COPING AND PSYCHOSOCIAL ADAPTATION - LONGITUDINAL EFFECTS OVER TIME AND STAGES IN BREAST-CANCER

Objectives: This study examined the relationship between coping and ps ychosocial adaptation in cancer patients over time and across distinct clinical events. Methods: In a prospective longitudinal study 74 pati ents with breast cancer were observed for 3 to 5 years at 3- to 6-mont h intervals. A total of 684 interviews were conducted at different obs ervation points. Three rating scales were used to assess coping and ad justment the Bernese Coping Modes, an observer rating scale devised to elicit 26 coping modes aggregated in this paper as the five Basic Cop ing Strategies of support, self-control, denial, diverting, and negati ve-emotional; second, an observer rating scale to ascertain psychosoci al adaptation; and third, a self-rating scale as a measure of either e motional distress or well-being. Results: a) When aggregated in illnes s stages, coping and distress data on the observed clinical time point s showed greater variability than time measures alone (analysis of var iance (ANOVA) for repeated measures p <.001). b) A significant relatio nship between the Basic Coping Strategies and psychosocial adaptation was demonstrated using discriminant and correlational analysis. Furthe rmore, in stage-dependent Pearson r correlations (p <.05 to .001), a c lear-cut relationship was found for hospitalization, chemotherapy, and rehabilitation, but not for convalescence and metastasis, c) A positi ve relationship was demonstrated between psychosocial adaptation and s trategies that can be generally categorized as good forms of coping su ch as support and self-control, and, to a lesser degree, diverting and denial. Conversely, poor coping exerted a negative effect on almost a ll illness stages and on most criteria of adjustment. Conclusions: In long-term studies on psychosocial adaptation and coping, stage-related measures should be preferred to time measures alone. The implications of different strategies for the psychological treatment of cancer pat ients are discussed.