Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-27T01:48:24.818Z Has data issue: false hasContentIssue false
  • English
  • Français

Stress and coping with advanced cancer

Published online by Cambridge University Press:  27 September 2006

BARBARA J. DE FAYE ,
KEITH G. WILSON ,
SUSAN CHATER ,
RAYMOND A. VIOLA  and
PIPPA HALL
BARBARA J. DE FAYE
Affiliation:
School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
KEITH G. WILSON
Affiliation:
Institute for Rehabilitation Research and Development, The Rehabilitation Centre, The Ottawa Hospital, Ottawa, Ontario, Canada
SUSAN CHATER
Affiliation:
Division of Palliative Medicine, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
RAYMOND A. VIOLA
Affiliation:
Palliative Care Medicine Program, Queen's University, Kingston, Ontario, Canada
PIPPA HALL
Affiliation:
Division of Palliative Medicine, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: For people with advanced cancer, the months preceding death can be very stressful. Moreover, cancer-related stressors can arise within multiple dimensions. However, little research has examined how people cope differentially with different types of stressors. The goal of this study was to examine patterns of coping across different dimensions of stress.

Method: Fifty-two patients who were receiving palliative care for cancer were asked to indicate their most significant stressors within social, physical, and existential dimensions. A structured interview was then conducted to describe how the participants coped with these stressors.

Results: Overall, stressor severity ratings were correlated significantly across the three dimensions, although physical symptoms received the highest mean rating. Participants generally used a range of coping strategies to deal with their stressors, but there were clear differences across dimensions in the relative use of problem-focused versus emotion-focused strategies. Problem-focused coping was less frequent for existential issues, whereas emotion-focused strategies were used less frequently for physical stressors. Coping efforts were not clearly related to psychological distress.

Significance of results: Although coping is an important research theme within psycho-oncology, it may be overly broad to ask, “How do people cope with cancer?” In fact, different cancer-related stressors are coped with in very different ways. There is not necessarily any particular pattern of coping that is best for relieving psychological distress.

