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Coping, Quality of Life, Depression, and Hopelessness in Cancer Patients in a Curative and Palliative, End-of-Life Care Setting

van Laarhoven, Hanneke W. M. MA, MD, PhD; Schilderman, Johannes PhD; Bleijenberg, Gijs PhD; Donders, Rogier PhD; Vissers, Kris C. MD, PhD; Verhagen, Constans A. H. H. V. M. MD, PhD; Prins, Judith B. PhD

doi: 10.1097/NCC.0b013e3181f9a040
Articles

Background: Coping strategies may be important factors influencing quality of life (QOL), depression, and hopelessness. However, most studies on this issue were performed in patients still undergoing anticancer treatment. Unknown is which coping strategies are of importance for palliative-cancer patients who no longer receive treatment.

Objective: The objectives of this study were to assess coping strategies in curatively treated and palliative-cancer patients no longer receiving anticancer treatment and to examine the relation of these coping strategies with QOL, depression, and hopelessness.

Methods: A descriptive research design was used. Ninety-two curative and 59 palliative patients filled out the COPE-Easy abbreviated version, the European Organisation for Research-and-Treatment of Cancer QOL-Questionnaire version 2.0, Beck Depression Inventory for Primary Care, and Beck Hopelessness Scale.

Results: In both curative and palliative patients, active coping strategies and acceptance were beneficial in terms of QOL, depression, and hopelessness, unlike avoidant coping strategies and venting of emotions. Palliative patients scored higher on the coping strategy, seeking moral support. For the outcome variable, emotional functioning, significant interactions were observed between the variable, curative/palliative care setting, and the coping strategy, seeking moral support. For the outcome variable, role functioning, significant interactions were observed between the variable, curative/palliative care setting, and the coping strategy, waiting.

Conclusions: Coping strategies were significantly correlated to QOL, depression, and hopelessness. However, this correlation differed in the curative and palliative, end-of-life care setting.

Implications for Practice: The observed relations between coping strategies, QOL, depression, and hopelessness give room to cognitive-behavioral nursing interventions. Specific attention is needed for differences in coping strategies between curative and palliative patients.

Author Affiliations: Department of Medical Oncology, Radboud University Nijmegen Medical Centre (Drs van Laarhoven and Verhagen); Department of Empirical Theology, Faculty of Theology, Radboud University Nijmegen (Drs van Laarhoven and Schilderman); and Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre (Dr Donders), Expert Centre of Palliative Care, Radboud University Nijmegen Medical Centre (Drs Vissers and Verhagen), Comprehensive Cancer Centre East (Dr Verhagen), Expert Centre of Chronic Fatigue and Department of Clinical Psychology, Radboud University Nijmegen Medical Centre (Drs Bleijenberg and Prins), Nijmegen, the Netherlands.

Correspondence: Hanneke W. M. van Laarhoven, MA, MD, PhD, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands (h.vanlaarhoven@onco.umcn.nl).

Accepted for publication August 24, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.