Effects of Chemotherapy-Induced Peripheral Neuropathy in Women With Breast Cancer: A Structural Equation Approach With the Theory of Unpleasant Symptoms

Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common neurotoxic effect. Chemotherapy-induced peripheral neuropathy symptoms have multidimensional characteristics that are associated with various physiologic, psychological, and situational factors and affect individual’s abilities to effectively function in performing daily tasks. The theory of unpleasant symptoms mediates the relationships among CIPN symptom experience, reduced performance in daily tasks, and causative factors. Objectives The aim of this study was to examine how influencing factors (physiologic, psychological, and situational) affect CIPN symptoms and the impact of symptom experience on functional interference in daily activities of chemotherapy-treated breast cancer survivors. Methods A cross-sectional survey about causative factors, CIPN symptoms, and functional interference was completed by 190 women treated with adjuvant chemotherapy for nonmetastatic breast cancer. The hypothetical model was tested using structural equation modeling analysis. Results The proposed model provided a good fit to the data. Physiologic and psychological factors accounted for 25.5% of the variance in CIPN symptom experience and explained 37.1% of the variance interfering with functional performance through CIPN symptom experience. Conclusion Disease- and treatment-related physiologic factors and coexisting psychological distress play crucial roles in explaining CIPN symptom experience and daily function in breast cancer survivors. Implications for Practice The findings help healthcare professionals to improve long-term care for breast cancer survivors in terms of education for self-monitoring, coping, and establishing supportive environment that can contribute to reducing the unmet needs and interference associated with persistent CIPN.