Prevalence, correlates, and costs of patients with poor adjustment to mixed cancers.
Approximately 2% to 3% of the Canadian society has experienced cancer. Literature indicates that there is poor adjustment to chronic illness. Individuals with poor adjustment to chronic illness have been found to disproportionately use more health services. The purpose of this study was to determine the prevalence, correlates, and costs associated with poor adjustment to mixed cancer. A consecutive sample (n = 171) of breast, lung, and prostate cancer patients at the Nova Scotia Regional Cancer Center were surveyed. Twenty-eight percent of the cancer group showed fair to poor adjustment to illness using the Psychological Adjustment to Illness Self-report Scale Psychological Adjustment to Illness Self-Report Scale raw score. Poor adjustment was moderately correlated with depression (r = 0.50, P < .0001) and evasive coping (r = 0.38, P < .0001) and unrelated to demographic variables. Depression explained 25% of the variance in poor adjustment to illness in regression analysis. Cancer patients with fair to poor adjustment to illness had statistically significantly higher annual healthcare expenditures (P < .002) than those with good adjustment to illness. Expenditure findings agree with previous literature on chronic illnesses. The prevalence of fair to poor adjustment in this cancer population using the Psychological Adjustment to Illness Self-Report Scale measure is similar to that reported for chronic illness to date, suggesting that only those with better adjustment consented to this study.
School of Nursing, Dalhousie University, 5969 University Avenue, Halifax, Nova Scotia, Canada B3H 3J5. lorna.butler@dal.ca
Lorna
L
Butler
Barbara
B
Downe-Wamboldt
Patricia
P
Melanson
Lynn
L
Coulter
Janice
J
Keefe
Jerome
J
Singleton
David
D
Bell
D000223:Adaptation, Psychological; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004180:Direct Service Costs / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008603:Mental Health; D009674:Nova Scotia / Q000453:epidemiology; D009730:Nursing Assessment; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D012044:Regression Analysis; D012917:Social Adjustment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires