| 1. |
- Wasteson, Elisabet, et al.
(författare)
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Comparison of a questionnaire commonly used for measuring coping with a daily-basis prospective coping measure
- 2006
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 61:6, s. 813-820
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Much research have investigated the relation between stress and health, with focus on the role of coping as a moderator. The use of the concept of coping is in need of more stringency since it is often used in a more or less careless manner. A contributory cause of the confusion within the research field is the often-negligent interpretation of results from the Mental Adjustment to Cancer (MAC) Scale (i.e., results are discussed in terms of coping strategies instead of mental adjustment). Furthermore, checklists are often used in research but seldom specify the stressor that patients are attempting to cope with. METHODS: Consecutive patients newly diagnosed with gastrointestinal (GI) cancer were included in this study. Of 151 eligible patients, 95 (63%) participated. As soon as their physical condition so permitted, patients were asked to assess their coping by way of two methods: an instrument commonly used for measuring coping (MAC Scale) and a daily-basis prospective coping measure [Daily Coping Assessment (DCA)]. The study investigated the relations between these two methods, which are used to evaluate different ways of coping with cancer, and related these to specified stressful events and psychologic distress outcomes [Hospital Anxiety and Depression Scale (HADS)]. RESULTS: Among patients with GI cancers, a comparison of the DCA with the MAC Scale renders important differences regarding the use of coping strategies. Furthermore, coping as measured by the DCA is more clearly separated from both stressors such as psychologic aspects and psychologic distress outcomes as measured by the HADS. DISCUSSION: A comparison between the two measures renders differences regarding the use of coping strategies among patients with GI cancers. The daily-basis prospective coping measure seems to be better separated from both stressful events and psychologic distress outcomes. The DCA offers a promising alternative to the use of coping checklists. The difference between the measures is in accordance with the original intention that the MAC Scale be used to measure mental adjustment rather than coping (i.e., the results do not support the use of the MAC Scale as a coping measure).
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| 2. |
- Wasteson, Elisabet, 1969-
(författare)
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Living and Coping with Cancer : Specific Challenges and Adaptation
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of this thesis were to prospectively investigate how specific challenges among patients with commonly occurring cancers are related to adaptation and well-being, to predict later well-being using a range of psychosocial aspects and to compare two ways of measuring coping with cancer. This was studied at diagnosis in patients with gastrointestinal cancers and their spouses and at termination of cancer treatment and during follow-up in a heterogeneous group of cancers. At diagnosis, higher levels of psychological distress were accompanied both by more coping attempts and less perceived control over the stressful events. Somatic aspects and Everyday concerns were frequent stressful events. The most frequently used coping strategies were emotion-focused. The Daily Coping Assessment (DCA) rendered a varied picture of ways of handling the stressful events (Study I). When studying coping as a process, the DCA has advantages compared to the commonly used measure MAC, since DCA better separates coping from both the stressful event and outcome. A comparison of the DCA and the MAC rendered differences regarding the usage of coping strategies (Study II). Patients with higher levels of anxiety/depression also had higher discrepancies between attainment and importance for most life values compared to patients with less anxiety/depression. For the patients, but not for the spouses, the discrepancies for several life values along with anxiety and depression decreased over time (Study III). Anxiety/depression at termination of treatment are strong predictors for anxiety/depression and QoL at follow-up. However, other variables like psychiatric history, the bother an event caused, the coping strategy Acceptance, the stressful event Thoughts/affects and emotional and instrumental aspects of social support contributed to the prediction (Study IV). Thus, it is concluded that detailed information regarding specific and frequent situations among cancer patients is possible to reveal and necessary for a better understanding of what influences well-being.
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| 3. |
- Winterling, Jeanette, et al.
(författare)
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Expectations for the recovery period after cancer treatment – a qualitative study
- 2009
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 18:6, s. 585-593
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore what expectations patients have concerning the recovery period after completed curative cancer treatment and the degree to which these expectations were realized slightly more than 1 year later. A purposeful sample of 16 patients was selected from a larger study and those patients were interviewed 16 months after treatment completion. The interviews were analysed using the phenomenographic method. Patients' expectation for their recovery period was generally to become well, but they often lacked plans for how to recover. If the recovery period was perceived as 'smooth' expectations were always met. However, if the period was perceived as 'tough' expectations were often unfulfilled, but most of these patients were satisfied with their current life anyway owing to positive changes and it was only a small proportion of the patients that still felt unwell. Even though most of the patients had managed to adjust well to the situation slightly more than 1 year after completed treatment, several patients had not been aware of how tough recovery could be and requested further support from the healthcare system.
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| 4. |
- Winterling, Jeanette, 1972-
(författare)
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Hope and Despair : Philosophy of life, expectations and optimism in cancer patients and their spouses
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim was to explore philosophy of life, expectations and optimism in patients and spouses in two different cancer situations, and to determine whether these aspects had relevance for psychological distress and quality of life. The first situation was being newly diagnosed with advanced cancer. Data on philosophy of life, optimism and psychological distress were gathered on one occasion (I). In addition, changes in life were described using a qualitative approach in a sub-sample (II). The second situation was having completed curative cancer treatment. Data on expectations for the recovery period, optimism, psychological distress and quality of life were gathered on three occasions (III). Moreover, expectations and how these turned out were described using a qualitative approach in a sub-sample (IV). The results show that being diagnosed with an advanced cancer influenced aspects of patients’ and spouses’ philosophy of life, including that existential questions were common and were related to higher psychological distress (I). All experienced substantial mental changes in life, often also physical, practical and sometimes positive changes. Patients more often seemed to accept their situation and prepared themselves for death, whereas spouses had more difficulties in handling the situation (II). Patients who had completed curative treatment generally had higher expectations for the recovery period than did their spouses, and patients expectations were fulfilled to a lesser degree, however, this generally had little importance for psychological distress or quality of life (III). Patients’ expectation for their recovery period was generally that they would get well. For those whose recovery period had been tough, expectations were often unfulfilled, but they were often satisfied with their current life anyway owing to positive changes (IV). Being optimistic was the most beneficial for decreased psychological distress in both samples, as well as for better quality of life in the recovery group (I, III).
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| 5. |
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| 6. |
- Winterling, Jeanette, et al.
(författare)
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The importance of expectations on the recovery period after cancer treatment
- 2008
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 17:2, s. 190-198
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to study expectations concerning recovery-related changes in life, e.g. beliefs regarding future adjustment back to 'normal' life after curative cancer treatment, whether these expectations were met and their importance for both patients' and their spouses' quality of life and psychological distress. Sixty-two patients and 42 spouses took part in the study. Data on recovery-related expectations, measured using a study-specific questionnaire (RRE), on quality of life using EORTC-QLQ C-30 and on psychological distress using HADS, were collected directly after completion of treatment, four and 16 months later. Optimism was measured using LOT at the last follow-up. The results demonstrate that patients generally had higher recovery-related expectations than did their spouses, and their expectations were also fulfilled to a lesser degree at both follow-ups. However, the expectations, or whether these were met, were generally not associated with their quality of life or psychological distress. The few associations that were made indicated that fulfilled expectations meant higher quality of life and/or less distress. The participants' optimism was associated with both their quality of life and psychological distress. It is concluded that optimism influenced the participants' quality of life and psychological distress to a higher degree than did their recovery-related expectations.
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