Coping strategies of Palestinian adolescents and young adults with cancer: a triangulation approach

Abstract

BackgroundCancer is the second leading cause of death in Palestine, accounting for 13·8% of all deaths. The adolescent and young adult (AYA) population is considered to include individuals aged 15–39 years. Diagnosing cancer at any age is an inevitable stressor. In the case of AYAs who have been diagnosed with cancer, fears relating to future and developmental consequences grow as they negotiate developmental normative tasks during this period of their lives. This study aimed to identify the strategies used by patients aged 15–39 years to cope with cancer. MethodsA triangulation approach was used, involving two hospitals—Beit-Jala governmental hospital and Augusta Victoria non-governmental hospital—offering oncology services in the West Bank between August, 2017, and April, 2018. These were chosen based on their capacity to treat cancer patients from all regions in West Bank and Jerusalem. The brief COPE scale (the abbreviated version of the COPE inventory) and the Arabic version of the SpREUK-P self-administered questionnaire were completed by a convenience sample of 165 patients aged 15–39 years from the hospitals. Qualitative in-depth interviews were also conducted with 12 individuals to obtain a more in-depth understanding of their coping strategies with cancer, based on content analysis. Statistical tests (Student's t-test, ANOVA, Tukey's honest significant difference, Pearson's correlation) were performed using IBM-SPSS (version 20). Written informed consent was obtained from patients, and parents or guardians of patients under 18 years old. The study was approved by the School of Public Health of Al-Quds University. FindingsOut of 196 respondents, 165 completed the questionnaire of the quantitative survey; a response rate of 84%. Individuals indicated the degree to which they use each coping strategy on a four-point Likert scale, ranging from 1 (not at all) to 4 (a lot). Different coping strategies were used by patients. Religion and acceptance of cancer were the most commonly used (mean 3·77, SD 0·5), followed by emotional support (3·65, 0·67), active coping (3·55, 0·64), and planning (3·43, 0·85). The lowest scores were for behavioural disengagement (1·46, 0·76), self-blame (1·56, 0·76), and substance use (1·69, 0·98). Respondents used problem-focused coping strategies (3·34, 0·53) more than emotion-focused coping strategies (2·67, 0·30). The major themes of coping identified in the interviewswere: coping mechanisms associated with religion, social support and affiliation, acceptance, positive reinterpretation and growth, self-distraction, planning, and spirituality coping. InterpretationOur findings underline the range of methods by which young people cope with cancer, and the importance of helping individuals to find and use the coping strategies thatare best suited tothem. FundingNone.