title: The relationship between coping strategies, quality of life, and mood in patients with incurable cancer.
abstract: BACKGROUND
  Patients with incurable cancer face many physical and emotional stressors, yet little is known about their coping strategies or the relationship between their coping strategies, quality of life (QOL), and mood.
  
  
  METHODS
  As part of a randomized trial of palliative care, this study assessed baseline QOL (Functional Assessment of Cancer Therapy-General), mood (Hospital Anxiety and Depression Scale), and coping (Brief COPE) in patients within 8 weeks of a diagnosis of incurable lung or gastrointestinal cancer and before randomization. To examine associations between coping strategies, QOL, and mood, we used linear regression, adjusting for patients' age, sex, marital status, and cancer type.
  
  
  RESULTS
  There were 350 participants (mean age, 64.9 years), and the majority were male (54.0%), were married (70.0%), and had lung cancer (54.6%). Most reported high utilization of emotional support coping (77.0%), whereas fewer reported high utilization of acceptance (44.8%), self-blame (37.9%), and denial (28.2%). Emotional support (QOL: β = 2.65, P < .01; depression: β = -0.56, P = .02) and acceptance (QOL: β = 1.55, P < .01; depression: β = -0.37, P = .01; anxiety: β = -0.34, P = .02) correlated with better QOL and mood. Denial (QOL: β = -1.97, P < .01; depression: β = 0.36, P = .01; anxiety: β = 0.61, P < .01) and self-blame (QOL: β = -2.31, P < .01; depression: β = 0.58, P < .01; anxiety: β = 0.66, P < .01) correlated with worse QOL and mood.
  
  
  CONCLUSIONS
  Patients with newly diagnosed, incurable cancer use a variety of coping strategies. The use of emotional support and acceptance coping strategies correlated with better QOL and mood, whereas the use of denial and self-blame negatively correlated with these outcomes. Interventions to improve patients' QOL and mood should seek to cultivate the use of adaptive coping strategies. Cancer 2016;122:2110-6. © 2016 American Cancer Society.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Nipp
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Areej
authors.initials: A
authors.lastname: El-Jawahri
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Joel N
authors.initials: JN
authors.lastname: Fishbein
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Justin
authors.initials: J
authors.lastname: Eusebio
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Stagl
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Gallagher
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.affiliation: Division of Palliative Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Jackson
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: William F
authors.initials: WF
authors.lastname: Pirl
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greer
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Temel
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012944:Social Support
keywords: anxiety; coping behavior; depression; incurable cancer; palliative care; quality of life