Quality of Life in Terminal Cancer Patients

Study Proves Emotional Support is Key 

 

Introduction

This article serves as a detailed summary of a significant study¹ conducted by researchers from the Massachusetts General Hospital Cancer Center. The study, published in the journal Cancer, explored how patients with newly diagnosed, incurable lung or gastrointestinal cancer cope with their illness. The researchers focused on understanding the coping strategies utilized by these patients and investigating the relationship between these coping strategies, their quality of life (QOL), and mood.

 

Methods

A total of 350 participants, within 8 weeks of receiving a diagnosis of incurable cancer, were enrolled in this study as part of a randomized trial of palliative care. Before randomization, these patients completed baseline assessments of QOL, mood, and coping strategies. The researchers utilized the Brief COPE questionnaire to evaluate the utilization of coping strategies. Linear regression models were employed to analyze the associations between coping strategies, QOL, and mood, while considering relevant demographic and clinical factors.

 

Results

The study sample consisted of predominantly male participants (54.0%) with a mean age of 64.9 years. The majority of participants were married (70.0%) and had a diagnosis of lung cancer (54.6%). Emotional support emerged as the most frequently employed coping strategy, with 77.0% of participants reporting high utilization. Additionally, acceptance coping (44.8%), self-blame coping (37.9%), and denial coping (28.2%) were also frequently utilized by a significant proportion of the patients.

 

The researchers found that high utilization of the emotional support coping strategy was associated with better QOL (β = 2.65, p < .01) and lower depression (β = -0.56, p = .02). Similarly, high utilization of the acceptance coping strategy was correlated with better QOL (β = 1.55, p < .01), lower depression (β = -0.37, p = .01), and lower anxiety (β = -0.34, p = .02). However, high utilization of denial coping was associated with worse QOL (β = -1.97, p < .01) and higher depression (β = 0.36, p = .01) and anxiety (β = 0.61, p < .01). Similarly, high utilization of self-blame coping correlated with worse QOL (β = -2.31, p < .01) and higher depression (β = 0.58, p < .01) and anxiety (β = 0.66, p < .01).

 

Discussion

This study sheds light on the coping strategies employed by patients with newly diagnosed, incurable lung or gastrointestinal cancer and provides valuable insights into the relationship between these coping strategies, QOL, and mood. The findings indicate that emotional support and acceptance coping strategies are associated with better QOL and mood outcomes, while denial and self-blame coping strategies are linked to poorer QOL and mood outcomes.

 

One important aspect highlighted by the study is the high utilization of emotional support coping, with a significant majority of patients relying on this strategy. Emotional support coping involves seeking comfort, advice, or companionship from others during times of distress. This coping strategy has been widely recognized as beneficial in enhancing emotional well-being and maintaining social connections. The findings strongly suggest that the provision of emotional support can have a positive impact on patients’ QOL and mood.

 

In contrast, the study also revealed that a considerable proportion of patients relied on maladaptive coping strategies such as denial and self-blame. Denial coping involves avoiding or minimizing the reality of one’s illness, while self-blame coping involves attributing blame and responsibility to oneself for the illness. These coping strategies were found to be associated with worse QOL and mood outcomes. Understanding the factors contributing to the use of these maladaptive coping strategies can help healthcare professionals tailor interventions that address patients’ emotional distress and improve their overall well-being.

 

Notably, the study identified differences in coping strategy utilization based on demographic factors. Younger patients were more likely to employ positive reframing and self-blame coping strategies, while patients with a smoking history and those with a lung cancer diagnosis were more prone to self-blame coping. These findings suggest that demographic characteristics and disease-specific factors influence coping strategies and should be considered when providing support to patients.

 

Conclusion

The study provides valuable insights into the coping strategies employed by patients newly diagnosed with incurable lung or gastrointestinal cancer. Emotional support and acceptance coping strategies were found to positively influence QOL and mood outcomes, while denial and self-blame coping strategies had negative associations with these outcomes. These findings emphasize the role of adaptive coping strategies in improving the well-being of patients. By recognizing the coping strategies employed by individual patients and offering targeted support, healthcare providers can enhance the quality of care provided to those facing incurable cancer. Future research should focus on developing interventions that promote adaptive coping strategies tailored to the unique needs of patients in this vulnerable population.

1 Nipp, R.D., El-Jawahri, A., Fishbein, J.N., Eusebio, J., Stagl, J.M., Gallagher, E.R., Park, E.R., Jackson, V.A., Pirl, W.F., Greer, J.A. and Temel, J.S. (2016), The relationship between coping strategies, quality of life, and mood in patients with incurable cancer. Cancer, 122: 2110-2116. https://doi.org/10.1002/cncr.30025

 

Beta (β) refers to the coefficient estimate obtained from a linear regression model. It tells us how much the outcome will change when we change the predictor by one unit, while keeping everything else the same.  Beta coefficients show us the direction and strength of the relationship between variables.

 

 

The p-value (p) is a way to figure out if our results are statistically meaningful.  It shows the chance of getting the results we observed, or even more extreme results if there was no real relationship between the variables.  When we do statistical tests, if the p-value is lower than a certain level (usually 0.05), it means the results are unlikely to happen just by chance.  This leads us to reject the idea that there’s no relationship and accept that there is a relationship.  A smaller p-value means there’s stronger evidence against the idea of no relationship.