title: Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings.
abstract: As a part of a European study, we cross-culturally examined the rate of emotional distress and maladaptive coping and their association with cancer patients' satisfaction with their interactions with the physician responsible for their care.
  
  
  
  Cancer patients (n = 302) from one Middle European (Austria) and two Southern European (Italy, Spain) countries completed the NCCN Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation (AP) and Hopelessness (H) sub-scales, and the Physician Patient Satisfaction with Doctors Questionnaire (PSQ).
  
  
  
  The prevalence of emotional distress (DT caseness) was 60% (26.1% mild, 18.8% moderate, and 14.9% severe distress). Maladaptive coping (Mini-MAC cases) was found in 22.8% (hopeless cases), and 22.5% (anxious preoccupation cases). PSQ-MD was significantly correlated with Mini-MAC/H and Mini-Mac/AP, while PSQ-PS was negatively correlated with Mini-MAC/H. DT cases and those with higher levels of hopelessness reported higher scores on PSQ-MD and lower on PSQ-PS than non-cases. Some differences were found between countries both as far as patients' coping and perception of the interaction with doctors. In hierarchical multiple regression analysis, after adjusting for socio-demographic and medical variables, Mini-MAC/H significantly predicted the scores on PSQ-MD (positive direction) and PSQ-PS (negative direction).
  
  
  
  The study confirms that about one out of three cancer patients have moderate to high level of emotional distress and about one out of four, clinically significant maladaptive coping. Also, patients showing hopelessness and distress tended to perceive their doctors as both disengaged and less supportive. These results highlights the need for physicians to monitor their patient's level of distress and coping mechanisms and to adjust their own relational and communication style according to patients' psychological condition. Also, cross-cultural issues should be taken into account when exploring psychosocial variables and cancer patients' perception of and satisfaction with the interaction with their doctors.
authors.affiliation: Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l,Meldola (FC),Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Meggiolaro
authors.affiliation: Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l,Meldola (FC),Italy.
authors.forename: Maria Alejandra
authors.initials: MA
authors.lastname: Berardi
authors.affiliation: Psycho-Oncology Service,Clinical Department of Oncology,University Medical Center of Internal Medicine,Medical University of Graz,Graz,Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Andritsch
authors.affiliation: Institute of Psychiatry,Department of Biomedical and Specialty Surgical Sciences,University of Ferrara,Italy and University Hospital Psychiatry Unit,Psycho-Oncology and Psychiatry in Palliative Care Program,Integrated Department of Mental Health,S. Anna University Hospital and Health Authorities,Ferrara,Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Nanni
authors.affiliation: Psycho-oncology Unit Oncology Department University Hospital Sant Joan de Reus,Reus,Spain.
authors.forename: Agustina
authors.initials: A
authors.lastname: Sirgo
authors.affiliation: Istituto Oncologico Romagnolo (IOR),Forlì,Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Samorì
authors.affiliation: Psycho-Oncology Service,Clinical Department of Oncology,University Medical Center of Internal Medicine,Medical University of Graz,Graz,Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Farkas
authors.affiliation: Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l,Meldola (FC),Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ruffilli
authors.affiliation: Institute of Psychiatry,Department of Biomedical and Specialty Surgical Sciences,University of Ferrara,Italy and University Hospital Psychiatry Unit,Psycho-Oncology and Psychiatry in Palliative Care Program,Integrated Department of Mental Health,S. Anna University Hospital and Health Authorities,Ferrara,Italy.
authors.forename: Rosangela
authors.initials: R
authors.lastname: Caruso
authors.affiliation: Department of Oncology,Cà Foncello Hospital of Treviso,Treviso,Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Bellé
authors.affiliation: Psycho-Oncology Unit,Hospital de la Santa Creu i Sant Pau,Barcelona,Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Juan Linares
authors.affiliation: Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l,Meldola (FC),Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Padova
authors.affiliation: Institute of Psychiatry,Department of Biomedical and Specialty Surgical Sciences,University of Ferrara,Italy and University Hospital Psychiatry Unit,Psycho-Oncology and Psychiatry in Palliative Care Program,Integrated Department of Mental Health,S. Anna University Hospital and Health Authorities,Ferrara,Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001317:Austria; D016638:Critical Illness / Q000523:psychology*; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology; D010465:Perception; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D013030:Spain; D013315:Stress, Psychological / Q000150:complications* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Cancer; Coping; Doctor-patient relation; Emotional distress