Understanding how people cope with cancer

The challenges associated with cancer diagnosis and treatment require a coping response. The nature of the response can be defined according to a number of theoretical models of adjustment. Presented is a review of 3 theoretical models of adjustment applied to the cancer experience (1) The problem solving model of stress and coping (Nezu, Nezu, Houts Friedman & Faddis, 1998); (2) An integrative framework and life events model (Billings and Moos, 1982); and (3) the cognitive model (Moorey and Greer, 2002). While the problem solving model highlights the importance of problem solving processes in mediating the impact of cancer on quality of life, the integrative framework and the life events model defines the relationship between cancer and adjustment as being mediated not only by coping responses but also by the individual’s personal and environmental resources as well as their cognitive appraisal of cancer-related stresses. The appraisal of cancer-related stresses is the central factor in the cognitive model, which proposes that it is patients’ perception of stress which determines the level of adjustment and quality of life. The theoretical frameworks reviewed here suggest that psychosocial interventions that aim to improve the adjustment of cancer patients should enhance problem-solving skills, increase personal and environmental coping resources, and facilitate the development of adaptive
appraisals of cancer-related stresses.