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RESOURCES, UNCERTAINTY AND COPING DECISIONS IN BREAST CANCER PATIENTS

Causal modeling techniques were utilized to examine a theoretically induced coping model of resources, uncertainty and coping responses. The purpose of this study was to determine the influence of five independent resource variables which included psychological resources, socio-community resources, marital role resources, parenting role resources and physical resources, and the influence of one situational variable, ambiguity, on the selection of differing coping decision responses, that is, minimizing stress behaviors, buffering situation behaviors and mobilizing infusion behaviors. The theoretical relationships of the constructs of resources, uncertainty and coping decisions were derived from the literature on coping, decisions under ambiguity and from a previous inductive study conducted with cancer patients by the investigator. The sample(s) selected for this study were patients previously treated for Stage I or II breast cancer and who were currently in remission within Pima County, Arizona, were of caucasian race and under 70 years of age. The sample was selected from patients treated or monitored from the Arizona Health Sciences Center, Department of Radiation-Oncology and Department of Hematology-Oncology and Kino Community Outpatient Cancer Clinic. Data was collected with an interviewer-administered questionnaire conducted in the subject's home and lasting approximately one hour. The data were analyzed by examining (1) the demographic characteristics, (2) correlations among the independent variables, (3) tests for causal assumptions, and (4) regression analysis of the theory model predictions. The evidence supports the original axiom that differential resources, namely, psychological, social and physical, account for an individual's differential selection of coping responses. Specifically, this study found that strong marital resources and a sense of mastery over the environment seems to deter the use of buffering behaviors; strong parenting role resources, physical resources and a self-denigrating attitude of one's self deter the use of mobilizing infusion behaviors. Specification errors included the probable dual dimensionality of the minimizing the mobilizing coping scales. Contributing variables that are absent in the model may include: social resource of occupation, disease and treatment staging, nature of the physician-patient relationship and the amount of accessible information and risk perceived in the situation. Measurement errors included the new reliability of the mastery scale, possible instrumentation error with the physical distress scale, and less than adequate scalability with the minimizing stress scale and mobilizing infusions scale, though these last two measurement errors could also be considered as misspecified variables. A multistaged empirical model of coping was generated from the findings of this study and will serve as the basis of further theory testing. An additional resource variable includes occupational role. Disease stage directly impacts the second stage of the coping model, uncertainty, which is expanded to include information and risk factors along with ambiguity. Coping responses in the third stage includes an additional category, taking direct action. The final stage of the model depicts the outcome of coping efficacy measured by increased psychological resources and reduced ambiguity.

Identiferoai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/281926
Date January 1981
CreatorsRyan, Sheila Anne
ContributorsHinshaw, Ada Sue
PublisherThe University of Arizona.
Source SetsUniversity of Arizona
Languageen_US
Detected LanguageEnglish
Typetext, Dissertation-Reproduction (electronic)
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.

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