Keywords

Palliative careStressCopingDepressionCancer
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 3 , September 2006 , pp. 239 - 249
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aldwin, C.M. (1994). Stress, Coping, and Development: An Integrative Perspective. New York: Guilford.
Aldwin, C.M., Sutton, K.J., Chiara, G., et al. (1996). Age differences in stress, coping, and appraisal: Findings from the Normative Aging Study. Journal of Gerontology: Psychological Science, 51B, 179–188.Google Scholar
Beck, A.T., Guth, D., Steer, R.A., et al. (1997). Screening for major depression in medical inpatients with the Beck Depression Inventory for Primary Care. Behaviour Research and Therapy, 35, 785–791.Google Scholar
Ben-Zur, H., Gilbar, O., & Lev, S. (2001). Coping with breast cancer: Patient, spouse and dyad models. Psychosomatic Medicine, 63, 32–39.Google Scholar
Brennan, J. (2001). Adjustment to cancer—coping or personal transition? Psycho-Oncology, 10, 1–18.Google Scholar
Cheng, C., Hui, W., & Lam, S. (2000). Perceptual style and behavioral pattern of individuals with functional gastrointestinal disorders. Health Psychology, 19, 146–154.Google Scholar
Chochinov, H.M., Hack, T., McClement, S., et al. (2002). Dignity in the terminally ill: A developing empirical model. Social Science and Medicine, 54, 433–443.Google Scholar
Chochinov, H.M., Wilson, K.G., & Enns, M. (1998). Depression, hopelessness and suicidal ideation in the terminally ill. Psychosomatics, 39, 366–370.Google Scholar
Classen, C., Koopman, C., Angell, K., et al. (1996). Coping styles associated with psychological adjustment to advanced breast cancer. Health Psychology, 15, 434–437.Google Scholar
Cohen, S.R., Mount, B.M., Bruera, E., et al. (1997). Validity of the McGill Quality of Life Questionnaire in the palliative care setting: A multi-centre Canadian study demonstrating the importance of the existential domain. Palliative Medicine, 11, 3–20.Google Scholar
Cohen, S.R., Mount, B.M., Thomas, J.J.N., et al. (1996). Existential well-being is an important determinant of quality of life. Cancer, 77, 576–586.Google Scholar
Compas, B.E., Malcarne, V.L., & Fondacaro, K.M. (1988). Coping with stressful events in older children and adolescents. Journal of Consulting and Clinical Psychology, 56, 167–175.Google Scholar
Corr, C.A. (1991–1992). A task-based approach to coping with dying. Omega, 24, 81–94.Google Scholar
Coyle, N., Adelhardt, J., Foley, K.M., et al. (1990). Character of terminal illness in the advanced cancer patient: Pain and other symptoms during the last 4 weeks of life. Journal of Pain and Symptom Management, 5, 83–93.Google Scholar
Coyne, J.C. & Racioppo, M.W. (2000). Never the twain shall meet? Closing the gap between coping research and clinical intervention research. American Psychologist, 55, 655–663.Google Scholar
Cunningham, A.J. (1992). The Healing Journey. Toronto: Key Porter Books.
Curtis, E.B., Krech, R., & Walsh, T.D. (1991). Common symptoms in patients with advanced cancer. Journal of Palliative Care, 7, 25–29.Google Scholar
Dunkel-Schetter, C., Feinstein, L.G., Taylor, S.E., et al. (1992). Patterns of coping with cancer. Health Psychology, 11, 79–87.Google Scholar
Epping-Jordan, J.E., Compas, B.E., Osowiecki, D.M., et al. (1999). Psychological adjustment in breast cancer: Processes of emotional distress. Health Psychology, 18, 315–326.Google Scholar
Feifel, H., Strack, S., & Nagy, V.T. (1987). Coping strategies and associated features of medically ill patients. Psychosomatic Medicine, 49, 616–625.Google Scholar
Folkman, S. (1992). Making the case for coping. In Personal Coping: Theory, Research and Application, Carpenter, B. (ed.), pp. 31–46. Westport, CT: Praeger.
Gotay, C.C. (1984). The experience of cancer during early and advanced stages: The views of patients and their mates. Social Science and Medicine, 18, 605–613.Google Scholar
Hack, T.F. & Degner, L.F. (2004). Coping responses following breast cancer diagnosis predict psychological adjustment three years later. Psycho-Oncology, 13, 235–247.Google Scholar
Heim, E., Valach, L., & Schaffner, L. (1997). Coping and psychosocial adaptation: Longitudinal effects over time and stages in breast cancer. Psychosomatic Medicine, 59, 408–418.Google Scholar
Hinton, J. (1994). Which patients with terminal cancer are admitted from home care? Palliative Medicine, 8, 197–210.Google Scholar
Houts, P.S., Yasko, J.M., Harvey, H.A., et al. (1988). Unmet needs of persons with cancer in Pennsylvania during the period of terminal care. Cancer, 62, 627–634.Google Scholar
Lazarus, R.S. (1993). Coping theory and research: Past, present and future. Psychosomatic Medicine, 55, 234–247.Google Scholar
Lazarus, R.S. & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.
Maes, S., Leventhal, H., De Ridder, D.T.D. (1996). Coping with chronic disease. In Handbook of Coping: Theory, Research, Applications, Zeidner, M. & Endler, N.S. (eds.), pp. 221–251. New York: Wiley.
Manne, S.L., Sabbioni, M., Bovbjerg, D.H., et al. (1994). Coping with chemotherapy for breast cancer. Journal of Behavioral Medicine, 17, 41–55.Google Scholar
Noyes, R., Kathol, R.G., Debelius-Enemark, P., et al. (1990). Distress associated with cancer as measured by the Illness Distress Scale. Psychosomatics, 31, 321–330.Google Scholar
Osowiecki, D.M. & Compas, B. (1998). Psychological adjustment to cancer: Control beliefs and coping in adult cancer patients. Cognitive Therapy and Research, 22, 483–499.Google Scholar
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1326–1336.Google Scholar
Saunders, C. (2000). The evolution of palliative care. Patient Education and Counseling, 41, 7–13.Google Scholar
Silberfarb, P.M., Maurer, H., & Crouthamel, C.S. (1980). Psychosocial aspects of neoplastic disease: I. Functional status of breast cancer patients during different treatment regimens. American Journal of Psychiatry, 137, 450–455.Google Scholar
Somerfield, M.R., Stefanek, M.E., Smith, T.J., et al. (1999). A systems model for adaptation to somatic distress among cancer survivors. Psycho-Oncology, 8, 334–343.Google Scholar
Stanton, A.L., Danoff-Burg, S., Cameron, C.L., et al. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68, 875–882.Google Scholar
Stanton, A.L., Danoff-Burg, S., & Huggins, M.E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11, 93–102.Google Scholar
Stanton, A.L. & Snider, P.R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12, 16–23.Google Scholar
Stone, A.A. & Neale, J.M. (1984). New measure of daily coping: Development and preliminary results. Journal of Personality and Social Psychology, 46, 892–906.Google Scholar
Street, A.F. & Kissane, D.W. (2001). Constructions of dignity in end-of-life care. Journal of Palliative Care, 17, 93–101.Google Scholar
Suls, J. & Fletcher, B. (1985). The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis. Health Psychology, 4, 249–288.Google Scholar
Taylor, S.E., Lichtman, R.R., & Wood, J.V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of Personality and Social Psychology, 6, 489–502.Google Scholar
Tobin, D.L., Holroyd, K.A., Reynolds, R.V., et al. (1989). The hierarchical factor structure of the Coping Strategies Inventory. Cognitive Therapy and Research, 13, 343–361.Google Scholar
Trail, M., Nelson, N.D., Van, J.N., et al. (2004). Major stressors facing patients with amyotrophic lateral sclerosis (ALS): A survey to identify their concerns and to compare with those of their caregivers. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders, 5, 40–45.Google Scholar
Twycross, R. (1994). Pain Relief in Advanced Cancer. Edinburgh: Churchill Livingstone.
Ventafridda, V., Ripamonti, C., DeConno, F., et al. (1990). Symptom prevalence and control during cancer patients' last days of life. Journal of Palliative Care, 6, 7–11.Google Scholar
Weisman, A.D. & Worden, J.W. (1985–1986). The emotional impact of recurrent cancer. Journal of Psychosocial Oncology, 3, 5–16.Google Scholar
Wertlieb, D., Weigel, C., & Feldstein, M. (1987). Measuring children's coping. American Journal of Orthopsychiatry, 57, 548–560.Google Scholar
Wilson, K.G., Curran, D., & McPherson, C.J. (2005). A burden to others: A common source of distress for the terminally ill. Cognitive Behaviour Therapy, 34, 115–123.Google Scholar
Wilson, K.G., Graham, I.D,, Viola, R.A., et al. (2004). Structured interview assessment of symptoms and concerns in palliative care. Canadian Journal of Psychiatry, 49, 350–358.Google Scholar
Wilson, K.G., Scott, J.F., Graham, I.D., et al. (2000). Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide. Archives of Internal Medicine, 160, 2454–2460.Google Scholar
Wilson, K.G., Stelzer, J., Bergman, J.N., et al. (1995). Problem solving, stress, and coping in adolescent suicide attempts. Suicide and Life Threatening Behavior, 25, 241–252.Google Scholar