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Cited by 88Cancer survivorship and carePalliative and Oncologic CareGrief, Bereavement, and Mental Health

Coping in Patients With Incurable Lung and Gastrointestinal Cancers: A Validation Study of the Brief COPE

Open access
Hagan, Teresa L., Fishbein, Joel N., Nipp, Ryan D., Jacobs, Jamie M., Traeger, Lara, Irwin, Kelly E., Pirl, William F., Greer, Joseph A. +3 more·2017·Journal of Pain and Symptom Management
DOI 10.1016/j.jpainsymman.2016.06.005PMC PMC5191904
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Abstract

Context Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple, distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. Objectives We sought to validate seven subscales of the Brief COPE in a large sample of patients newly diagnosed with incurable lung and non-colorectal gastrointestinal cancers (N=350). Methods Participants completed the Brief COPE and measures assessing quality of life (Functional Assessment of Cancer Therapy – General) and psychological distress (Hospital Anxiety and Depression Scale) within eight weeks of diagnosis of incurable cancer. We evaluated the psychometric properties of the Brief COPE using a confirmatory factor analysis and tests of correlation with the quality of life and distress scales. Results The Brief COPE factors were consistent with the original subscales, though the behavioral disengagement scale had low internal consistency. Factors showed anticipated relationships with quality of life and distress measures, except emotional support coping, which was correlated with increased depression and anxiety. We also conducted an exploratory higher-order factor analysis to determine if subscales’ score variances grouped together. The higher-order factor analysis resulted in two factors, with active, emotional support, positive reframing, and acceptance loading onto one factor and denial and self-blame loading onto the second. Conclusion The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers.

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Crossref · 10.1016/j.jpainsymman.2016.06.005

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    Greater use of self-blame, denial, and behavioral disengagement coping was associated with greater emotional distress.

    “We also found that greater use of self-blame, denial, and behavioral disengagement coping is associated with greater emotional distress (9, 22, 24).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] Brunault, 2015, Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients: psychological risk factors for lower quality of life after breast cancer, Psychooncology source

      Not checked in the free run.

    • cites [22] Stanton, 2000, Emotionally expressive coping predicts psychological and physical adjustment to breast cancer, J Consult Clin Psychol source

      Not checked in the free run.

    • cites [24] Costanzo, 2006, Coping and quality of life among women extensively treated for gynecologic cancer, Psychooncology source

      Not checked in the free run.

  • Findingown data

    The seven factors accounted for 60.9% of the variance in item responses.

    “These seven factors explained 60.9% of the variance in item responses, and many subscales were significantly correlated with each other (Table 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    The factor analysis produced rotated loadings that matched the original Brief COPE factors.

    “As we hypothesized in evaluating the psychometric validity of the scale, the factor analysis resulted in rotated factor loadings consistent with the original Brief COPE factors (Table 2).”
    • Also stated in: § Results · plain
      “The Brief COPE factors were consistent with the original subscales, though the behavioral disengagement scale had low internal consistency.”
    Quote in the paperSubstantial claim
  • Findingown data

    Many Brief COPE subscales were significantly correlated with one another.

    “These seven factors explained 60.9% of the variance in item responses, and many subscales were significantly correlated with each other (Table 3).”
    Quote in the paperNot a substantial claim
  • Findingown data

    The trial enrolled 350 patients with incurable cancer who completed baseline measures included in this analysis.

    “Between May 2011 and July 2015, we enrolled in the trial 350 patients with incurable cancer who completed baseline measures, which are included in this analysis.”
    Quote in the paperSubstantial claim
  • May combine two claims. 29
  • Classified as probably not a substantial claim. 16

  • May combine two claims.

    Findingnone given

    All Brief COPE subscales were significantly correlated with the FACT-G, with more engaged coping positively associated and less engaged coping negatively associated.

    “All Brief COPE subscales were significantly correlated with the FACT-G with more engaged types of coping demonstrating a positive association and less engaged types having a negative association.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Moving the item to the self-blame subscale did not significantly change the subscale's internal consistency or the scale's explained variance.

    “In addition, moving the item to the self-blame subscale did not significantly impact the subscale’s internal constancy or scale’s explained variance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    HADS anxiety and depression correlated with Brief COPE subscales as anticipated, except emotional support was positively correlated with anxiety (r = 0.16, p ≤ 0.01) and depression (r = 0.29, p ≤ 0.001) rather than negatively.

