Health-Promotion Behaviors and Psychological Distress in Cancer Survivors

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To determine whether cancer survivors engage in health-promotion behaviors, to evaluate the extent of their experience of psychological distress, and to investigate the relationship between the practice of health-promotion behaviors and psychological distress.


Cross-sectional secondary data analysis.


A national, face-to-face interview conducted by personnel of the U.S. Census Bureau using a random sampling of American adults.


1,784 survey respondents who reported a previous cancer diagnosis.


Data from the 2009 National Health Interview Survey were used to examine the prevalence of smoking, physical inactivity, alcohol use, and reports of psychosocial distress. Interviews pertained to the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive.

Main Research Variables:

Age, current smoking prevalence, alcohol consumption, physical activity, and the experience of feeling hopelessness, sadness, and anxiety.


Cancer survivors continue to smoke at a rate similar to the national average. Overall, most respondents reported no symptoms of psychological distress. However, age appears to play a major role, showing significant differences in the prevalence of current smoking, participation in physical activity, alcohol use, and reported level of distress.


This study provides estimates of the prevalence of health-promotion behaviors and experience of psychological distress among American cancer survivors. The results reveal opportunities for interventions among cancer survivors.

Implications for Nursing:

Nurses should be proactive in providing guidance to survivors regarding the adoption of healthy lifestyle behaviors. Those who encounter younger cancer survivors need to be alert to the higher potential for distress in that population, perform appropriate screenings, and be prepared to offer guidance, supportive care, and referrals for psychological care if needed.

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