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Coping, psychopathology, and quality of life in cancer patients under palliative care

Published online by Cambridge University Press:  30 April 2014

Daniela B. Sorato  and
Flávia L. Osório
Daniela B. Sorato*
Affiliation:
Palliative Care/Pain Unit, Barretos Cancer Hospital, PIO XII Foundation, Barretos, Brazil
Flávia L. Osório
Affiliation:
Barretos Cancer Hospital, PIO XII Foundation, and School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
*
Address correspondence and reprint requests to: Daniela Batista Sorato, Hospital São Judas Tadeu, Fundação Pio XII, Rua 20, n. 221, Centro, CEP, 14780-070, Barretos SP, Brazil. E-mail: danibspsico@yahoo.com.br
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Abstract

Objective:

To assess hopelessness, anxiety, depression, and quality of life in cancer patients undergoing palliative treatment by comparing their scores at the onset of treatment and one month later and by assessing possible correlations with coping strategies.

Method:

Participants included 85 patients of both genders (56.5% female) diagnosed with advanced cancer who did not have curative therapeutic options who were assessed with self-applied instruments (the Beck Hopelessness Scale, the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire–Cancer 30, the Hospital Anxiety and Depression Scale, and the Coping Strategies Inventory by Folkman and Lazarus) at two timepoints: first before their appointment with doctors and other professionals in their first visit to the palliative care outpatient clinic (PCOC) and then as soon as patients arrived at the PCOC for their first medical follow-up visit (approximately 30 days after the first appointment).

Results:

The scores for hopelessness, anxiety, and depression remained stable (p = 0.24). The results were the same for the quality-of-life (QoL) variables, except for the fatigue and pain scores, which decreased (p = 0.01), and social impairment, which increased (p = 0.03). Analysis of the correlations between the coping mechanisms used after the onset of palliative treatment showed that confronting coping, seeking social support, and positive reappraisal were inversely correlated with hopelessness. Seeking social support, planful problem solving, and positive reappraisal were inversely correlated with indicators of depression. In contrast, use of the escape–avoidance strategy and reduced use of the planful problem-solving strategy were associated with increased anxiety.

Significance of results:

The employment of problem-focused coping strategies exerted a positive impact on the end-of-life process and, above all, protected patients from the negative experiences associated with psychiatric symptoms, thus enabling them to look for alternative solutions for experiencing the end-of-life process in a more well-adjusted manner.

Keywords

CancerOncologyPalliative carePsychopathological symptomsCopingQuality of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 3 , June 2015 , pp. 517 - 525
Copyright
Copyright © Cambridge University Press 2014 

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