title: Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients.
abstract: OBJECTIVE
  To study self-reported coping style by the COPE questionnaire and the association to tumour node distant metastasis (TNM) stage, received treatment and health-related quality of life (HRQoL) in a population of successfully treated head and neck squamous cell carcinoma (HNSCC) patients.
  
  
  METHODS
  Disease free HNSCC patients were interviewed during a regular outpatient visit to the Department.
  
  
  METHODS
  All patients <80 years who had been diagnosed with HNSCC, in Western Norway, in the period from 1992 to 1997 and who were disease free in the year 2000 were included.
  
  
  METHODS
  The HNSCC patients were studied by the European organization for research and treatment of cancer quality of life (QoL) questionnaire and by the COPE questionnaire from which coping styles profiles were extracted. Clinical and socio-demographic variables were also gathered.
  
  
  RESULTS
  Level of problem focused coping style was associated with the T stage and whether or not the patient was given neck radiotherapy. An avoidance-focused coping style was generally associated with lowered HRQoL. Employment of emotional focused coping was associated with low HRQoL among the patients treated with surgery only, and associated with increased HRQoL among patients treated with radiation therapy only. The associations between HRQoL and coping style levels were stronger for HRQoL indexes reflecting cognitive/emotional function than for HRQoL indexes reflecting physical function.
  
  
  CONCLUSIONS
  In former HNSCC patients, level of problem focused coping style was associated with the T stage and if given neck radiotherapy. Level of avoidance coping was inversely associated with the HRQoL, and level of emotional coping was associated with HRQoL in a complex manner.
authors.affiliation: Department of Surgical Sciences, Section of Otolaryngology/Head and Neck Surgery, Faculty of Medicine, University of Bergen, Bergen, Norway.
authors.forename: A K H
authors.initials: AK
authors.lastname: Aarstad
authors.forename: H J
authors.initials: HJ
authors.lastname: Aarstad
authors.forename: E
authors.initials: E
authors.lastname: Bru
authors.forename: J
authors.initials: J
authors.lastname: Olofsson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002294:Carcinoma, Squamous Cell / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D003071:Cognition; D018572:Disease-Free Survival; D004644:Emotions; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000528:radiation effects; D037981:Neck Dissection; D009367:Neoplasm Staging; D011788:Quality of Life; D020266:Radiotherapy, Conformal; D012111:Residence Characteristics; D012944:Social Support; D017741:Survivors