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Coping, psychopathology, and quality of life in cancer patients under palliative care

Published online by Cambridge University Press:  30 April 2014

Daniela B. Sorato  and
Flávia L. Osório
Daniela B. Sorato*
Affiliation:
Palliative Care/Pain Unit, Barretos Cancer Hospital, PIO XII Foundation, Barretos, Brazil
Flávia L. Osório
Affiliation:
Barretos Cancer Hospital, PIO XII Foundation, and School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
*
Address correspondence and reprint requests to: Daniela Batista Sorato, Hospital São Judas Tadeu, Fundação Pio XII, Rua 20, n. 221, Centro, CEP, 14780-070, Barretos SP, Brazil. E-mail: [email protected]
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Abstract

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.

Method:

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.

Significance of results:

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.

Keywords

CancerOncologyPalliative carePsychopathological symptomsCopingQuality of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 3 , June 2015 , pp. 517 - 525
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Aaronson, N.K., Kaasa, S., Ahmedzai, S., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ–C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.Google Scholar
Beck, A.T., Steer, R.A., Beck, J.S., et al. (1993). Hopelessness, depression, suicidal ideation, and clinical diagnosis of depression. Suicide and Life-Threatening Behavior, 23(2), 139–145.Google Scholar
Botega, N.J., Pondé, M.P., Medeiros, P., et al. (1998). Validação da escala hospitalar de ansiedade e depressão (HADS) em pacientes epilépticos ambulatoriais. Jornal Brasileiro de Psiquiatria, 47, 285–289.Google Scholar
Brabo, E.P., Paschoal, M.E., Biasoli, I., et al. (2006). Brazilian version of the QLQ–LC13 lung cancer module of the European Organization for Research and Treatment of Cancer: Preliminary reliability and validity report. Quality of Life Research, 15(9), 1519–1524.Google Scholar
Breitbart, W.S., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. The Journal of the American Medical Association, 284, 290.Google Scholar
Chapman, K.J. & Pepler, C.N. (1998). Coping, hope, and anticipatory grief in family members in a palliative home care. Cancer Nursing, 21, 226–234.Google Scholar
Cunha, J.A. (2001). Manual da versão em português das Escalas Beck. São Paulo: Casa do Psicólogo.Google Scholar
DataSUS (2013). Dados de mortalidade do Brasil. Acesso em 23 de abril de 2013. Disponível em http://w3.datasus.gov.br/datasus/datasus.Google Scholar
Folkman, S. & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219–239.Google Scholar
Franceschini, J., Jardim, J.R., Fernandes, A.L., et al. (2010). Reproducibility of the Brazilian Portuguese version of the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire used in conjunction with its lung cancer-specific module. Jornal Brasileiro de Pneumologia, 36(5), 595–602.Google Scholar
Gibson, K., Rueda, S., Rourke, S.B., et al. (2011). Mastery and coping moderate the negative effect of acute and chronic stressors on mental health–related quality of life in HIV. AIDS Patient Care and STDs, 25(6), 371–381.Google Scholar
International Agency for Research on Cancer, World Health Organization (2008). GLOBOCAN 2008: Cancer incidence and mortality worldwide in 2008. Lyon: World Health Organization. Available from http://globocan.iarc.fr/.Google Scholar
Kennett, C. & Payne, M. (2005). Understanding why palliative care patients like “day care” and “getting out.” Journal of Palliative Care, 21(4), 292–298.Google Scholar
Kolva, E., Rosenfeld, B., Pessin, H., et al. (2011). Anxiety in terminally ill cancer patients. Journal of Pain and Symptom Management, 42(5), 691–701.Google Scholar
Lazarus, R.S. (1966). Story telling and the measurement of motivation: The direct versus substitutive controversy. Journal of Consulting Psychology, 30(6), 483–437.Google Scholar
Lichtenthal, W.G., Nilsson, M., Zhang, B., et al. (2009). Do rates of mental disorders and existential distress among advanced stage cancer patients increase as death approaches? Psycho-Oncology, 18, 50–61.Google Scholar
Lien, C.Y., Lin, H.R., Kuo, I.T., et al. (2009). Perceived uncertainty, social support and psychological adjustment in older patients with cancer being treated with surgery. Journal of Clinical Nursing, 18, 2311–2319.Google Scholar
Mann, J.J., & Currier, D. (2008). Suicide and attempted suicide. In The medical basis of psychiatry. Fatemi, S.H. & Clayton, P.J. (eds.), pp. 561–576. Philadelphia: Humana Press.Google Scholar