    “In addition, the HADS anxiety and depression subscales correlated with the Brief COPE subscales as anticipated with the exception of the emotional support subscale being positively correlated with the anxiety (r = 0.16, p ≤ 0.01) and depression (r = 0.29, p ≤ 0.001) subscales rather than negatively correlated as originally hypothesized.”
    • Also stated in: § Results · plain
      “Factors showed anticipated relationships with quality of life and distress measures, except emotional support coping, which was correlated with increased depression and anxiety.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The behavioral disengagement subscale had weak factor loadings: one item loaded 0.241 on its subscale and cross-loaded 0.242 on self-blame.

    “The behavioral disengagement subscale performed poorly when considering its factor loadings: one of the two items (“I’ve been giving up the attempt to cope.”) had a very low loading (0.241) onto the subscale with a cross-loading (0.242) on the self-blame subscale.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Removing items did not significantly improve the overall factor structure or the scale's explained score variance.

    “Removal of the items did not significantly improve the overall factor structure or the scale’s explanation of score variance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The positive reframing subscale was not significantly correlated with anxiety (r = −0.06, p = 0.28) but was correlated with depression (r = 0.23, p ≤ 0.001).

    “Also, the positive reframing subscale was not significantly correlated with the anxiety subscale (r = −0.06, p = 0.28), though it was with the depression subscale (r = 0.23, p ≤ 0.001).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The emotional support subscale was negatively related to approach-oriented coping (acceptance, positive reframing, active) and positively related to avoidance coping (self-blame, behavioral disengagement).

    “Notably, the emotional support subscale was negatively associated with more approach-oriented types of coping (e.g., acceptance, positive reframing, and active) and positively associated with more avoidance types of coping (e.g. self-blame and behavioral disengagement).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The proportion of eligible patients who enrolled was 72.9%.

    “The rate of eligible participants who enrolled in the study was 72.9%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The first higher-order factor comprised active, positive reframing, emotional support (negatively loaded), and acceptance; the second comprised denial and self-blame.

    “The first higher-order factor included active, positive reframing, emotional support (negatively loaded), and acceptance. The second higher-order factor included denial and self-blame.”
    • Also stated in: § Results · plain
      “The higher-order factor analysis resulted in two factors, with active, emotional support, positive reframing, and acceptance loading onto one factor and denial and self-blame loading onto the second.”
    • Also stated in: § Discussion · plain
      “Our exploratory higher-order factor analysis revealed a two-factor solution with active, positive reframing, emotional support (negatively loaded), and acceptance loading onto the first higher-order factor, and denial and self-blame loading onto the second higher-order factor.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Across the fourteen items, internal consistency was α = 0.563, and subscale alphas ranged from 0.223 for behavioral disengagement to 0.814 for acceptance.

    “The internal consistency was acceptable at α = 0.563 across the fourteen items with subscales’ alphas ranging from 0.223 (behavioral disengagement) to 0.814 (acceptance).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The scree plot showed that two or three factors explained most item variance, with several additional factors present.

    “The scree plot demonstrated that two or three factors explained the majority of the item variance with several additional factors present.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Brief COPE is a frequently used instrument designed to assess multiple separate coping strategies.

    “The Brief COPE is an abbreviated version of the COPE measure, an inventory of various types of coping styles (7).”
    • Also stated in: § Introduction · plain
      “As one of the most frequently employed measures to assess coping, the Brief COPE was included in the Coping with Cancer study, a large, multi-site investigation of patients with advanced cancer (8) as well as in other studies of cancer populations (9–11), providing empirical support for use of the measure in this population.”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [7] Carver, 1997, You want to measure coping but your protocol's too long: consider the brief COPE, Int J Behav Med source

      Not checked in the free run.

    • cites [8] Mack, 2008, Peace, equanimity and acceptance in the cancer experience (PEACE), Cancer source

      Not checked in the free run.

    • cites [9] Brunault, 2015, Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients: psychological risk factors for lower quality of life after breast cancer, Psychooncology source

      Not checked in the free run.

    • cites [10] Asuzu, 2013, Assessing cancer patients' quality of life and coping mechanisms in Radiotherapy Department of the University College Hospital, Ibadan: cancer patients, quality of life and coping mechanisms, Psychooncology source

      Not checked in the free run.

