Stress Reactivity, Health Behaviors, and Compliance to Medical Care in Breast Cancer Survivors

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To explore relationships among quality of life (QOL), stress reactivity, health behaviors, and compliance to medical care in breast cancer survivors.


One-time descriptive laboratory study.


A visual motor laboratory at a rural university in the southeastern United States.


25 breast cancer survivors.


Participants were subjected to the Trier Social Stress Test (TSST) in a laboratory setting and completed questionnaires at home prior to and after the laboratory session.

Main Research Variables:

Changes in heart rate variability (HRV), salivary cortisol, and state anxiety from the State-@ Trait Anxiety Inventory (STAI) estimated stress reactivity. Health behaviors, QOL, and trait anxiety were determined by questionnaires. Compliance to medical care was determined from medical records.


Analyses of variance (ANOVAs) indicated that QOL scores were higher for participants with lower compared to higher stress reactivity (p < 0.05). In addition, ANOVAs revealed that participants high in compliance to medical care indicated a lower stress response as determined by HRV (p < 0.01) and the STAI (p < 0.05) compared to those low in compliance. No significant differences were noted in any of the health behaviors based on stress reactivity.


The data suggest that breast cancer survivors who indicate the greatest stress reactivity tend to have the poorest compliance to medical care and lowest QOL. Implications for Nursing: Nurses may wish to provide additional support to breast cancer survivors who indicate high stress reactivity in the hopes of improving compliance to medical care and QOL.

Knowledge Translation:

The data suggest that supportive care strategies that reduce stress could potentially improve compliance to medical care in breast cancer survivors. In addition, strategies for managing stress may result in improvements in QOL. Health behaviors, according to the data, do not seem to be influenced by stress reactivity.

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