Improvements in physical and mental health following a rehabilitation programme for breast cancer patients Aina Johnsson a, b, * , Artur Tenenbaum c , Hugo Westerlund d a Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Social Work, Sweden b Department of Social Work, Karolinska University Hospital, Stockholm, Sweden c Hälsan & Arbetslivet in the Västra Götaland Region, Sweden d National Institute for Psychosocial Medicine, Stockholm, Sweden Keywords: Breast cancer In-patient rehabilitation Life satisfaction Mental health abstract Purpose: To investigate how breast cancer patients referred to in-patient rehabilitation at Mösseberg Rehabilitation Centre (MRC) in Sweden perceive their life situation, and if their life satisfaction and mental health have changed three months later. Method: This prospective study is based on 46 women, all of them in working age. Three validated questionnaires were used, the Life Satisfaction (Li-Sat 11) scale, the Maastricht Questionnaire and the Shirom-Melamed Burnout Questionnaire (SMBQ). Results: Statistically significant improvements for the variables physical and mental health were seen in the measurements made using the Li-Sat 11 scale. The SMBQ survey showed a statistically significant improvement in the composite results for the indices involved. Likewise, the Maastricht Questionnaire showed statistically significant improvements in health status with respect to feelings of exhaustion and fatigue. Conclusion: More effective treatments have resulted in an increase in the number of breast cancer survivors and in the demand for rehabilitation. This study shows improvements in health and satis- faction with health, but cannot conclude this result as only an effect of the rehabilitation programme. Since only a few studies have until now shed light on the benefits of in-patient rehabilitation following a breast cancer diagnosis, there is an urgent need for continued research in this area. Ó 2010 Elsevier Ltd. All rights reserved. Introduction Breast cancer is the most common type of cancer among women in the Western world. Over 7000 women are diagnosed with breast cancer in Sweden each year. Women who develop breast cancer are often offered a combination of therapies, such as surgery, radiation therapy, hormonal therapy and chemotherapy. Thanks to the treatments that are available, more and more women are being cured of their malignancies (Talbäck et al., 2003). Breast cancer and its attendant therapies can cause biological, physical, mental and social problems. The nature of these problems varies over time (Hewitt et al., 2003; Kim et al., 2008). The psychosocial effects of the disease and its consequences in terms of quality of life have been described in numerous studies. Examples of reactions characterized as common in the literature include anxiety and depression (Shapiro et al., 2001). Some of the conse- quences of the disease are universal, while others depend on the woman’s current life situation (Sammarco, 2001). The physical damage that can occur is often disabling. One example of such damage is lymphoedema and other arm complications after axil- lary node dissection for breast cancer (Loudon and Petrek, 2000; Nagel et al., 2003). Women who develop lymphoedema have more difficulty performing their jobs and leisure activities than women who are not affected by lymphoedema (Carter, 1997; Ververs et al., 2001). Women often require rehabilitation following breast cancer treatment. The studies that have been conducted concerning the benefits of exercise or physical activity in connection with a breast cancer diagnosis indicate that patients rehabilitate more quickly and see their quality of life improve if they engage in such activities (Bicego et al., 2009; Cramp and Daniel, 2008). Research, such as that conducted at the rehabilitation hospital Sonnenberg-Klinik Bad Sooden-Allendorf in Germany (Heim et al., 2007) and at the ‘Reha- Klinik Am Kurpark’ in Bad Kissingen, Germany (Hartmann et al., 2007) has shown that breast cancer patients both need and * Corresponding author. Department of Oncology, Södersjukhuset, SE-118 83 Stockholm, Sweden. Fax: þ46 8 616 44 88. E-mail address: aina.johnsson@karolinska.se (A. Johnsson). Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon 1462-3889/$ e see front matter Ó 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejon.2010.05.004 European Journal of Oncology Nursing 15 (2011) 12e15