Impact of hot flashes on quality of life among postmenopausal women being treated for breast cancer.

Hot flashes are among the most commonly reported symptoms among women who have completed treatment for breast cancer. Relatively little is known, however, about hot flashes among women while they are undergoing breast cancer treatment. The present study investigated the prevalence and severity of hot flashes of women during chemotherapy and radiotherapy for breast cancer. We also sought to identify the medical, demographic, and treatment correlates of hot flashes during treatment and to document the impact of hot flashes on quality of life. Seventy postmenopausal women with breast cancer completed a self-report questionnaire packet during chemotherapy and radiotherapy. Forty percent (n = 28) reported hot flashes during the week prior to assessment. Of the 28 women endorsing hot flashes, 25% (n = 7) rated them as severe, 39% (n = 11) rated them as moderate, and 36% (n = 10) rated them as mild. Women with hot flashes were significantly (p < 0.05) younger and reported significantly (p < 0.001) more fatigue, poorer sleep quality, and poorer physical health compared to women without hot flashes. Multivariate analyses revealed that, even after controlling for relevant medical, demographic, and treatment variables, the prevalence of hot flashes significantly (p < 0.05) predicted poorer sleep quality, more fatigue, and worse physical health. The results indicate that hot flashes are experienced by a sizable percentage of postmenopausal breast cancer patients as they undergo treatment. Hot flashes during cancer treatment appear to have a negative impact upon patient quality of life that may be due, in part, to fatigue and interference with sleep. Future research should seek to evaluate interventions to relieve hot flashes during breast cancer treatment as a means of improving patient quality of life.

The influence of alcohol expectancy priming and mood manipulation on subsequent alcohol consumption.

Studies showing that verbal priming can implicitly affect alcohol consumption have been used to support cognitive models of expectancies. However, because expectancy words reflect affective states as well as drinking outcomes, mediation through an affective pathway remains theoretically plausible (i.e., such words inadvertently may affect mood, which in turn influences drinking). The primary pathway was identified (and expectancy theory was tested) by comparing memory priming (using alcohol expectancy or neutral words) with mood induction (using positive or neutral music); an unrelated experiment paradigm allowed the priming manipulation to implicitly affect drinking. Men in the alcohol priming group drank significantly more than men in each of the other conditions, and, consistent with theory, men with histories of heavier drinking drank the most when primed with alcohol expectancies, indicating that expectancies can function as automatic memory processes.

A multidimensional measure of fatigue for use with cancer patients.

PURPOSE: The purpose of this study was to develop and validate a multidimensional measure of fatigue for use with cancer patients. DESCRIPTION OF STUDY: Items for the Multidimensional Fatigue Symptom Inventory (MFSI) were generated through literature review, discussion with healthcare providers, and a survey of currently available measures of fatigue. The 83-item MFSI was designed to assess global, somatic, affective, cognitive, and behavioral symptoms of fatigue. The instrument was administered on three occasions to 275 women who had received or were undergoing treatment for breast cancer and 70 women with no history of cancer. Reliability, validity, and factorial structure of the MFSI were analyzed. RESULTS: The factor analysis produced five empirically derived scales that correspond generally to the five rationally derived scales. Reliability of the rationally and empirically derived scales was excellent (alpha coefficients .87 to .96). Estimates of test-retest reliability were also favorable. Other results support the validity of both the rationally and empirically derived scales. The MFSI appears to be sensitive to fatigue, accurately discriminating cancer patients from control subjects and between patients with varying levels of performance status. CLINICAL IMPLICATIONS: The MFSI may be useful in identifying patterns of fatigue within individual patients and across treatment modalities. Such specificity may allow the clinician to develop, implement, and evaluate interventions that are targeted for differing patterns of fatigue. Because the measure is keyed to a 1-week time frame, it may be useful during the course of cancer treatment. The MFSI appears to be a valid and reliable tool to assess the full spectrum of symptoms that characterize the construct of fatigue.