Narratives of Survivorship: A Study of Breast Cancer Pathographies and Their Place in Cancer Rehabilitation.

The focus on cancer rehabilitation has increased, but breast cancer patients still report unmet rehabilitation needs. Since many women today will live long beyond their diagnosis, there are multiple challenges for the healthcare system in supporting these women in their new life situation. A more individualized approach is seen as necessary to optimize the rehabilitation for survivors. Pathographies, i.e., autobiographical or biographical accounts of experiences of illness, expose us to personal accounts of the journey through illness and treatment, offering us details, emotions, phrasings, and imagery from an individual perspective. In this literary study, we have analyzed two contemporary Swedish-speaking pathographies about breast cancer. In our analysis, we have presented perspectives on survivorship, and the authors' ways of conveying their breast cancer experiences through narrative. The pathographies envision the prominent impact the breast cancer has on the authors' lives. Narratives of survivorship have the potential to complement the more general medical knowledge with their nuanced and multifaceted stories of breast cancer. Learning from this type of material may improve the understanding of the complexity of breast cancer survivorship issues. This may be a way to become more attuned to identifying individual needs and preferences of breast cancer patients.

Psychological Resilience and Health-Related Quality of Life in 418 Swedish Women with Primary Breast Cancer: Results from a Prospective Longitudinal Study.

Psychological resilience is considered a major protective psychological mechanism that enables a person to successfully handle significant adversities, e.g., a cancer diagnosis. Higher levels of resilience have been associated with higher levels of health-related quality of life (HRQoL) in breast cancer (BC) patients, but research examining the longitudinal process of resilience is limited. The aim of this population-based longitudinal study was to investigate resilience and HRQoL from diagnosis to one year later in 418 Swedish women with primary BC. Resilience was measured with the Connor-Davidson Resilience Scale 25, and HRQoL was measured with the Short Form Health Survey. The participants responded to questions regarding demographic and study-specific variables. Clinicopathological variables were collected from the Swedish National Quality Register for Breast Cancer. The mean score for resilience was 70.6 (standard deviation, SD = 13.0) at diagnosis and 68.9 (SD = 14.0) one year later, p < 0.001. The level of trust in the treatment and financial situation demonstrated the greatest association with the change in resilience levels. No oncological treatment modality was associated with a change in resilience levels. HRQoL decreased over time in the cohort. Resilience was positively associated with HRQoL at one year post diagnosis, which demonstrates that resilience is an important factor in maintaining HRQoL.

Psychological Resilience and Health-Related Quality of Life in Swedish Women with Newly Diagnosed Breast Cancer.

PURPOSE: Psychological resilience appears to be an important influencing factor in various aspects of health-related quality of life (HRQoL) in a context of adversity, eg, being informed of a cancer diagnosis. The purpose was to investigate psychological resilience and HRQoL in Swedish women with newly diagnosed breast cancer in relation to demographic and clinicopathological characteristics. METHODS: A population-based cross-sectional study was conducted including 517 women with breast cancer in the South Swedish Health Care Region. Participants were enrolled at the time of consultation for the diagnosis. Psychological resilience was assessed with the Connor-Davidson Resilience Scale 25 (CD-RISC25), and HRQoL was assessed with the Short Form Health Survey. The participants responded to questions regarding demographic variables. Clinicopathological data were collected from the Swedish National Quality Register for Breast Cancer. RESULTS: The mean score for psychological resilience was 70.6, identifying 15% of included patients with a score lower than 58 (-1 standard deviation). The study cohort had significantly lower mean scores for several aspects of HRQoL compared with Swedish normative data. Regression analyses demonstrated that psychological resilience was significantly associated with all domains of HRQoL after adjustment for demographic and clinicopathological factors. CONCLUSION: Higher levels of psychological resilience were significantly related to higher levels of HRQoL in Swedish women with newly diagnosed breast cancer and no modifying factor was identified. The assessment of psychological resilience at the time of breast cancer diagnosis might allow for early identification of women in need of more intense psychosocial support. Future studies are needed to identify a clinically relevant threshold of the CD-RISC25.