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. 2024 Nov 26;12(1):693.
doi: 10.1186/s40359-024-02211-9.

Effective and ineffective psychological adjustment in breast cancer patients before receiving neoadjuvant chemotherapy: insights from a cohort study

Majid Omari  1   2   3 , Salima Kriya  4   5 , Sara Nadi  4   6 , Ghita Zerhouni  7 , Chaymae El Abbas  7 , Achraf El Asri  4   6 , Zineb Benbrahim  8   9 , Nawfel Mellas  8   9 , Karima El Rhazi  4 , Mohammed El Amine Ragala  4   7 , Jaouad El Hilaly  10   11 , Karima Halim  12   13 , Lamiae Amaadour  8   9 , Btissame Zarrouq  14   15
Affiliations

Effective and ineffective psychological adjustment in breast cancer patients before receiving neoadjuvant chemotherapy: insights from a cohort study

Majid Omari et al. BMC Psychol. .

Abstract

Background: The timing of a breast cancer (BC) diagnosis has a significant psychological impact on patients. However, it reported that those eligible for treatment regimens based on neoadjuvant chemotherapy may experience high levels of depression, anxiety and distress. To cope with this situation, patients deploy psychological coping strategies. The aim of this study is to explore effective and ineffective psychological adjustment mobilized by Moroccan patients newly diagnosed with BC and before receiving neoadjuvant chemotherapy, as well as to identify their associations to socio-demographic and clinical determinants.

Materials and methods: A total of 209 patients were recruited in outpatient in oncology department in the public oncology hospital of Fez city, between 2021 and 2023. Ethics approval was obtained for this study and patients has signed an informed consent form. The questionnaire interview included socio-economic and clinical variables and the Arabic version of Mini-Mental Adjustment to Cancer (Mini-MAC) scale, which measures the strategies of mental adjustment to disease, as fighting spirit (FS), hopelessness/helplessness (HH), anxious preoccupations (AP), cognitive avoidance (CA), fatalism (FA), "maladaptive coping" and "adaptive coping". Bivariate analysis of psychological adjustment strategies and sociodemographic and clinical variables was carried out using statistical tests according to the nature of the variables, to their normality and the homogeneity of their variances. Univariate and multivariate linear regression modelling was carried out using a forward "enter" regression procedure.

Results: A mean age of 47.43 ± 9.45 was found among participants. Assessment of mental adjustment to cancer using Mini-MAC scores revealed that psychological adjustment strategies with a higher mean score were FA, FS and "adaptive coping" strategies. Based mainly on multiple linear Regression, monthly family income was negatively associated with HH, and FS and positively linked to FA and "adaptive coping" strategies. Moreover, the left side as BC laterality was negatively associated with AP and "maladaptive coping" strategies. Furthermore, positive ER status was negatively associated with HH and "maladaptive coping" strategies and high Ki-67 levels were positively linked to AP.

Conclusion: Programs to strengthen psychological adjustment in patients with BC candidates for NACT, taking into consideration the determinants found associated in this study, are of great importance since the first oncology consultation.

Keywords: Breast cancer; Clinical determinants; Neoadjuvant chemotherapy; Psychological adjustment; Socio-demographic determinants.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted according to the guidelines of the Declaration of Helsinki and the ethical approval was obtained from the hospital-university ethics committee of Sidi Mohamed Ben Abdellah University (N°24/18). Informed consent was taken from all the participants. All the participants were notified about the aim of the study and had provided written consent before starting the investigation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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