Exercise in breast cancer survivors: Predicting quality of life with the Cognitive -Appraisal Model of Stress and Coping
Abstract
Breast cancer survivors face a multitude of physical and psychological sequelae following treatment with potential negative impact on quality of life (QOL). Past research has demonstrated that these physical and psychological symptoms are amenable to improvement with exercise, and breast cancer survivors who exercise regularly report greater use of adaptive coping than women who are sedentary. This study investigated the relationship between exercise and QOL of breast cancer survivors, in addition to physical, psychological, and cognitive correlates as outlined by the Cognitive-Appraisal Model of Stress and Coping. Ninety-eight breast cancer survivors, recruited through an existing research database, local cancer center, support group newsletter, and gyms completed surveys via mail assessing physical health and symptoms, mood, QOL, coping, social support, appraisals, body-esteem, and health locus of control. Group comparisons were made on physical health, mental health, health locus of control, social support and coping between women considered high in exercise and women low in exercise, based on a median split of the Godin Leisure Time Index. Exploratory correlation analyses were conducted between appraisals and the remaining variables outlined in the Cognitive-Appraisal Model of Stress and Coping. Finally, an exploratory path analysis was conducted to examine associations between appraisals, exercise, coping, and social support and physical and mental health QOL. The results indicated significant group differences based on exercise status in general health, mental health and exercise confidence, but not physical symptoms, health locus of control, social support or coping. Appraisals correlated most strongly with mental health and social support. The data revealed limited support for the Cognitive-Appraisal Model of Stress and Coping in predicting QOL. Appraisals failed to correlate with coping and active coping did not correlate with physical or mental health QOL. The trimmed model suggested exercise is an important determinant of physical health. It also identified harm/loss and threat appraisals and escapist coping as detrimental to mental health QOL. More research is needed clarifying relations among stress, appraisals, coping and QOL, and to determine the mechanisms by which exercise improves QOL and what frequency and types of activity bestow maximum benefit to cancer survivors.
Degree
Ph.D.
Advisors
Bigatti, Purdue University.
Subject Area
Psychotherapy
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