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Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings*

Published online by Cambridge University Press:  09 July 2015

Elena Meggiolaro ,
Maria Alejandra Berardi ,
Elisabeth Andritsch ,
Maria Giulia Nanni ,
Agustina Sirgo ,
Elena Samorì ,
Clemens Farkas ,
Federica Ruffilli ,
Rosangela Caruso  and
Marta Bellé
...Show all authors
Elena Meggiolaro
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Maria Alejandra Berardi
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Elisabeth Andritsch
Affiliation:
Psycho-Oncology Service, Clinical Department of Oncology, University Medical Center of Internal Medicine, Medical University of Graz, Graz, Austria
Maria Giulia Nanni
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
Agustina Sirgo
Affiliation:
Psycho-oncology Unit Oncology Department University Hospital Sant Joan de Reus, Reus, Spain
Elena Samorì
Affiliation:
Istituto Oncologico Romagnolo (IOR), Forlì, Italy
Clemens Farkas
Affiliation:
Psycho-Oncology Service, Clinical Department of Oncology, University Medical Center of Internal Medicine, Medical University of Graz, Graz, Austria
Federica Ruffilli
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Rosangela Caruso
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
Marta Bellé
Affiliation:
Department of Oncology, Cà Foncello Hospital of Treviso, Treviso, Italy
Eva Juan Linares
Affiliation:
Psycho-Oncology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Silvia de Padova
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Luigi Grassi*
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
*
Address correspondence and reprint requests to: Luigi Grassi, Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy. E-mail luigi.grassi@unife.it
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Abstract

Objective:

As a part of a European study, we cross-culturally examined the rate of emotional distress and maladaptive coping and their association with cancer patients' satisfaction with their interactions with the physician responsible for their care.

Methods:

Cancer patients (n = 302) from one Middle European (Austria) and two Southern European (Italy, Spain) countries completed the NCCN Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation (AP) and Hopelessness (H) sub-scales, and the Physician Patient Satisfaction with Doctors Questionnaire (PSQ).

Results:

The prevalence of emotional distress (DT caseness) was 60% (26.1% mild, 18.8% moderate, and 14.9% severe distress). Maladaptive coping (Mini-MAC cases) was found in 22.8% (hopeless cases), and 22.5% (anxious preoccupation cases). PSQ-MD was significantly correlated with Mini-MAC/H and Mini-Mac/AP, while PSQ-PS was negatively correlated with Mini-MAC/H. DT cases and those with higher levels of hopelessness reported higher scores on PSQ-MD and lower on PSQ-PS than non-cases. Some differences were found between countries both as far as patients' coping and perception of the interaction with doctors. In hierarchical multiple regression analysis, after adjusting for socio-demographic and medical variables, Mini-MAC/H significantly predicted the scores on PSQ-MD (positive direction) and PSQ-PS (negative direction).

Significance of results:

The study confirms that about one out of three cancer patients have moderate to high level of emotional distress and about one out of four, clinically significant maladaptive coping. Also, patients showing hopelessness and distress tended to perceive their doctors as both disengaged and less supportive. These results highlights the need for physicians to monitor their patient's level of distress and coping mechanisms and to adjust their own relational and communication style according to patients' psychological condition. Also, cross-cultural issues should be taken into account when exploring psychosocial variables and cancer patients' perception of and satisfaction with the interaction with their doctors.

Keywords

Emotional distressCopingDoctor-patient relationCancer
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 3 , June 2016 , pp. 204 - 211
Copyright
Copyright © Cambridge University Press 2015 

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Footnotes

*

The paper is co-authored by the The IOR-IRST Psycho-Oncology Working Group and the UNIFE Psychiatry Working Group: Giorgia Bellini, Tatiana Bertelli, Laura Cavana, Maria Cristina Colistro, Alessandra Montesi, Maura Muccini, Elisa Ruggeri, Ilaria Strada, Antonella Carbonara, Sara Massarenti, Silvana Sabato

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