Perceived stress and resilience in women after cancer: Examining the impact of a lifestyle intervention in women previously treated for breast, gynecological or blood cancer

Abstract

Introduction: For most women a cancer diagnosis is associated with considerable stress and anxiety. While symptoms can abate over time, some women report persistently elevated distress and this has been linked with a number of adverse health outcomes. This paper examines the reciprocity between perceived stress and resilience over a 24 week period and explores the potential impact of a lifestyle intervention to decrease stress and enhance resilience. Methods: Longitudinal data from 351 women previously treated for breast, gynaecological or blood cancer from the Australian Women’s Wellness After Cancer Program (WWACP) were examined. Perceived stress (Perceived Stress Scale) and resilience (Connor-Davidson Resilience Scale 10) were measured across 3 time points (baseline, 12 weeks post-intervention, and 24 weeks for sustained change) and were analysed using hierarchical regression models. Results: At baseline, more than half (56%) of women reported moderate (PSS range from14-26) or high (PSS ≥ 27) perceived stress. Correlations between perceived stress and resilience at all time points suggested that while the indices were correlated, they were empirically distinguishable (Time 1: r = -.54; Time 2: r = -.61; Time 3: r = -.65). Linear mixed-effect models estimated the relationships between perceived stress and resilience by group (intervention vs. control) over time. Results showed significant within-group (p <.05) and interaction (time x group, p <.01) effects for perceived stress and a significant interaction effect (p <.05) for resilience between baseline and 24 weeks. Conclusions: Findings suggested that while perceived stress as relatively high in this group, symptoms were amenable to intervention. This study highlights the importance of stress reduction and positive coping strategies to promote emotional wellbeing for women previously treated cancer.