Patient-Reported Self-Efficacy, Anxiety, and Health-Related Quality of Life During Chemotherapy: Results From a Longitudinal Study

PURPOSE/OBJECTIVES: To explore changes over time in self-efficacy and the predictive ability of changes in state anxiety and health-related quality of life during chemotherapy.
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DESIGN: Secondary analysis of a longitudinal dataset derived from a larger, multicenter study.
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SETTING: Outpatient oncology clinics across eight general hospitals in England, Scotland, and Northern Ireland.
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SAMPLE: 137 patients scheduled to receive adjuvant chemotherapy for breast or colorectal cancer.
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METHODS: At the beginning of each of six chemotherapy cycles, participants completed the Strategies Used by People to Promote Health questionnaire, the State-Trait Anxiety Inventory, and the Functional Assessment of Cancer Therapy-Breast or -Colorectal questionnaire. Multilevel model analysis was used to analyze longitudinal data, adjusted for demographic and clinical variables.
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MAIN RESEARCH VARIABLES: Self-efficacy, anxiety, and health-related quality of life.
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FINDINGS: No significant time effects were found for patients' overall perceived self-efficacy or self-efficacy parameters. A trend toward greater self-efficacy was evident as chemotherapy progressed. Self-efficacy was significantly associated with decreased state anxiety throughout chemotherapy. Increases in overall self-efficacy and perceived ability to maintain a positive attitude were significantly associated with over-time increases in physical, emotional, and functional well-being, as well as with fewer cancer-related concerns.
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CONCLUSIONS: Findings highlight the importance of clinical assessments throughout treatment that focus on patients' perceived self-efficacy as a positive regulator of mood and well-being. 
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IMPLICATIONS FOR NURSING: The current study suggests self-efficacy enhancement should be a key component of psycho-behavioral programs designed to support patients with cancer throughout chemotherapy.