    • cites [11] Kershaw, 2004, Coping strategies and quality of life in women with advanced breast cancer and their family caregivers, Psychol Health source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The Kaiser-Meyer-Olkin statistic was 0.72, indicating moderate sampling adequacy, and Bartlett's test was significant at p ≤ 0.001, indicating the factor correlations were not an identity matrix.

    “The KMO statistic of 0.72 represented a moderate sampling adequacy, and significant Bartlett’s test (p ≤ 0.001) indicated that factor correlations do not reflect an identity matrix.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Logarithmic transformations were used to correct skewed Brief COPE items before factor analysis.

    “After identifying high levels of skewness (± 4) on several Brief COPE items related to floor and ceiling effects of item responses, we used logarithmic transformations to correct these variables in order to proceed with the factor analysis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Participants completed the Brief COPE within eight weeks of diagnosis and may not have had enough time to engage in the full range of coping strategies.

    “Participants completed the Brief COPE within eight weeks of their cancer diagnosis and may not have had sufficient time to engage in the potential range of coping strategies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Carver's original higher-order factor analysis of all 14 subscales found active, positive reframing, and one acceptance item loading on one factor, with denial and self-blame loading on another.

    “Similarly, Carver’s (7) original higher-order factor analysis of all 14 subscales found active, positive reframing, and one acceptance item loading onto one factor, with denial and self-blame loading onto another factor.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Carver, 1997, You want to measure coping but your protocol's too long: consider the brief COPE, Int J Behav Med source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The Brief COPE subscales showed generally expected inter-relationships and associations with quality of life and psychological distress, with some exceptions.

    “The Brief COPE subscales showed generally expected inter-relationships and associations with QOL and psychological distress symptoms with some exceptions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    All participants gave written informed consent before randomization.

    “After being introduced to the study by their medical oncologist, all participants provided written informed consent prior to randomization.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    The FACT-G and HADS were chosen because strong literature evidence described their relationships with coping and because both were collected in the parent study.

    “We chose these measures because (a) strong evidence exists in the literature describing the relationships between each construct and coping from which we could develop hypotheses and (b) we collected both measures as a part of the parent study.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The results supported many hypotheses, with noted variations including poor behavioral disengagement performance and unexpected positive correlations of emotional support with distress and avoidant coping.

    “While the results support many of our hypotheses, noted variations included poor performance of the behavioral disengagement subscale and unexpected positive correlations of the emotional support subscale with psychological distress and more avoidant types of coping.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Cancer increases risk for psychological distress, which is linked with poorer quality of life, greater barriers to quality cancer care, and worse morbidity and mortality.

    “These coping patterns are important because cancer elevates risk for psychological distress (25) which in turn has been linked with poorer QOL (26–28), greater barriers to quality cancer care (29–33) and worse morbidity and mortality (32–36).”
    Quote in the paperSubstantial claim0 of 9 sources checked
    • cites [25] Mitchell, 2011, Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies, Lancet Oncol source

      Not checked in the free run.

    • cites [26] El-Jawahri, 2015, Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation, Cancer source

      Not checked in the free run.

    • cites [27] Brown, 2010, The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain, Psychooncology source

      Not checked in the free run.

    • cites [28] Clevenger, 2013, Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis, Cancer source

      Not checked in the free run.

    • cites [29] Greer, 2008, Behavioral and psychological predictors of chemotherapy adherence in patients with advanced non-small cell lung cancer, J Psychosom Res source

      Not checked in the free run.

    • cites [30] Brink, 2008, Determinants of do-not-resuscitate orders in palliative home care, J Palliat Med source

      Not checked in the free run.

    • cites [31] Thompson, 2009, Prognostic acceptance and the well-being of patients receiving palliative care for cancer, J Clin Oncol source

      Not checked in the free run.

    • cites [32] Faller, 2002, Coping and survival in lung cancer: a 10-year follow-up, Am J Psychiatry source

      Not checked in the free run.

    • cites [33] Satin, 2009, Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis, Cancer source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The emotional support subscale showed unexpected results: it was negatively associated with engaged coping, had a negative higher-order factor loading, and was positively associated with anxiety and depression.

    “The emotional support subscale demonstrated unexpected results throughout our analysis. It was negatively associated with engaged types of coping, had a moderately strong but negative factor loading in the higher-order factor analysis, and was positively associated with anxiety and depression.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The HADS is widely used among patients with cancer.

    “The HADS is widely used among patients with cancer.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Zigmond, 1983, The Hospital Anxiety and Depression Scale, Acta Psychiatr Scand source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Previous studies were mostly in early-stage breast cancer, and the current data corroborate and reinforce these findings in a new sample of patients with incurable lung and GI cancers.

    “Since previous studies were conducted mostly among patients with early-stage breast cancer, our data corroborate and reinforce these findings in a new sample of patients with incurable lung and GI cancers.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The original seven-factor model was retained because it had superior conceptual congruency and strong statistical results compared with alternative models.

    “When we compared this 7-factor model to alternate models using Promax rotation, principal axis factoring, and fewer factors, we decided to retain the original 7-factor model given its superior conceptual congruency and strong statistical results.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Multiple iterations of exploratory analysis were examined to ensure results remained strong across different extraction, rotation, and loading methods.

    “We examined multiple iterations of the exploratory analysis to compare different modes of factor extraction, rotation, and factor loadings to ensure our results remained strong across varying types of analysis.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Research suggests that individuals who appraise their cancer as more threatening have lower well-being and greater psychological distress.

    “We based this hypothesis on research suggesting that individuals who appraise their cancer as more threatening have lower well-being and greater psychological distress (9, 18).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [9] Brunault, 2015, Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients: psychological risk factors for lower quality of life after breast cancer, Psychooncology source

      Not checked in the free run.

    • cites [18] Hamama-Raz, 2006, Psychological adjustment of melanoma survivors: the contribution of hardiness, attachment, and cognitive appraisal, J Individ Differ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Cancer Center protocol staff, separate from the study staff, administered baseline questionnaires after consent and before randomization.

    “Cancer Center protocol staff, who were separate from the study staff, administered baseline questionnaires to participants immediately following informed consent and prior to randomization.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The results largely supported a seven-factor solution matching the original subscales, except behavioral disengagement had very low internal consistency and a weak factor loading.

    “Our results largely supported a seven factor solution matching the original subscales, with the exception of the behavioral disengagement subscale that had an extremely low internal consistency and a weak factor loading.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    A large study of coping in patients with cancer used factor analysis to identify five coping patterns: seeking or using social support, focusing on the positive, distancing, cognitive escape-avoidance, and behavioral escape-avoidance.

    “In a large study of coping in patients with cancer, investigators used factor analysis to identify five coping patterns: seeking or using social support, focusing on the positive, distancing, cognitive escape-avoidance, and behavioral escape-avoidance (6).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Dunkel-Schetter, 1992, Patterns of coping with cancer, Health Psychol source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The acceptance subscale cross-loaded on both higher-order factors but was retained in the first because of its stronger loading and theoretical similarity.

    “While the acceptance subscale cross-loaded onto both factors, we retained it in the first higher-order factor given its stronger loading and theoretical similarity with the other subscales in this factor.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Most participants had incurable non-small cell lung or pancreatic cancer and may have different stressors and coping styles than patients with other incurable cancers.

    “Also, the majority of participants were diagnosed with incurable non-small cell lung and pancreatic cancer and may have different stressors and coping styles than patients with other types of incurable cancer.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evidence suggests that the stress of a cancer diagnosis can increase use of more defensive coping, such as denial.

    “Evidence also suggests that the stress of a cancer diagnosis can increase use of more defensive coping, such as denial (37), and that poor perceived skills for coping with stress have predicted worse well-being among patients (38).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Perry, 2015, Defensive functioning among women with breast cancer and matched community controls, Psychiatry

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Although emotional support is generally considered active and engaged coping, the results indicate it is distinct from other active coping because of its association with behavioral disengagement and self-blame.

    “Nonetheless, using emotional support is generally considered an active, engaged form of coping, yet our results indicate that it is distinct from other forms of active coping given its association with behavioral disengagement and self-blaming coping.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The Dana-Farber/Harvard Cancer Center Institutional Review Board approved the study before it began.

    “The Dana-Farber/Harvard Cancer Center Institutional Review Board approved this study prior to initiation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisereasoning

    Patients with incurable cancer may cope differently from those with early-stage cancer or other non-terminal illnesses because the disease is life-threatening and often rapidly progressive.

    “Patients with incurable cancer may cope differently than those with early-stage cancer or other non-terminal illnesses given the life-threatening and often rapidly progressive nature of the disease.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Lung and gastrointestinal cancers have poor prognosis and high symptom burden.

