A review of potential factors relevant to coping in patients with advanced cancer

Aims. The aim was to identify characteristics that are considered to describe coping in patients with advanced cancer, as seen from a patient perspective. Based on the identified characteristics, the second aim was to identify potential factors that are relevant to coping in patients with advanced cancer. Background. Patients with advanced or incurable cancer often express a need for professional help to cope with their complex situation. Furthermore, the support of health care professionals may often be dominated by a focus on symptom treatment and its effectiveness and less on the kind of needs that the patients consider most important. Design. Systematic review. Methods. Based on guidelines from the Centre for Review and Dissemination, York University, a systematic literature search identified 30 articles. Using Lazarus and Folkman's theory of coping as the theoretical framework, relevant data were extracted, analysed and synthesised. Results. Based on the identification of 160 characteristics, seven potential factors emerged: 'Creating meaning', 'Support systems', 'Minimising the impact of cancer', 'Bodily and mental functioning', 'Control' and 'Uncertainty' and 'Emotions'. Conclusions. The results indicate that emotion-focused coping may be used more often by patients with advanced cancer than problem-focused coping. However, it cannot be ruled out that this finding relates to a nomenclature of coping function that is too limited. Furthermore, the results indicate that the seven potential factors may be related to both the appraisal process and the coping process. Relevance to clinical practice. By choosing, as the theoretical framework, Lazarus and Folkman's theory about the connection between the stress, appraisal and coping processes, it has been possible to highlight how the identified factors may be used as the underlying basis of clinical questions focusing on the patients' appraisal of and coping with the concrete situation.