Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study

PURPOSE: As many patients experience distress after breast cancer, we investigated whether perceived self-efficacy predicts breast cancer patients' emotional, physical and social well-being and whether mental adjustment styles mediate this association.

METHODS: A sample of 684 women with breast cancer completed a questionnaire including the general self-efficacy scale at baseline, the Mini-MAC at 1-month follow-up and the EORTC QLQ-C30 at 12-month follow-up. Multiple linear regression was used to assess associations between self-efficacy, mental adjustment style and well-being. Disease-related and sociodemographic factors were examined as confounders.

RESULTS: Greater self-efficacy at baseline was associated with emotional well-being after 12 months (beta = 0.59; 95% CI, 0.35-0.82). Fighting spirit, anxious preoccupation and helplessness-hopelessness partly mediated the effect of self-efficacy, but self-efficacy also had a direct effect on emotional functioning (beta = 0.26; 95% CI, 0.02-0.51). No association was found between self-efficacy and physical and social well-being. Significant associations were observed between self-efficacy and education and time since diagnosis and also between well-being and age, education, relapse and time since diagnosis.

CONCLUSION: Self-efficacy was a significant predictor of an active adjustment style and emotional well-being in breast cancer patients. Hence, it could be a valuable target of rehabilitation programs.