Coping of cancer patients during and after radiotherapy - a follow-up of 2 years

Aim: We wanted to understand coping strategies specific to
different phases up to two years after radiotherapy, to identify
patients who are at higher risk of mood disturbances and to
characterise the association between coping strategies and
psychosocial adaptation. Patients and Methods: From 1997 to 2001,
2,169 patients with different diagnoses were screened (27.8%
refused to participate). Data of 276 patients from the beginning of
radiotherapy (ti1) and 5 follow-up investigations (ti6/2 years)
could be analysed. With the FKV ( Freiburg Questionnaire Coping
with Disease) cancer-specific coping aspects were assessed. The
association between coping styles and psychosocial adaptation was
evaluated using the Questionnaire on Stress in Cancer Patients
(QSC) and the questionnaire on Functional Assessment of Cancer
Treatment (FACT-G). Results: `Active problem-orientated' coping and
`distractions' are the most important coping strategies. Only
`active problem-orientated' and `depressive' coping showed a
significant decrease. We observed higher means on the scales of the
FKV in women. Marital status ( single, married, divorced/widowed)
had a significant influence on active problem-orientated coping and
spirituality. Age, children, education, T/M status and curative/
palliative intention of treatment had no influence on coping
styles. Breast cancer patients and lymphoma patients demonstrated
the highest use of coping strategies after radiotherapy with a
significant decrease of `active problem-orientated coping'.
Depressive coping and minimizing importance at ti1 were associated
with high psychosocial distress and low quality of life (QoL) at
ti6. Conclusion: The correlation of coping mechanisms at the
beginning of radiotherapy with low QoL and high psychosocial stress
at 2 years could help to identify patients at risk for low
psychosocial adaptation. Psychooncologically trained teams of
physicians would best correspond to this profile of needs and would
contribute significantly to an ameliorated adaptation of patients
to cancer which could lead to higher life satisfaction.