Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease. Implications for cancer screening and management

BACKGROUND

Two main psychologic coping styles for dealing with cancer and other health threats have been identified: monitoring (attending to) or blunting (avoiding) potentially threatening information. This article reviews results and implications from this research relevant to cancer screening and management.

METHODS

The Monitor-Blunter Style Scale has been used extensively to assess and categorize patients with regard to these coping styles to predict their differential responses to various cancer-related screening and management regimens.

RESULTS

Patients characterized by a monitoring coping style generally are more concerned and distressed about their cancer risk, experience greater treatment side effects, are more knowledgeable about their medical situation, and are less satisfied with and more demanding about the psychosocial aspects of their care. They also prefer a more passive role in clinical decision making, are more adherent to medical recommendations, and manifest greater psychologic morbidity in response to cancer-related threats.

CONCLUSIONS

Patients fare better (psychologically, behaviorally, and physiologically) when the information they receive about their medical condition is tailored to their own coping styles: generally those with a monitoring style tend to do better when given more information, and those with a blunting style do better with less information. However, patients with a monitoring style who are pessimistic about their future or who face long term, intensely threatening, and uncontrollable medical situations may require not just more information, but also, more emotional support to help them deal with their disease.

Causal Attributions: Theoretical Considerations and Their Relevance to Occupational Therapy Practice and Education

The aims of this article are to outline the principles of causal attribution theory, within the broader context of social learning theory; to relate these theories to occupational therapy practice; and to describe ways in which the authors have applied these constructs to the education of occupational therapy students. The last involved both the teaching of this subject to senior students and the use of theoretical constructs in the assessment of students' coping strategies in clinical fieldwork placements.