Biopsychosocial correlates of adjustment to cancer during chemotherapy: the key role of health-related quality of life
Open accessAbstract
BACKGROUND: Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). AIMS: Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient's age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. METHODS: One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. RESULTS: We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient's age had no significant relationships in the model. DISCUSSION: HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient's mental health individually and involving significant others in supportive care, respectively.
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Attempts to control and being caught up in internal experience related to cancer-related fatigue lead to high levels of anxiety and depression, which cause high alert of cancer-related fatigue and sustained distress.
“Attempts to control and being caught up in the internal experience related to CRF lead to high levels of anxiety and depression,17 which cause the high alert of CRF, bringing about sustained distress during the cancer trajectory.18”
From Effects of Acceptance and Commitment Therapy on fatigue interference and health-related quality of life among patients with advanced lung cancer: A pilot randomized controlled trial (2022) · cites this paper as [18]
The Conclusion (page unavailable) links avoidance of cancer-related thoughts with poor mental health and anxious preoccupation, and says avoidance may relieve anxiety briefly but be ineffective in the long run. It does not establish that attempts to control fatigue-related experiences cause high anxiety and depression, or that these cause heightened alertness to fatigue and sustained distress. The Structural Model (page unavailable) reports associations, not that causal chain. (LLM, conf=0.84)
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References 66 · Cited by 26
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- [34]Patoo M. Allahyari A. A. Moradi A. R. Payandeh M. Hassani L. Studying the relation between mental adjustment to cancer and health-related quality of life in breast cancer patients International Journal of Cancer Management 2018 11 7 2-s2.0-85052491119
- [59]Tomai M. Lauriola M. Caputo A. Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages? Mediterranean Journal of Clinical Psychology In press
- [63]Ringle C. M. Wende S. Becker J. M. SmartPLS 3. 2015 (2015) 10.1109/GreenTech.2013.15 · DOI
- Authors
- Lauriola, M., & Tomai, M.
- Affiliations
- Sapienza University of Rome (IT)
- Corresponding author
- Lauriola, Marco
- Tomai, Manuela
- Venue
- The Scientific World JOURNAL
- Publisher
- Wiley
- Published
- 2019-03-10
- Volume
- 2019
- Pages
- 1-12
- ISSN
- 1537-744X (ISSN-L)
- 2356-6140
- PMC
- PMC6431483
- OpenAlex
- W2920951309
- Cited by
- 26
- References
- 66
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 8 · 2021: 4 · 2020: 1
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Scientific World JOURNAL (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- adjustment to cancer, chemotherapy patients, health-related quality of life, biopsychosocial model, tumor stage, gender differences, social support, positive thinking, coping styles, anxious preoccupation, cognitive avoidance, fighting spirit, fatalism, mental health, physical function
- MeSH terms
- Adaptation, Psychological, Aged, Antineoplastic Agents, Female, Humans, Male, Mental Health, Middle Aged, Neoplasms, Quality of Life, Social Support, Patient-Centered Care
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