The Impact of Illness Perceptions and Coping Strategies on Use of Supportive Care for Cancer.

Peta Stephenson,Evelien R Spelten,Eva Yuen,Carlene Wilson,Gemma Skaczkowski,Sheina Orbell

doi:10.3390/cancers13102501

Abstract

Simple SummaryCancer survivorship support programmes improve wellbeing, but most oncology patients and survivors do not use them. The current study examined whether people who saw themselves as having greater personal control over their illness used more problem-focused coping strategies, and if this resulted in higher use of survivorship support services. The study also examined the possibility that use of supportive care services was higher amongst those patients who used more emotion-focused coping strategies and who were experiencing greater emotional distress about their cancer. We found that people using more survivorship support services tended to have a greater belief in their ability to do something to control their cancer but were not emotionally distressed.Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and the mediating role of coping strategies. Cancer patients and survivors (n = 336 from Australia, n = 61 from the UK; 191 males, 206 females) aged 20–83 years (Mean (M) = 62.73, Standard Deviation (SD) = 13.28) completed an online questionnaire. Predictor variables were cognitive and emotional representations of cancer, as measured by the Illness Perception Questionnaire—Revised (IPQ-R), and problem- and emotion-focused coping strategies, as measured by the Brief-Coping Orientation to Problems Experienced inventory (Brief-COPE). The outcome variable was survivorship support programme use within the preceding month. Perceived personal control over cancer predicted supportive care use, but cancer-related emotional distress did not. Coping was an inconsistent mediator of the relationships. Problem-focused coping mediated the relationship between personal control and supportive care use; emotion-focused coping did not mediate between emotional responses to cancer and the uptake of survivorship support programmes. The Common Sense Model provides a useful framework for understanding survivorship support programme use. However, more clarity around the relationship between illness beliefs and coping is required.

Highlights

Recent studies reported that over one-third of people with cancer exhibit significant levels of psychological distress [1,2]
Significant differences were found for gender, (χ2 (1, N = 397) = 11.87, p = 0.001), with a greater proportion of women reporting supportive care use (67%), and for marital status, (χ2 (3, N = 397) = 11.73, p = 0.008), with the majority of supportive care users
As predicted by the Common Sense Model, the present results suggest that people with cancer who take the decisive step to engage with psychosocial support services perceive their cancer to be within their control but they are more likely to adopt problem-focused coping procedures more readily, which, in turn, predicts supportive care use

Summary

Introduction

Recent studies reported that over one-third of people with cancer exhibit significant levels of psychological distress [1,2]. Engaging with survivorship support services, including cancer helplines, joining professionally led peer support groups, attending educational seminars or meeting with social workers, therapists, counsellors, chaplains and spiritual advisors has been shown to reduce patients’ emotional distress and improve wellbeing [4,5]. Survivorship supportive care is understood as a multidimensional, person-centred approach to delivering essential services for people with cancer to help them fulfil their physical, psychological, practical, informational, spiritual and social needs during cancer diagnosis, treatment and survivorship [4]. Patient evaluations of cancer survivorship support programmes, whether offered in a hospital or an outpatient setting, indicate multiple benefits including reduced stress levels, more energy, better sleep, and elevated hopefulness and empowerment [6]. Many oncology patients do not take advantage of supportive care services [7]

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