title: Coping and psychological distress among head and neck cancer patients.
abstract: BACKGROUND
  Few studies have described the relationship between the psychological distress associated with head and neck cancer and how patients cope with their disease.
  
  
  OBJECTIVE
  The purpose of this study is to investigate how head and neck cancer patients 6-12 months after their diagnosis cope with their disease and how their coping skills are related to their anxiety and depression levels.
  
  
  METHODS
  We conducted a cross-sectional study among 157 head and neck cancer patients. We evaluated coping strategies using the Ways of Coping Checklist and anxiety and depression using The Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Bivariate analyses revealed that there was an association between patients' levels of anxiety and depression and the type of coping strategies used. Patients with higher levels of anxiety and depression used more "blamed self", "wishful thinking", and "avoidance" coping strategies. These associations were further confirmed by multivariate linear regression analyses that controlled for age, gender, time since end of treatment, tumor stage, and occupation.
  
  
  CONCLUSIONS
  These findings suggest that coping strategies in head and neck cancer patients vary according to their level of psychological distress. However, the cross-sectional nature of the data does not permit directional inferences for this association.
authors.affiliation: McGill University, Montreal, Quebec, Canada. hawazin.elani@mail.mcgill.ca
authors.forename: Hawazin W
authors.initials: HW
authors.lastname: Elani
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Allison
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis