore
| | - Ling Jie Cheng
- National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xin Rong Lam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore
- National University Health System, Singapore, Singapore
| | - Honggu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore.
- National University Health System, Singapore, Singapore.
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Viitala A, Åstedt-Kurki P, Lehto JT, Palonen M. 'I am still valuable' - A qualitative study of incurable cancer patients coping in hospice care. Scand J Caring Sci 2023; 37:720-731. [PMID: 36852620 DOI: 10.1111/scs.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Knowledge of the experiences of coping in patients with incurable cancer is essential for high-quality palliative and end-of-life care. AIM AND OBJECTIVE To describe the coping experiences of patients with incurable cancer in hospice care to better develop patient-centred care. METHODS The data for this qualitative study were collected through semi structured interviews, with patients with incurable cancer in hospice care (N = 20) and analysed with inductive content analysis. Ethical and organisational approvals were obtained, and the participants received both verbal and written information before consenting to participate. RESULTS The patients' coping was enhanced with their involvement in treatment-related decisions. Valuing day-to-day living and coping with emotional stressors helped them accept their own life situations. Accepting their increasing fragility was enhanced by their self-reappraisal. The patients found security in the possibility of receiving support when they needed it. Although the ordinariness of dying in hospice care settings was sometimes too much to bear, they understood dying to be a part of the natural cycle of life. They questioned the responsiveness of healthcare services because they felt that they were not always heard. STUDY LIMITATIONS Because this study was limited to a specific population of cancer patients in hospice care, the results might not be generalised to other patient groups with chronic diseases or other palliative care settings. CONCLUSIONS The experiences of patients in hospice care of coping with incurable cancer were reminiscent of the common coping process descriptions. Surprisingly, even though participants voiced that they had accepted their situation, dying itself was something they did not find crucial to discuss. The crucial aspects - without being in denial - dealt more with focusing on positive thinking and facing life.
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Affiliation(s)
- Anu Viitala
- Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
| | - Päivi Åstedt-Kurki
- Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Juho T Lehto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Palliative Care Centre and Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Mira Palonen
- Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Ajmera P, Miraj M, Kalra S, Goyal RK, Chorsiya V, Shaik RA, Alzhrani M, Alanazi A, Alqahtani M, Miraj SA, Pawaria S, Mehta V. Impact of telehealth interventions on physiological and psychological outcomes in breast cancer survivors: A meta-analysis of randomised controlled trials. Front Oncol 2023; 12:1017343. [PMID: 36686741 PMCID: PMC9850160 DOI: 10.3389/fonc.2022.1017343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The use of telehealth interventions has been evaluated in different perspectives in women and also supported with various clinical trials, but its overall efficacy is still ascertained. The objective of the present review is to identify, appraise and analyze randomized controlled trials on breast cancer survivors who have participated in technology-based intervention programs incorporating a wide range of physical and psychological outcome measures. Material and methods We conducted electronic search of the literature during last twenty years i.e., from 2001 till August 10, 2021 through four databases. Standardized mean difference with 95% confidence interval was used. Results A total of 56 records were included in the qualitative and 28 in quantitative analysis. Pooled results show that telehealth interventions were associated with improved quality of life (SMD 0.48, 95% CI 0.03 to 0.92, p=0.04), reduced depression (SMD -1.27, 95% CI =-2.43 to -0.10 p=0.03), low distress and less perceived stress (SMD -0.40, 95% CI =-0.68 to -0.12, p=0.005). However, no significant differences were observed on weight change (SMD -0.27, 95% CI =-2.39 to 1.86, p=0.81) and anxiety scores (SMD -0.09, 95% CI =-0.20 to 0.02, p=0.10) between the two groups. Improvement in health care competence and fitness among participants was also reported. Conclusion Study concludes that telehealth care is a quick, convenient and assuring approach to breast cancer care in women that can reduce treatment burden and subsequent disturbance to the lives of breast cancer survivors.
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Affiliation(s)
- Puneeta Ajmera
- Department of Public Health, School of Allied Health Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Mohammad Miraj
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia,*Correspondence: Mohammad Miraj,
| | - Sheetal Kalra
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Ramesh K. Goyal
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Varsha Chorsiya
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Mazen Alqahtani
- College of Applied Medical Sciences, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia
| | - Shaima Ali Miraj
- Department of Public Health, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Sonia Pawaria
- Faculty of Physiotherapy, SGT University, Gurugram, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Sanchez L, Fernandez N, Calle AP, Ladera V, Casado I, Bayon E, Garcia I, Sahagun AM. Assessing the Expression of Emotions in Breast Cancer Survivors during the Time of Recovery: Perspective from Focus Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9672. [PMID: 35955033 PMCID: PMC9368609 DOI: 10.3390/ijerph19159672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Breast cancer has major public health implications, as it is the most frequent malignant tumor and the leading cause of cancer death in women. Survivors have many needs, including strategies to cope with the associated distress. We explore whether focus groups are useful for nurses to obtain information about the emotional state of breast cancer women, and develop strategies for coping with the stress that this disease entails. A qualitative study was carried out, involving 25 focus groups with 83 women treated for breast cancer, recruited from the local Breast Cancer Association (ALMOM). Four open-ended questions were employed, and 60-min discussions were carried out. They were transcribed, analyzed, coded, and the themes identified. Four major themes emerged, including "complex emotional evolution", "emotional isolation", "lack of information" and "inability to give advice". Women admitted that this disease had been a stressful factor for them, causing emotional (anxiety, irritability, anger or guilt) and cognitive disorders (confusion, lack of concentration, forgetfulness). The use of focus groups in breast cancer survivors allows nurses to evaluate the expression of emotions in these women, and collect and share information about their feelings, thoughts and experiences, so that survivors can cope more easily with the stress related to their illness.
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Affiliation(s)
- Leticia Sanchez
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Nelida Fernandez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Angela P. Calle
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Valentina Ladera
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain
| | - Ines Casado
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Enrique Bayon
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Isaias Garcia
- Department of Electrical and Systems Engineering. University of Leon, 24071 Leon, Spain
| | - Ana M. Sahagun
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
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Botto R, De Leonardis B, Salussolia A, Di Nardo C, Ala A, Torta R, Stanizzo MR. Assessment of anxiety, depression, and distress in breast cancer patients: A comparison among different phases of illness. Health Care Women Int 2022; 45:390-402. [PMID: 35695501 DOI: 10.1080/07399332.2022.2078325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
We aimed to assess the levels of anxious and depressive symptoms and distress in a sample of breast cancer patients in the different phases of the illness. We performed a cross-sectional study. We divided 301 female breast cancer patients into three groups, based on the phase of illness they were in being in post-surgery (N = 100), receiving adjuvant therapies (N = 86), and receiving follow-up care (N = 115). We included the follow-up within the phases of illness. We further divided each group into first diagnosed or with recurrence and we administered Hospital Anxiety and Depression Scale and Distress Thermometer. First-diagnosed patients with clinically relevant anxiety increased from being post-surgery (35.8%), to receiving adjuvant therapies (53.7%), and to being in follow-up (61.5%). In patients with recurrence, distress was stable among the illness phases, but many patients had clinically relevant anxiety (55.65%) and depression (43.48%). First-diagnosed patients' emotional distress could be more linked to follow-up-related difficulties. During recurrence, high distress could be due to the failure of previous treatments. Distress screening can better orient psycho-social interventions and healthcare resources.
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Affiliation(s)
- Rossana Botto
- Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Brigitta De Leonardis
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Annarita Salussolia
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Cristina Di Nardo
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Ada Ala
- Department of Surgery, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
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Allostatic Load as an Insight into the Psychological Burden after Primary Treatment in Women with Breast Cancer: Influence of Physical Side Effects and Pain Perception. J Clin Med 2022; 11:jcm11082144. [PMID: 35456237 PMCID: PMC9031666 DOI: 10.3390/jcm11082144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
Breast cancer (BC) diagnosis and treatment have become a cumulative long-standing chronic disease impairment, causing stress and turning into an allostatic load (AL) framework. This study aimed to investigate the relationship between physical issues and mental health in patients with BC after medical treatment. We conducted an observational study of 61 female patients with BC, and clinical and psychological markers have been detected. We conducted descriptive statistics, ANOVA analyses, correlations, and mediation analyses to verify the effect of the comorbidity index on psychological dimensions. The findings showed high levels of distress and moderate pain, and 32.8% of the patients showed moderate physical impairment. Significant effects of “age” and “physical issues” were found. The adult group reported a higher incidence of physical issues, and the group of patients reporting moderate physical impairment seemed more depressed than patients with mild physical issues. Finally, the comorbidity condition mediated the presence of signs of depression. Patients with BC seemed to experience negative emotions related to comorbidities associated with compromised activities of daily living. Our findings highlighted allostatic overload as a predictive framework to better understand the mental health of women with BC diagnoses to tailor effective psychological treatments for enhanced recovery.
