Psychosocial adaptation to cancer: A structural model and classification scheme
This study assessed risk factors for psychosocial morbidity and predictive models of psychosocial adaptation to cancer. Using 187 patients and survivors with a variety of cancer sites and stages, this study examined: (a) how demographic and disease variables could cluster individuals into groups that varied in "risk" for psychosocial adjustment problems; (b) models of adaptation which depicted psychosocial factors (i.e., coping cognitive processes, social support) as mediators between demographic and disease-related variables, on the one hand and psychosocial adjustment, on the other; (c) models of adaptation which proposed certain constructs as mechanisms of effect; and (d) differences in adjustment, coping, cognitive processes, and social support between survivors and patients, and men and women.^ First, participants clustered into three unique risk groups: low risk (low stage, later phase, high health, high education and income), moderate risk (low stage, later phase, high health, low education and income), and high risk (high stage, early phase, low health, low education and income), with significant differences across these clusters in terms of adjustment, coping behavior, cognitive processes, and social support illustrated. Second, structural modeling analyses supported prediction models which depicted psychosocial factors mediating between demographic and disease variables, on the one hand, and psychosocial adjustment, on the other. Third, structural modeling analyses showed that coping behaviors mediated between cognitive processes and social support, on the one hand, and psychosocial adjustment on the other. Fourth, minor differences in adjustment were found between patients and survivors, and no differences were found across these groups in terms of coping behavior, cognitive processes, and social support. Finally, though men and women did not differ in reported levels of adjustment, they did differ in terms of coping, cognitive processes, and social support. These results highlight the role of demographic and disease variables as contextual risk-factors and the role of psychosocial factors as mediating variables in prediction models of adjustment to cancer. Clinical implications of the results are discussed including: (a) targeting interventions towards those at greater risk for adjustment problems, and (b) the specific therapy components that may be needed to effectively enhance the psychosocial well-being of patients and survivors. ^
Health Sciences, Nursing|Psychology, Clinical|Psychology, Physiological|Health Sciences, Oncology
Robert Adam Schnoll,
"Psychosocial adaptation to cancer: A structural model and classification scheme"
Dissertations and Master's Theses (Campus Access).