Appraisals and coping in people living with cancer: a meta-analysis.

The present meta-analysis examined the relationship between primary appraisal dimensions and coping strategies in people with cancer. Primary appraisals were operationalized as appraisals of threat, challenge, and harm/loss. Coping was operationalized according to two coping taxonomies: the first based on coping efforts to manage the stressor itself and/or the distressful feelings associated with it (problem- or emotion-focused coping, respectively) and the second based on the general orientation of the coping efforts (approach or avoidance coping). Appraisals of threat were (counter-intuitively) related to use of problem-focused coping (r=0.20); appraisals of harm and/or loss were related to avoidance coping (r=0.23); and appraisals of challenge were related to both problem-focused (r=0.15) and approach coping (r=0.14). These findings suggest that individuals with cancer who appraise their illness as a threat are likely to use more problem-focused coping strategies. Individuals who appraise their cancer as a harm/loss, however, are likely to use more avoidance coping strategies. And finally, those who appraise their cancer as a challenge are likely to use approach coping strategies. Factors found to moderate the relationship between appraisals and coping included age of the participant, time since diagnosis, and type of cancer. Copyright 2006 John Wiley & Sons, Ltd.