The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment.

Given the marked individual variability in psychological adjustment in response to breast cancer, it is important to specify factors contributing to adaptive survivorship. This longitudinal study of 70 women with Stage I or II breast cancer tested the ability of situation-specific coping strategies and a more stable attribute, hope, to predict adjustment prospectively from the point shortly following diagnosis through the first year. Consonant with previous studies, coping through active acceptance at diagnosis predicted more positive adjustment across time, and avoidance-oriented coping predicted greater fear of cancer recurrence, over and above participant age and initial status on dependent variables. The hypothesis that coping through turning to religion would be more effective for less hopeful women was supported, and mixed support emerged for the hypothesis that approach-oriented coping strategies would yield greater adaptational benefits for women high in hope. Findings suggest that risk and protective factors for adjustment across the first year of survivorship can be identified even prior to definitive surgery for breast cancer, particularly when both dispositional characteristics such as hope and situation-specific coping strategies are considered. Copyright 2002 John Wiley & Sons, Ltd.