Centrality of event and cancer-related post-traumatic stress symptoms: an explorative analysis in Danish and Palestinian breast cancer patients — ASN Events
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Centrality of event and cancer-related post-traumatic stress symptoms: an explorative analysis in Danish and Palestinian breast cancer patients (#288)

Maja Johannsen 1 , Mimi Y. Mehlsen 1 2 , Maja O'Connor 3 , Bashir Hajjar 4 , Anders B. Jensen 5 , Robert Zachariae 1 2
  1. Unit of Psychooncology and Health Psychology, Dept. of Oncology, Aarhus University Hospital, Aarhus, Denmark
  2. Unit of Psychooncology and Health Psychology, Dept. of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark
  3. Dept. of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark
  4. Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
  5. Dept. of Oncology, Aarhus University Hospital, Aarhus, Denmark

Background: Cancer diagnosis has been associated with post-traumatic stress (PTS). Several risk factors may influence the development of PTS-symptoms, including the degree to which the cancer diagnosis is construed as a central reference point for the patients’ personal identities.

Aim: To investigate the association between centrality of the cancer diagnosis and PTS-symptoms and explore possible differences between two culturally distinct samples.

Methods: As part of two larger studies, 489 of 643 Palestinian women (mean age: 47.6 yrs) and 683 of 992 Danish women (mean age: 58.1 yrs) treated for breast cancer completed cancer-related versions of the Centrality of Event Scale (CES) and the Impact of Event Scale-Revised (IES-R).

Results: Palestinian women had considerably higher IES-scores (M=39.85; SD=13.7) than Danish women (M=15.68; SD=21.73) (p>0.001). In contrast, Danish women showed higher CES-scores (M=22.25, SD=6.57) than Palestinian women (M=19.48, SD=6.58) (p>0.001). When adjusting for demographic and clinical variables in multiple regressions, adding CES-scores to the model yielded a slightly higher increase in R2 in the Danish (∆R2=0.29) than in the Palestinian (∆R2=0.23) sample. In the Palestinian sample, IES-scores were associated with higher CES-scores (β=0.52, p<0.001; CI:0.91-1.24), not receiving radiotherapy (β=0.24, p<0.001; CI:-9.90 to -4.97), higher educational level (β=0.11, p<0.01; CI:1.01-5.98), and number of children (β=0.12, p<0.01; CI:0.22-1.41). In the Danish sample, CES-scores (β=0.57, p<0.001; CI:1.44-1.82), older age (β=0.10, p<0.05; CI:0.04-0.39), and lower educational level (β=0.13, p<0.001; CI:-11.49 to -3.84) predicted IES-scores.

Conclusions: The degree to which the cancer diagnosis is perceived as central to identity may increase PTS-symptomatology. Although Palestinian women, compared to Danish women, experienced more PTS-symptoms and perceived the diagnosis as less central to their identity, the centrality of the cancer remained a significant predictor in Palestinian women. Furthermore, different demographic and clinical factors appeared to predict PTS-symptoms in the two culturally distinct samples. Further exploration of cultural differences is needed.