Explaining quality of life with crisis theory.

Based on the premises of crisis theory, we expected cancer patients in-crisis to report a poorer quality of life (QL) and cancer patients post-crisis to report a similar level of overall QL in comparison to healthy individuals. To explain these hypothesized findings, we expected the coping resources and strategies of patients in-crisis to be equally effective and those of patients post-crisis to be more effective as compared to those of healthy individuals. The sample consisted of: (a) 217 consecutive cancer patients in the acute phases of their illness (patients in-crisis); (b) 192 disease-free cancer patients (patients post-crisis); and (c) 201 randomly selected healthy individuals. Established measures of QL, self-esteem and neuroticism (coping resources) and coping behavior (coping strategies) were mailed. As expected, patients in-crisis reported a poorer QL (p < 0.001) and patients post-crisis a similar overall QL as compared to healthy individuals. There were no significant or systematic differences between the mean levels of coping resources and strategies between the respective groups. Two-way analysis of variance indicated a group X coping resource interaction effect on overall QL for self-esteem (p < 0.01). As expected, the amount of variance of overall QL explained by self-esteem was largest for patients post-crisis (27%) and comparable for patients in-crisis and healthy individuals (10 and 11%). Patients in-crisis were not able to make their coping resources and strategies more effective, whereas patients post-crisis seemed to have enhanced the effectiveness of self-esteem in restoring their QL as compared to healthy persons. Copyright 2002 John Wiley & Sons, Ltd.