Do allogeneic bone marrow transplant candidates match coping to controllability of pre-treatment stressors?

Abstract

According to the Person x Situation theoretical framework, people adjust their coping to address the unique challenges of encountered stressors. Whether their strategies fit or appropriately address these stressor challenges influences adjustment. We examined the fit between pre-treatment stressors reported by hematological cancer patients awaiting allogeneic bone marrow transplantation (alloBMT) and their coping responses. Stressors were categorized as controllable versus uncontrollable; coping responses were categorized as problem- versus emotion-focused versus mixed (i.e., elements of both coping types). We hypothesized that patients would employ coping responses that fit the controllability of stressors (i.e., a match between stressor and coping response): problem-focused coping for controllable stressors and emotion-focused coping for uncontrollable stressors. In qualitative interviews, pre-BMT patients (10 men, 7 women) described encountered stressors and how they coped with them. Every reported stressor was linked with its associated coping response, resulting in a stressor-coping pair. We determined the proportion of total stressor-coping pairs in which the coping response matched the controllability of its linked stressor. Most stressor-coping pairs involving uncontrollable stressors showed the hypothesized match with emotion-focused or mixed coping. Contrary to hypotheses, fewer stressor-coping pairs that involved controllable stressors matched with problem-focused or mixed coping. Rather, these pairs were more likely to link controllable stressors with emotion-focused coping (i.e., mismatch between stressor controllability and type of coping). AlloBMT candidates may appraise the pre-treatment stage, globally, as permitting very little control. Coping efforts may consequently emphasize regulation of negative emotions (i.e., emotion-focused coping).