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Multicenter Study
. 2023 Nov;32(11):1694-1701.
doi: 10.1002/pon.6219. Epub 2023 Oct 3.

Coping strategies as mediators of uncertainty and psychological distress in patients with advanced cancer

Berta Obispo  1 , Patricia Cruz-Castellanos  2 , Ana Fernández-Montes  3 , Sara Coca-Membribes  4 , Jacobo Rogado  1 , Mónica Antoñanzas  5 , Oscar A Castillo-Trujillo  6 , Helena López-Ceballos  7 , Adán Rodríguez-González  6 , Paula Jiménez-Fonseca  6 , Caterina Calderon  8
Affiliations
Multicenter Study

Coping strategies as mediators of uncertainty and psychological distress in patients with advanced cancer

Berta Obispo et al. Psychooncology. 2023 Nov.

Abstract

Purpose: Uncertainty in the context of advanced cancer diagnosis often incurs significant psychological distress. The aims were to evaluate the incidence of psychological distress upon diagnosis of advanced cancer and to analyze whether the relationship between illness uncertainty and psychological distress can be mediated by coping strategies.

Methods: A multicenter, prospective, cross-sectional study was conducted in 15 medical oncology departments across Spain. Individuals with unresectable advanced cancer completed questionnaires on uncertainty (Michel Uncertainty of Illness Scale, coping strategies (Mental Adjustment to Cancer, M-MAC), and psychological distress (Brief Symptom Inventory, BSI-18) after the diagnostic and treatment appointment and before beginning systemic cancer treatment.

Results: 841 patients eligible for systemic treatment with palliative intent were included between February 2020 and April 2022. A total of 71.7% had clinically significant levels of psychological distress. Univariate analyses identified that the groups with less psychological distress were male (ηp2 = 0.016), married (ηp2 = 0.006), and had a better performance status (ηp2 = 0.007). The most widely used coping strategies were positive attitude and cognitive avoidance. A positive relationship was found between uncertainty, coping strategies, and psychological distress (p < 0.05). Participants who responded with anxious preoccupation suffered more helplessness and psychological distress, while those who responded with cognitive avoidance displayed greater positive attitude and lesser psychological distress.

Conclusion: Patients with newly diagnosed unresectable advanced cancer frequently experience psychological distress in the face of uncertainty, potentially influenced by coping strategies like cognitive avoidance.

Keywords: anxious preoccupation; cancer; cognitive avoidance; coping strategies; helplessness; oncology; positive attitude; psychological distress; systemic treatment; uncertainty.

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References

REFERENCES

    1. Xu S, Wang X, Wang R. The effects of integrated palliative care on quality of life and psychological distress in patients with advanced cancer: a systematic review and meta-analysis. Ann Palliat Med. 2022;11(8):2586-2599. https://doi.org/10.21037/apm-22-162
    1. Mishel MH. Uncertainty in illness. Image J Nurs Sch. 1988;20(4):225-232. https://doi.org/10.1111/j.1547-5069.1988.tb00082.x
    1. Richardson A, Wagland R, Foster R, et al. Uncertainty and anxiety in the cancer of unknown primary patient journey: a multiperspective qualitative study. BMJ Support Palliat Care. 2015;5(4):366-372. https://doi.org/10.1136/bmjspcare-2013-000482
    1. Hall DL, Mishel MH, Germino BB. Living with cancer-related uncertainty: associations with fatigue, insomnia, and affect in younger breast cancer survivors. Support Care Cancer. 2014;22(9):2489-2495. https://doi.org/10.1007/s00520-014-2243-y
    1. Gramling R, Stanek S, Han PKJ, et al. Distress due to prognostic uncertainty in palliative care: frequency, distribution, and outcomes among hospitalized patients with advanced cancer. J Palliat Med. 2018;21(3):315-321. https://doi.org/10.1089/jpm.2017.0285

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