Coping strategies and psychological distress in patients with advanced cancer.

PURPOSE/OBJECTIVES: To examine the relationship between coping mechanisms and psychological distress in patients with advanced cancer receiving chemotherapy.

DESIGN

Descriptive, correlational study.

SETTING

Private and public hospitals in New York, NY.

SAMPLE

132 patients, ages 33-83, with advanced breast, ovarian, lung, colorectal, or other cancers.

METHODS

Mail survey using the Ways of Coping Inventory-Cancer Version and the Profile of Mood States.

MAIN RESEARCH VARIABLES

Coping strategies, psychological distress.

FINDINGS

The coping strategies distancing, cognitive escape-avoidance, and behavioral escape-avoidance were related to psychological distress. Distancing was negatively related (r = -0.25) and cognitive escape-avoidance (r = 0.38) and behavioral escape-avoidance (r = 0.38) were positively related to psychological distress (p < 0.01). Collectively, the coping strategies explained 36% of the variance of psychological distress. The most important coping mechanism contributing to overall psychological distress was behavioral escape-avoidance, followed by cognitive escape-avoidance.

CONCLUSIONS

Low levels of psychological distress were associated with low levels of cognitive and behavioral escape-avoidance and high levels of distancing.

IMPLICATIONS FOR NURSING PRACTICE

Nursing interventions that reduce cognitive and behavioral escape-avoidance and enhance distancing should be tested, through further research, in relation to their ability to decrease psychological distress in patients with advanced cancer.