How do cancer patients who try to take control of their disease differ from those who do not?
The objective of this study was to compare patients who do and do not describe their coping strategies as attempts to control their cancer. This was a cross-sectional study of adult, oncology outpatients from an urban medical centre diagnosed 6-24 months previously. Using open-ended questions, we asked participants if they tried to 'control' their cancer or situation. If 'yes', how? If 'no', how had they 'dealt with' it? The Hospital Anxiety and Depression Scale (HAD) measured anxiety and depression. The Mental Adjustment to Cancer Scale (MAC) assessed six coping styles. Of the 44 participants, 57% were female. The mean age was 57 years. Eighteen (41%) said they used control strategies (control-yes), 11 (25%) said they did not (control-no), and 15 (34%) gave unclear responses (control-unclear). Participants cited 97 different coping strategies that were grouped into proactive (e.g. lifestyle changes) and reactive strategies (e.g. stoic behaviour). In comparing these groups, the control-yes group was more likely to be younger (P = 0.0001), live with other(s) (P = 0.003), be confident of being cured (P = 0.006), have greater 'fighting spirit' on the MAC (P = 0.04) and use more proactive strategies (P = 0.0001). The conclusion of this study is that cancer patients use many coping strategies, but those who think of them as methods of control are younger and more confident of being cured, and use more proactive strategies.
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Department of Epidemiology, Mailman School of Public Health, Columbia University, NY 10032, USA. LBL10@columbia.edu
Robbins
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Mancuso
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Charlson
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D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*