A number of studies have shown that self-rated health reliably predicts mortality. This study assessed the impact of perseveration on self-rated health, physical functioning, and physical symptoms (pain, fatigue, breast cancer symptoms) among breast cancer patients. We hypothesized that cancer-related distress would serve as an intervening variable between both worry and rumination and self-rated health, physical functioning, and physical symptoms. Women (N = 124) who were approximately 7 weeks post-surgery but pre adjuvant treatment completed the Impact of Events Scale, the Penn State Worry Questionnaire, and the Rumination Scale. They also rated their pain, fatigue, physical functioning, and self-rated health using the RAND-36 and breast cancer symptoms with the Breast Cancer Prevention Trial Symptom Checklist (BCPT). Covariates included body mass index, age, cancer stage, menopause status, and physical comorbidities. Worry was associated with higher cancer-related distress, which in turn predicted greater pain and breast cancer symptoms, poorer physical functioning, and lower self-rated health. Rumination also predicted greater cancer-related distress, which ultimately contributed to greater pain along with poorer physical functioning and self-rated health. Models with fatigue as an outcome were not significant. These findings suggest that perseveration can heighten cancer-related distress and subsequent perceptions of physical symptoms and health among breast cancer patients prior to adjuvant treatment. Perseveration early in the cancer trajectory can adversely increase the impact of a cancer diagnosis and treatment on functioning and quality of life.

许多研究表明，自我评估的健康状况可以可靠地预测死亡率。本研究评估了坚持不懈对乳腺癌患者自评健康、身体机能和身体症状（疼痛、疲劳、乳腺癌症状）的影响。我们假设与癌症相关的痛苦将成为担忧和沉思与自评健康、身体机能和身体症状之间的干预变量。妇女 ( N = 124）在手术后约 7 周但辅助治疗前完成了事件影响量表、宾夕法尼亚州立大学忧虑问卷和反刍量表。他们还使用 RAND-36 评估了他们的疼痛、疲劳、身体机能和自评健康状况，并使用乳腺癌预防试验症状清单 (BCPT) 评估了乳腺癌症状。协变量包括体重指数、年龄、癌症分期、绝经状态和身体合并症。担心与更高的癌症相关痛苦有关，这反过来又预示着更大的疼痛和乳腺癌症状、更差的身体机能和更低的自我评估健康状况。反刍还预示着与癌症相关的更大痛苦，最终导致更大的疼痛以及更差的身体机能和自我评估的健康状况。以疲劳为结果的模型并不显着。这些研究结果表明，在辅助治疗之前，坚持不懈会增加乳腺癌患者与癌症相关的痛苦以及随后对身体症状和健康的感知。在癌症轨迹的早期坚持可能会不利地增加癌症诊断和治疗对功能和生活质量的影响。