Perceived social support, coping, and psychological distress in advanced cancer patients

Abstract

<p>The purpose of this study was to examine the extent to which perceived social support and coping mechanisms contribute to explaining psychological distress in advanced cancer patients receiving chemotherapy. The Lazarus and Folkman stress and coping model (1984a) provided the framework. Data were collected in a convenience sample of 132 advanced cancer patients, aged 33 to 83 from the metropolitan area of New York. The participants had breast (30%), ovarian (20%), lung (13%), colorectal (10%), or other (27%) cancers. Perceived social support was assessed by the Personal Resource Questionnaire-85-Part 2 (Brandt &amp; Weinert, 1987); the coping strategies of cognitive escape-avoidance, behavioral escape-avoidance, distancing, focusing on the positive, and seeking support were assessed by the Ways of Coping Inventory-Cancer Version (Dunkel-Schetter et al., 1992); and psychological distress was measured by the Profile of Mood States (McNair et al., 1992). The data were analyzed using the Pearson product moment correlation and multiple regression analyses. The coping strategies distancing and cognitive and behavioral escape-avoidance relate individually to psychological distress. Distancing was negatively related ($r = {-}.25$) and cognitive escape-avoidance ($r = .39$) and behavioral escape-avoidance ($r = .38$) positively related to psychological distress ($p &lt; .01$). Collectively the coping strategies explained 36% of the variance of psychological distress. Behavioral escape-avoidance was the most important coping mechanism (Beta =.40, $p &lt; .001$) contributing to overall psychological distress. This was followed by cognitive escape-avoidance (Beta =.29, $p &lt; .001$) and distancing (Beta = $-$.24, $p &lt; .01$). Over and above coping strategies, perceived social support explained an extra 7.6% of the variance of psychological distress. Perceived social support interacted with behavioral escape-avoidance. High psychological distress occurred when advanced cancer patients had high levels of behavioral avoidance, especially when they perceived social support to be low. The coping strategies did not mediate the effect between perceived social support and psychological distress. To lower psychological distress in advanced cancer patients health professionals must help patients to suppress cognitive and behavioral escape-avoidance and potentiate distancing as well as their perception of social support.</p>