The stressors facing people who must deal with a terminal diagnosis and palliative care are complex and varied. However, relatively little is known about the manner in which people cope with these stressors. Additionally, there has been little research into those characteristics that may predispose individuals to cope in particular ways. Therefore, this study investigates the process of coping with various end-of-life stressors, while also considering individual differences in how people prefer to cope. Fifty-two people who were receiving palliative care for advanced cancer underwent in-depth, semi-structured interviews. The interviews considered the tendency to monitor (focus on) or blunt (avoid) threat-relevant cues when dealing with stress, and whether this tendency was predictive of variations in actual coping behaviour, or variations in the experience of distress. Stress and coping were examined within three distinct conceptual dimensions comprising physical symptoms, social issues, and existential concerns. Specifically, participants were asked to identify their most significant problem in each dimension, and then to report how they coped with those problems. Their coping responses were then coded as reflecting either "problem-focused," "emotion-focused approach" or "emotion-focused avoidance". The results revealed that, unlike other health-related research, the tendency to "monitor" or "blunt" did not predict variations in the experience of psychological distress or variations in self-reported coping behaviour. Across the three dimensions of stress, physical symptoms received the highest severity ratings, but the dimensions were significantly intercorrelated with one another. A consistent individual difference was also noted in terms of the numbers of coping strategies participants generated to manage stressors. That is, participants who reported using a high number of coping strategies to manage a social stressor also reported using a high number of strategies in response to stressors in the other two dimensions. Participants generally used a combination of specific coping strategies to deal with their stressors. However, there were clear differences across dimensions of stress in the relative use of problem-focused versus emotion-focused strategies. Problem-focused coping was uncommon for existential issues while emotion-focused approach and emotion-focused avoidance strategies were used less frequently for physical stressors. Coping efforts were not related to psychological distress or to discrete anxiety and depressive disorders, which were diagnosed in 44.2% of the participants.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/6203 |
| Date | January 2002 |
| Creators | de Faye, Barbara J. |
| Contributors | Wilson, K. G., |
| Publisher | University of Ottawa (Canada) |
| Source Sets | Université d’Ottawa |
| Detected Language | English |
| Type | Thesis |
| Format | 182 p. |
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