Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages

Abstract

Background: Many people experience cancer as a chronic disease followed by adaptation to a new reality. Adjustment to cancer is a continuous process that follows the progression of the disease. Aims: We aimed to support the claim that patients in different stages of cancer develop different adjustment patterns, and that the stage of the disease modifies the interrelationships among social support, coping styles, and quality of life. We also hypothesized that greater perceived social support influence more adaptive coping strategies, which mediate the relationship between social support and adjustment, differently in the early and advanced stage of cancer. Methods. One-hundred-two consecutive cancer patients were recruited. Measures. We administered the Social Provision Scale, the Mini-Mental Adjustment to Cancer, the Brief-COPE, and the SF-12 health survey. Results. No differences emerged in adjustment to cancer, coping relate variables and quality of life between stage III and stage IV patients. Subsequent analyses revealed that the stage of the disease moderated the relationships between fatalism and fighting spirit and those between physical health and both avoidance and problem-solving. Regardless of the stage of illness, positive thinking mediated between social support and fighting spirit. Conclusion. Although the average adjustment pattern was the same for early-stage and advanced patients, adjustment processes were different according to cancer stage. The results confirm that social support and disease stage are important for adjustment to cancer. Favouring acceptance, positive reframing, and humour, social support helped patients to be more determined in fighting the disease and contrasted helpless-hopelessness and anxious preoccupations.