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Torralba-Martínez E, Quintana MJ, Carbonell MC, de Las Sias E, Carrillo CPS, Codern-Bové N. Coping experiences of women in the different phases of breast cancer. Support Care Cancer 2021; 30:197-206. [PMID: 34247298 DOI: 10.1007/s00520-021-06400-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/27/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To understand the evolution of coping among women diagnosed with breast cancer over time, and the effect of age and family income on coping. METHOD Using a phenomenological qualitative study, data was collected through semi-structured interviews with sixteen women in a hospital in Barcelona (Spain) between January 2018 and June 2019. An analysis of thematic content and discursive profile was carried out, assisted by the Nvivo v.12 program. RESULTS Coping strategies change according to the meaning of breast cancer in each phase and the age and family income. In the acute phase, multiple coping strategies are identified, and this variety was more frequent among the young women in the study. In the extended phase, planning, distancing, and seeking social support become important. The latter used during treatment by older women in the study, regardless of family income. In the follow-up phase, distancing stands out, but also the search for social support among young women with fewer resources. CONCLUSIONS Coping with breast cancer evolves according to the meaning that the disease receives in each phase. In addition, the analysis by discursive profile shows how the social support context is also related to the coping strategies in each phase.
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Affiliation(s)
- Elena Torralba-Martínez
- Department of Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Av. de Can Domènech 737, Cerdanyola del Vallès, 08193, Barcelona, Spain
| | - María Jesús Quintana
- Department of Clinical Epidemiology and Public Health-Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau), Carrer Sant Antoni Ma Claret 167, 08025, Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma de Barcelona, 08041, Barcelona, Catalonia, Spain
| | - Magda Ciendones Carbonell
- Unidad de Patología Mamaria, Hospital de La Santa Creu I Sant Pau, Carrer Sant Quintí 89, 08041, Barcelona, Catalonia, Spain
| | - Elena de Las Sias
- Independent Clinical Psycho-Oncology, Universidad Complutense de Madrid, Av. Séneca, 2, 28040, Madrid, Spain
| | | | - Núria Codern-Bové
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, c/ de la Riba 90, 08221, Terrassa, Catalonia, Spain.
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Civilotti C, Botto R, Maran DA, Leonardis BD, Bianciotto B, Stanizzo MR. Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables. ACTA ACUST UNITED AC 2021; 57:medicina57050454. [PMID: 34066935 PMCID: PMC8148592 DOI: 10.3390/medicina57050454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of patients most at risk of developing psychiatric disorders. The present study analyzes, in a sample of women newly diagnosed with breast cancer, the relationships between their levels of anxiety and depression and several socio-demographic characteristics. The study was cross-sectional. Materials and Methods: Four hundred and seventy eight women newly diagnosed with breast cancer completed the Hospital Anxiety and Depression Scale during the pre-surgical phase. Results: Findings show that almost 40% of the sample had clinically relevant anxious symptoms and about a quarter of the sample had significant depressive symptoms. Their prevalence was higher in widows. Moreover, depressive symptoms were higher in older women and anxious symptoms were higher in patients with a lower educational level. In the pre-surgical phase, women can suffer from clinically relevant anxiety and depression, especially the widows, older women, and women with a lower educational level. Conclusions: Identifying the most psychologically vulnerable patients, due to specific socio-demographic characteristics, is essential in order to provide adequate psycho-oncological treatments to the categories of patients, who are most at risk of developing psychopathological concerns.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
| | - Rossana Botto
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
| | - Daniela Acquadro Maran
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
- Correspondence: ; Tel.: +39-011-6702262
| | - Brigitta De Leonardis
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
| | - Beatrice Bianciotto
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
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Coping Strategies and Their Impact on Emotional Distress and Fatigue Among Breast Cancer Survivors: A Cross-sectional Survey. Cancer J 2021; 27:83-89. [PMID: 33750065 DOI: 10.1097/ppo.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study examined the relations between subjective stress and strategies for coping with stress (emotion control strategies and self-compassion), as well as the relations between emotional distress and fatigue. METHODS The study used a cross-sectional survey design. Participants were 170 women aged 24 to 82 years with diagnoses of breast cancer stages I to III who were 1 to 12 months postchemotherapy, with no current evidence of disease and no previous cancer diagnosis. Participants were recruited by consecutive sampling, and the overall response rate was 85%. RESULTS Higher subjective stress was associated with higher emotional control (r = 0.23, P < 0.01), and both were associated with higher emotional distress (r = 0.63, P < 0.001; r = 0.20, P < 0.05). Lower self-compassion was associated with higher emotional distress (r = -0.20, P < 0.05). Fatigue exhibited a high association with emotional distress (r = 0.67, P < 0.001), which increased as subjective stress increased. Older age was associated with emotional control (r = 0.16, P < 0.05), whereas younger age was associated with emotional distress. Time elapsed since chemotherapy was negatively associated with both emotional distress (r = -0.19, P < 0.05) and fatigue (r = -0.18, P < 0.05). A strong positive association emerged between fatigue and emotional distress (r = 0.67, P < 0.001). CONCLUSIONS The results of this study underline the importance of self-compassion as a coping strategy to decrease emotional distress among breast cancer survivors.
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