Determinants of psychological distress and post-traumatic growth levels of breast cancer survivors during the COVID-19 pandemic: A controlled study

The main purpose of this study is to examine the factors associated with the psychological distress (depression, anxiety, and stress) and post-traumatic growth (TSG) levels of breast cancer survivors who had experienced an intensely stressful life event such as cancer before the Covid-19 pandemic. The sample of the study was composed of 95 breast cancer survivors between the ages of 26-74 (Mean= 49.86, SD= 9.31) as the study group, and 87 undiagnosed between the ages of 27-69 (Mean= 47.60, SD= 10.04) as the control group, with a total of 182 women. Sociodemographic Information Form, Depression Anxiety Stress Scale (DAS-21), Post Traumatic Growth Inventory (TSGE), Social Support Scale, Intolerance of Uncertainty Scale (IUS-12) and Coping Strategies Short Form (CS-SF) were administered to the participants. T-test, one-way analysis of variance (ANOVA), multivariate analysis of variance (MANOVA), Pearson correlation analysis and hierarchical regression analysis were applied to test the relationship between sociodemographic variables, Covid-19-related variables, social support, intolerance to uncertainty, coping strategies and psychological distress and PTG. According to the analyzes, the diagnosis of breast cancer was not effective in the depression and anxiety levels of women in the Covid-19 period. However, breast cancer diagnosis was associated with decreased stress and increased TSG levels. Decreased level of social support, increased intolerance of uncertainty and increased emotion-focused coping predict increased psychological distress, while decreased problem-focused coping predicted only increased anxiety and stress levels from independent variables. Increased level of social support, increased intolerance of uncertainty, and increased problem-focused coping were the variables that increased PTG level. As Covid-19-related factors, the fact that a relative of women was diagnosed with Covid-19 and women's relatives who died due to Covid-19 were associated with increased stress level, and women's self-diagnosis of Covid-19 was associated with increased TSG levels. As sociodemographic variables, age was negatively associated with stress level and education level was positively associated with PTG level. Finally, as the anxiety level increased, PTG level also increased. When the findings were evaluated, it was found that the variables affecting psychological distress and PTG were social support, intolerance to uncertainty and coping. For this reason, focusing on the results of this study by professionals working with both the general population and individuals who have experienced a traumatic process such as cancer will help therapeutic interventions that will contribute to the increase of positive psychological results while decreasing the negative psychological consequences of Covid-19 period.