Coping to Alleviate Stress and Improve Quality of Life among Breast Cancer Patients

Sampoornam. W

Lecturer, PhD Scholar, Saveetha University, Chennai

*Corresponding Author’s Email: sampoornamwebster@yahoo.in

ABSTRACT:

Context: The intervening role coping plays between stress and quality of life may depend on the types of stress encountered and the types of coping strategies used. Objective: The present study investigated the relationship between stress, coping, and quality of life. Methods: Breast cancer patients recently diagnosed with recurrence (N=38) were assessed shortly after the diagnosis and 3 months later. P. Herschbach Questionnaire on Stress in Cancer Patients (QSC-R23) was used to assess the level of stress. QOL instrument was used to assess quality of life. The Brief COPE was used to assess frequency of engaging in 13 different coping strategies. Researcher taught the emotional coping strategies for all the participants after the pretest. Results: Statistical and clinical significance was found with coping to alleviate stress and improve quality of life among breast cancer patients. Conclusion: The findings imply that interventions teaching coping strategies would be important for patients experiencing high symptom stress and could be important for all patients.

KEYWORDS: Stripping, Late Infant outcome, Late developmental Outcome, DDST-II.

INTRODUCTION:

Diagnosis with breast cancer recurrence often brings high levels of stress. Successful coping to alleviate stress could improve patients’ quality of life (QoL). The intervening role coping plays between stress and QoL may depend on the types of stress encountered and the types of coping strategies used. Patients are challenged to cope as best as they can in the face of a difficult situation (Folkman S, Lazarus RS, 1991). Coping is the process of using emotional, cognitive, and/or behavioral strategies to manage one’s stress in order to reduce its potential harmful impact on psychological adjustment (Lazarus RS, 1993). Strategies can be as varied as the stressors which prompt them.

METHODS:

Women diagnosed with their first recurrence of breast cancer were eligible to participate in the study. Patients were consecutive cases in a medical oncology ward at Erode Cancer Centre, Erode. Pre experimental one group pretest posttest design was used. Among 50 eligible patients, 10 declined to participate and 40 were accrued. The participants were less likely to have a spouse or a partner. P. Herschbach Questionnaire on Stress in Cancer Patients (QSC-R23) was used to assess the level

of stress. QOL instrument was used to assess quality of life. The Brief COPE was used to assess frequency of engaging in 13 different coping strategies. The initial assessment was performed for 1 week after receiving the recurrence diagnosis. Structured interviews that included questionnaire completion, health status assessment with medical chart inspection and physician consultation as needed. Emotional Coping strategies were taught and practiced by the participants. Approximately 3 months after the initial assessment, the patients were similarly reassessed. Two women did not complete the follow-up assessment for reasons of study dropout (n=1) and death (n=1).

RESULTS:

The group did not significantly differ in socio demographics (age, education, employment, and family income), disease characteristics (stage), or cancer treatment received for recurrence (surgery, radiation, hormonal, and chemotherapy. The sample was primarily middle aged married (77%). As treatment typically begins shortly after diagnosis, most (70%) had received or were continuing with cancer treatment at the time of assessment (post-surgery=19%, chemotherapy=61%, radiation therapy=45%, hormonal therapy=24%).

Table 1- Pretest and posttest descriptive and inferential statistics on correlations among stress, coping strategy, and quality of life variables (N=38)

Variables	Pretest		Posttest		Correlation coefficient	Paired t test
	Mean	Standard deviation	Mean	Standard deviation
Stress	16.5	15.84	12.41	11.76	0.89	6.75
Coping	5.45	7.34	8.96	10.32		7.94
					0.92
Quality of life	13.92	14.23	16.56	15.33		5.48

Table 1 elicits the picture of decreased stress level and improved quality of life after implementing the emotional coping strategies. Correlation coefficient states the strong positive relationship between stress and coping, quality of life and coping. Paired t test has shown the statistical and clinical significance of coping to alleviate stress and improve quality of life among breast cancer patients.

DISCUSSION:

The context of study the diagnosis of cancer recurrence is an important one, and of all the points along the cancer trajectory, it has received the least behavioral study. In contrast, coping has long been regarded as a core concept in understanding stress effects and has received significant study. Regarding stressful circumstances, those patients with higher symptom stress are particularly burdened. Beyond the adverse effects of symptoms on their quality of life, high symptom stress may also lead individuals to behave in ways which make the situation worse. The findings support prior ones demonstrating associations between positive outcomes and coping strategies.

REFERENCE:

1. Folkman S, Lazarus RS, (1991) “Coping and Emotion” In: Monat A, Lazarus RS, eds. Stress and Coping: An Anthology. New York: Columbia University Press; 207–227.

2. Lazarus RS, (1993) “Coping theory and research: Past, present, and future” Psychosom Med.; 55: 234–247.

3. Perczek RE, Burke MA, Carver CS, Krongrad A, Terris MK, (2002) “ Facing a prostate cancer diagnosis: Who is at risk for increased distress? “ Cancer.; 94: 2923–2929.

4. Roesch SC, Adams L, Hines A, et al., (2005) “Coping with prostate cancer: A meta-analytic review” J Behav Med.; 28: 281–293.

5. Carver CS, (1997) “You want to measure coping but your protocol's too long: Consider the brief COPE” Int J Behav Med.; 4: 92–100.

Received on 14.05.2016 Modified on 21.05.2016

Int. J. Nur. Edu. and Research. 2016; 4(4): 427-428.

DOI: 10.5958/2454-2660.2016.00077.6