Coping, psychopathology, and quality of life in cancer patients under palliative care.
OBJECTIVE
To assess hopelessness, anxiety, depression, and quality of life in cancer patients undergoing palliative treatment by comparing their scores at the onset of treatment and one month later and by assessing possible correlations with coping strategies.


METHODS
Participants included 85 patients of both genders (56.5% female) diagnosed with advanced cancer who did not have curative therapeutic options who were assessed with self-applied instruments (the Beck Hopelessness Scale, the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire-Cancer 30, the Hospital Anxiety and Depression Scale, and the Coping Strategies Inventory by Folkman and Lazarus) at two timepoints: first before their appointment with doctors and other professionals in their first visit to the palliative care outpatient clinic (PCOC) and then as soon as patients arrived at the PCOC for their first medical follow-up visit (approximately 30 days after the first appointment).


RESULTS
The scores for hopelessness, anxiety, and depression remained stable (p = 0.24). The results were the same for the quality-of-life (QoL) variables, except for the fatigue and pain scores, which decreased (p = 0.01), and social impairment, which increased (p = 0.03). Analysis of the correlations between the coping mechanisms used after the onset of palliative treatment showed that confronting coping, seeking social support, and positive reappraisal were inversely correlated with hopelessness. Seeking social support, planful problem solving, and positive reappraisal were inversely correlated with indicators of depression. In contrast, use of the escape-avoidance strategy and reduced use of the planful problem-solving strategy were associated with increased anxiety.


CONCLUSIONS
The employment of problem-focused coping strategies exerted a positive impact on the end-of-life process and, above all, protected patients from the negative experiences associated with psychiatric symptoms, thus enabling them to look for alternative solutions for experiencing the end-of-life process in a more well-adjusted manner.
Palliative Care/Pain Unit,Barretos Cancer Hospital,PIO XII Foundation,Barretos,Brazil.
Daniela B
DB
Sorato
Barretos Cancer Hospital,PIO XII Foundation,and School of Medicine of Ribeirão Preto,University of São Paulo,Brazil.
Flávia L
FL
Osório
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires
Cancer; Coping; Oncology; Palliative care; Psychopathological symptoms; Quality of life