Physical activity and fatigue in breast cancer survivors: a panel model examining the role of self-efficacy and depression
Open accessAbstract
Background: Physical activity is associated with reductions in fatigue in breast cancer survivors. However, mechanisms underlying this relationship are not well-understood. The purpose of this study was to longitudinally test a model examining the role of self-efficacy and depression as potential mediators of the relationship between physical activity and fatigue in a sample of breast cancer survivors using both self-report and objective measures of physical activity. Methods: All participants (N = 1,527) completed self-report measures of physical activity, self-efficacy, depression, and fatigue at baseline and 6 months. A subsample was randomly selected to wear an accelerometer at both time points. It was hypothesized that physical activity indirectly influences fatigue via self-efficacy and depression. Relationships among model constructs were examined over the 6-month period using panel analysis within a covariance modeling framework. Results: The hypothesized model provided a good model-data fit (χ2 = 599.66, df = 105, P ≤ 0.001; CFI = 0.96; SRMR = 0.02) in the full sample when controlling for covariates. At baseline, physical activity indirectly influenced fatigue via self-efficacy and depression. These relationships were also supported across time. In addition, the majority of the hypothesized relationships were supported in the subsample with accelerometer data (χ2 = 387.48, df = 147, P ≤ 0.001, CFI = 0.94, SRMR = 0.04). Conclusions: This study provides evidence to suggest the relationship between physical activity and fatigue in breast cancer survivors may be mediated by more proximal, modifiable outcomes of physical activity participation. Impact: Recommendations are made relative to future applications and research concerning these relationships. Cancer Epidemiol Biomarkers Prev; 22(5); 773–81. ©2013 AACR.
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Psychological flexibility and self-efficacy may contribute to differences in pain severity and the impact of persistent post-surgical pain.
“Two additional psychosocial variables that may contribute to differences in the experience of pain severity and the impact of PSP are: 1) psychological flexibility18–20, a flexible behavior pattern broadly oriented toward ones chosen personal values, even in the presence of discomforts (such as pain), and 2) self-efficacy21–25, the belief in one’s ability to effectively manage pain.”
From Improving well-being for individuals with persistent pain after surgery for breast cancer, lobular carcinoma in situ, or ductal carcinoma in situ: A randomized clinical trial (2022) · cites this paper as [24]
The citation is attached to the self-efficacy portion of the sentence, not psychological flexibility. The Results (Model Results; page unavailable) associate exercise self-efficacy with fatigue and depression in breast cancer survivors. The Measures section assesses confidence in exercising, not managing pain; the paper does not establish a relationship with persistent post-surgical pain severity or its impact. (LLM, conf=0.78)
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- Authors
- Phillips, S. M., & McAuley, E.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- Corresponding author
- Phillips, Siobhan M.
- Venue
- Cancer Epidemiology, Biomarkers & Prevention
- Published
- 2013-05-01
- Volume
- 22
- Issue
- 5
- Pages
- 773-781
- ISSN
- 1055-9965 (ISSN-L)
- 1538-7755
- PMC
- PMC3650084
- OpenAlex
- W2138428156
- Cited by
- 63
- References
- 63
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 7 · 2018: 7 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 7 · 2013: 1
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R56AG020118, F31AG034025, R01AG020118, AG020118)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- physical activity, fatigue, breast cancer survivors, self-efficacy, depression, mediation, accelerometer-measured activity, cancer survivorship
- MeSH terms
- Breast Neoplasms, Data Collection, Depressive Disorder, Fatigue, Female, Humans, Longitudinal Studies, Middle Aged, Motor Activity, Quality of Life, Surveys and Questionnaires, Survivors, Self Efficacy, Self Report, Accelerometry
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