Emotional state, fatigue, functional status and quality of life in breast cancer: exploring the moderating role of psychological inflexibility

Previous findings demonstrate that psychological flexibility (PF) might be a protective factor regarding distress in breast cancer patients. Our research aimed to examine the moderating effect of psychological inflexibility (PI) on the relationship between emotional state, fatigue, functional status and quality of life (QOL) in breast cancer. The research was conducted on 64 women (M-age=58.36, SD=11.30) while undergoing radiation therapy. Five moderation analyses were performed with depression, anxiety, stress (Depression Anxiety Stress Scales - 21; DASS-21), fatigue (the Fatigue Assessment Scale Serbian; FAS) and functional status (the Upper Extremity Functional Index; UEFI) as predictors, QOL (Quality of Life Instrument - Breast Cancer Patient Version; QOL-BC) as criterion and PI (Acceptance and Action Questionnaire; AAQ II) as a moderator. The significant moderating effect of PI was obtained in the relationship of QOL with the depression, anxiety, fatigue and functional status. As anxiety, depression, fatigue and functional difficulties decrease, participants who are psychologically flexible report better QOL. On the other hand, psychologically inflexible individuals consistently report impaired QOL, regardless of whether indicators of depression, anxiety, fatigue and diminished functional status are prominent or not. Our findings support the notion that PF may have an important role in the improvement of emotional state and QOL in breast cancer patients. It would be also plausible to assume that interventions aimed at modifying the capacity for PF, might be useful in coping with fatigue and functional complications, which should be explored in future studies.