Coping strategies used by cancer patients in anticipation of Cancer Centre follow-up appointments

Abstract

Sixty cancer patients who had completed their course of treatment were contacted prior to a scheduled follow-up appointment at the Thunder Bay Regional Cancer Centre. Subjects completed four questionnaires (Daily Stress Inventory, Ways of Coping, Desirability of Control, Multidimensional Health Locus of Control), two brief scales (Hope and Dread), and were interviewed individually on the day of the follow-up appointment. The structured interview included questions concerning appointment-induced stress, individual coping strategies, personal beliefs concerning health, existing support systems, and opinions regarding the Cancer Centre. Follow-up visits may be very stressful life events for cancer patients. For some the visit may be anticipated with hopeful expectancy, while for others it may be a dreaded experience, and the individual's coping style plays a large part in determining how stressful the visit may be. This study assessed patients' use of emotion-focused and problemfocused coping strategies, the degree of personal control generally deemed desirable by the individual in a variety of situations, the belief concerning the degree of control specific to their personal health, and related these factors to the amount of stress reported daily for a fourteen-day period prior to the visit. It was hypothesized that: (1) patients more inclined to use emotion-focused coping, as opposed to problem-focused coping, would experience lower levels of stress, and that (2) patients who reported a higher desirability for control in general, yet believed they had little control over their health, would cope least effectively and would experience higher levels of stress than their counterparts. The findings indicated that patients did not consider the follow-up appointment to be unusually stressful and that both emotion-focused and problem-focused coping positively correlated with stress, although problem-focused coping was the best predictor of daily stress. The interaction between desire for control and belief in health control in mitigating stress is worthy of further investigation. Implications for the care of cancer patients are discussed.