    “especially lung and gastrointestinal cancers which have a poor prognosis and high symptom profile (12, 13).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [12] Hopwood, 1995, Symptoms at presentation for treatment in patients with lung cancer: implications for the evaluation of palliative treatment, Br J Cancer source

      Not checked in the free run.

    • cites [13] Dobie, 2006, Completion of therapy by Medicare patients with stage III colon cancer, J Natl Cancer Inst source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The FACT-G is a valid, reliable scale with 28 items across four quality-of-life domains: physical, functional, emotional, and social well-being.

    “This valid, reliable scale consists of 28 items across four QOL domains including physical, functional, emotional, and social well-being.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Cella, 1993, The Functional Assessment of Cancer Therapy scale: development and validation of the general measure, J Clin Oncol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Coping researchers have debated how to label higher-order coping categories, and at least 14 categorization systems exist in the literature.

    “Coping researchers have debated how best to label higher order categories of coping and at least 14 categorization systems have been identified in the literature (20).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Skinner, 2003, Searching for the structure of coping: a review and critique of category systems for classifying ways of coping, Psychol Bull source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The behavioral disengagement subscale was kept to preserve conceptual clarity with the original measure.

    “Despite these shortcomings, the subscale was maintained to retain conceptual clarity with the original measure.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Poor perceived skills for coping with stress have predicted worse well-being among patients.

    “Evidence also suggests that the stress of a cancer diagnosis can increase use of more defensive coping, such as denial (37), and that poor perceived skills for coping with stress have predicted worse well-being among patients (38).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Penedo, 2013, Association of stress management skills and perceived stress with physical and emotional well-being among advanced prostate cancer survivors following androgen deprivation treatment, J Clin Psychol Med Settings source

      Not checked in the free run.

41 of 41

  • The paper relies on this without support.

    No prior study has validated the Brief COPE in patients with incurable cancer.

    “The Brief COPE has not been validated among patients with incurable cancer.”
    “However, to the best of our knowledge, no investigators to date have assessed the psychometric properties of the Brief COPE in a cohort of patients with incurable cancer, especially lung and gastrointestinal cancers which have a poor prognosis and high symptom profile (12, 13).”

  • The paper relies on this without support.

    This study is the first to psychometrically validate the Brief COPE in newly diagnosed incurable lung and GI cancers.

    “To our knowledge, this study is the first to psychometrically validate the Brief COPE within a sample of patients newly diagnosed with incurable lung and GI cancers.”
2 of 2

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Positive reframing's depression result conflicts with the stated conclusion

    Major

    The reported positive correlation associates greater positive reframing with greater depression, whereas the discussion says greater positive reframing was associated with less emotional distress.

  • The analysis is described as both confirmatory and exploratory

    Minor

    The abstract says the study used a confirmatory factor analysis, but the methods say it used an exploratory factor analysis with an unforced number of factors to test that hypothesis.

2 of 2

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Authors
Hagan, T. L., Fishbein, J. N., Nipp, R. D., Jacobs, J. M., Traeger, L., Irwin, K. E., Pirl, W. F., Greer, J. A., Park, E. R., Jackson, V. A., & Temel, J. S.
Affiliations
Harvard University (US)
ORCID
Venue
Journal of Pain and Symptom Management
Publisher
Elsevier BV
Published
2017-01
Volume
53
Issue
1
Pages
131-138
ISSN
0885-3924 (ISSN-L)
DOI
10.1016/j.jpainsymman.2016.06.005
PMC
PMC5191904
OpenAlex
W2528519564
Semantic Scholar
60e8602c2d5f3c0e61d5fb72a9610fd6121daebd
Cited by
88
References
41
Citations by year
2026: 3 · 2025: 6 · 2024: 7 · 2023: 12 · 2022: 19 · 2021: 13 · 2020: 13 · 2019: 5 · 2018: 4 · 2017: 6
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain and Symptom Management (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Nursing Research (R01 NR012735)
  • National Cancer Institute (K24 CA181253)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
Keywords
Brief COPE, coping styles, incurable cancer, lung cancer, gastrointestinal cancer, psychometric validation, quality of life, psychological distress, anxiety, depression, positive reframing, acceptance, denial, self-blame
MeSH terms
Adaptation, Psychological, Aged, Anxiety, Depression, Female, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Palliative Care, Psychometrics, Quality of Life, Surveys and Questionnaires, Stress, Psychological

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