Sources of Stress for Breast Cancer Survivors Involved in Dragon Boating: Examining Associations with Treatment Characteristics and Self-Esteem

This study sought to (1) identify common stressors faced by breast cancer survivors involved in dragon boating, (2) examine the conceptual and statistical factor groupings of the stressors, (3) identify differences in stressor factors based on treatment characteristics, and (4) examine the associations between stressor factors and two indicators of self-esteem.Survivors (n = 470) involved in dragon boating completed a survey assessing stressor frequency, stressor intensity, stressor valence, physical self-worth, and global self-esteem, along with demographic and cancer treatment information.An exploratory factor analyses (EFA) using maximum likelihood extraction with oblique rotation revealed a four-factor solution that included physical, emotional, social, and exercise-related stressors. Exercise-related stressors were reported more frequently and intensely but were appraised positively by most survivors. The physical, emotional, and social stressors were perceived predominantly as negative. Findings also revealed that physical and emotional stressors and exercise-related stressors were correlates of physical self-worth (R(2) = 0.26). Emotional, social, and exercise-related stressors were significant correlates of global self-esteem (R(2) = 0.11). Cancer treatments were also associated with the experience of stressors, with the strongest effects reported for chemotherapy treatment.Overall, the results demonstrate that participants experienced many stressors but that exercise-related stressors were viewed as more adaptive and were positive correlates of self-esteem processes.