Matsumoto, D.Y. (2012). Cuidados Paliativos: Conceitos, fundamentos e princípios. In Manual de cuidados paliativos. Academia Nacional de Cuidados Paliativos. Porto Alegre: Sulina.Google Scholar
McClain, C., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally ill cancer patients. Lancet, 361(9369), 1603–1607.Google Scholar
Ministério da Saúde (BR) (1996). Conselho Nacional de Saúde. Comissão Nacional de Ética em Pesquisa—CONEP. Resolução n° 196/96. Dispõe sobre pesquisa envolvendo seres humanos. Brasília (DF): Ministério da Saúde.Google Scholar
Miovic, M. & Block, S. (2007). Psychiatric disorders in advanced cancer. Cancer, 15(110), 1665–1676.Google Scholar
Miyazaki, M.C.O.S., Domingos, N.A.M., Valério, N.I., et al. (2005). Tratamento da hepatite C: Sintomas psicológicos e estratégias de enfrentamento. Revista Brasileira de Terapia Cognitiva, 1(1), 119–128.Google Scholar
Morita, T., Akechi, T., Ikenaga, M., et al. (2005). Late referrals to specialized palliative care service in Japan. Journal of Clinical Oncology, 23, 2637–2644.Google Scholar
Mystakidou, K., Tsilika, E., Prapa, E., et al. (2008). Predictors of spirituality at the end of life. Canadian Family Physician , 54, 1720–1721.Google Scholar
National Cancer Institute (2008). PDQ supportive and palliative care editorial board. Retrieved January 4, 2009, from http://www.cancer.gov/cancertopics/pdq/supportivecare/adjustment/HealthProfessional/page1.Google Scholar
Oerlemans, S., Husson, O., Mols, F., et al. (2012). Perceived information provision and satisfaction among lymphoma and multiple myeloma survivors: Results from a Dutch population-based study. Annals of Hematology, 91(10), 1587–1595.Google Scholar
Pacheco, S. (2004). Cuidar a pessoa em fase terminal. 2a ed. Lisboa: Lusociência.Google Scholar
Peçanha, D.L.N. (2008). Câncer: Recursos de enfrentamento na trajetória da doença. In Temas em psico-oncologia. Carvalho, V.A. et al. (eds.), pp. 209–217. São Paulo: Summus.Google Scholar
Penedo, F.J., Gonzalez, J.S., Davis, C., et al. (2003). Coping and psychological distress among symptomatic HIV+ men who have sex with men. Annals of Behavioral Medicine, 25, 203–213.Google Scholar
Pereira, K., Benarroz, M.O., Silva, C.H.D., et al. (2010). Constipação intestinal nos pacientes com câncer avançado em Cuidados Paliativos com uso de opióides. In Anais do IV congresso internacional de cuidados paliativos: Educar para paliar. São Paulo.Google Scholar
Saporetti, L.A., Andrade, L., Sachs, M.F.A., et al. (2012). Diagnóstico e abordagem do sofrimento humano. In Manual de cuidados paliativos. Academia Nacional de Cuidados Paliativos. Porto Alegre: Sulina.Google Scholar
Savóia, M.G., Santana, P.R. & Mejias, N.P. (1996). Adaptação do Inventário de Estratégias de Coping de Folkman e Lazarus para o português. Psicologia USP, 7(1/2), 183–201.Google Scholar
Soares, M., Moura, M., Carvalho, M., et al. (2000). Ajustamento emocional, afectividade e estratégias de coping na doença do foro oncológico. Psicologia, Saúde & Doenças, 1(1), 19–25.Google Scholar
Stanton, A.L., Revenson, T.A. & Tennen, H. (2007). Health psychology: Psychological adjustment to chronic disease. Annual Review of Psychology, 58, 565–592.Google Scholar
Straub, R.O. (2005). Psicologia da saúde. 1a ed. Porto Alegre: Artes Médicas.Google Scholar
Temel, J.S., Greer, J.A., Muzikansky, A., et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. The New England Journal of Medicine, 363, 733–742.Google Scholar
Thompson, N.J., Walker, E., Obolensky, N., et al. (2010). Distance delivery of mindfulness-based cognitive therapy for depression: Project UPLIFT. Epilepsy & Behavior, 19(3), 247–254.Google Scholar
Trevino, K.M., Maciejewski, P.K., Fasciano, K., et al. (2012). Coping and psychological distress in young adults with advanced cancer. Journal of Supportive Oncology, 10, 124–130.Google Scholar
Weaver, K.E., Antoni, M.H., Lechner, S.C., et al. (2004). Perceived stress mediates the effects of coping on the quality of life of HIV-positive women on highly active antiretroviral therapy. AIDS and Behavior, 8, 175–183.Google Scholar
Yennurajalingam, S., Atkinson, B., Masterson, J., et al. (2012). The impact of an outpatient palliative care consultation on symptom burden in advanced prostate cancer patients. Journal of Palliative Medicine, 15(1), 20–24.Google Scholar
Zabora, J.R. & Loscalzo, M.J. (2002). Psychosocial consequences of advanced cancer. In Principles and practice of palliative care and supportive oncology. Berger, A.M. et al. (eds.), pp. 740–761. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar