Variability and stability of coping in women with breast cancer

Coping Strategies-Oriented Interventions in Breast Cancer Women: A Systematic Scoping Review of the Quantitative Evidence

Context: Coping strategies can predict breast cancer patients’ emotional well-being. Objectives: The aim of this systematic scoping review was to investigate the effect of coping strategies-oriented interventions on coping skills in breast cancer women. Data Sources: A systematic scoping review was conducted using a broad search across PubMed, Scopus, Springer, Elsevier, Cochrane Library, Science Direct, Web of Science, Magiran, Scientific Information Database, and Google scholar from 2009 - 2018. Study Selection: Clinical or quasi-experimental trials using interventions and control groups on the coping strategies-oriented interventions in breast cancer women in English or Persian were included. Data Extraction: Two independent researchers selected the final papers. In the case of a disagreement, the third researcher made the final decision. The quality of the included studies was assessed using the Jadad scale. Results: The coping strategies-oriented interventions were classified into four main categories: psychological interventions, such as cognitive-behavioral therapy, mindfulness, coping therapy, self-management, and psychoeducation; spiritual-religious interventions; social interventions, such as family therapy; and complementary interventions, such as acupuncture. Most interventions improved the coping skills of the studied women. Based on the Jadad scale, only two studies had good quality. Conclusions: Considering that most interventions improved the coping skills of breast cancer women, it is suggested that healthcare providers be proficient in examination techniques that maximize the patient’s coping skills. However, there remains a need for further culture-based research to adopt the best interventions and make changes in policy.

Coping response following a diagnosis of breast cancer: A systematic review

Introduction

Coping with breast cancer is an important health issue that results in adjustments to the disease in survivors. The present systematic review aims to synthesize the evidence about the coping strategies used by women who are primary breast cancer survivors to adjust to their new situations in their lives.

Methods

Searches were conducted using Google Scholar, PubMed, Scopus, Wiley Online Library, and PsycINFO, using the terms “breast cancer,” “breast malignancy,” “coping strategies,” “coping behaviors,” and “adjustment” from January 2000 to July 2015. Only relevant studies in English were selected at the end of the search. Only those papers were selected that focused on coping strategies/behaviors that were used by breast cancer survivors.

Results

Searching the electronic databases resulted in 2390 articles. Ultimately, 20 studies met the inclusion criteria of the present study and were included in the review. Two reviewers independently reviewed all relevant articles using the same inclusion criteria. The reviewers completed a quality assessment using the Newcastle–Ottawa Quality Assessment scales for observational studies. The more frequent coping strategies that patients with breast cancer used in the studies were 1) seeking social support (9 studies), 2) positive reframing and reappraisal behaviors as problem focused strategies (7 studies), 3) religious/spirituality-focused efforts (8 studies), 4) emotional expression as positive emotion-focused strategies (3 studies), and 5) avoidance and distraction as avoidance orientated strategies (6 studies). Women with different ethnicities and educational levels used different coping strategies with breast cancer, and they used different strategies in different phases of the disease.

Conclusion

This systematic review revealed that seeking social support and emotion-focused efforts were the main coping strategies that women with breast cancer diagnosis used, especially in the early phase of breast cancer diagnosis. This information about the coping responses of patients may be useful in designing interventional programs to assist other women in dealing with the various challenges imposed upon them by their illness.

Coping with breast cancer and relapse: Stability of coping and long-term outcomes in an observational study over 10 years

Many studies dealing with relationships between coping and breast cancer were based on a single measurement of coping behaviour. Assessments were taking place soon after surgery of primary breast cancer, and effects on long-term outcomes were considered. In our study it was examined whether coping behaviours are stable over time and whether they were associated with breast cancer recurrence. The analyses were based on a long-term study with initially 254 patients with three interviews and an outcome assessment within a total study period of 10 years. Data were collected by means of qualitative interviews and standardized questionnaires. Ways of coping in terms of helplessness, denial, mastery, and hope/optimism were classified by interviewer-based ratings within the framework of a standardized rating procedure. The reliability of rating standards was assured by continuous training and by estimating inter-rater agreements. Outcome measures were drawn from registries and patients' files. Coping behaviours over three interviews within six years after surgery turned out to be highly variable, and the respective correlations were low. For none of the four ways of coping associations with recurrence emerged. Coping in response to breast cancer was not stable over time, so we may conclude that the results of one measurement assessed early in the disease course should not be considered as constant over longer time periods. Coping behaviours were unrelated with recurrence, a finding that might be relieving from a patient perspective.