Diane Roberts1, Lynn Calman2, Paul Large3, Lynda Appleton4, Gunn Grande1, Mari Lloyd-Williams5, Catherine Walshe6. 1. The Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK. 2. Faculty of Health Sciences, University of Southampton, Southampton, UK. 3. User representative, UK. 4. Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK. 5. Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, UK. 6. International Observatory on End of Life Care, Lancaster University, Lancaster, UK.
Abstract
OBJECTIVE: To explore whether the Folkman and Greer theoretical model of appraisal and coping reflects the processes used by people living with advanced cancer. METHODS: Interview data from a longitudinal qualitative study with people with advanced (stage 3 or 4) cancer (n = 26) were mapped onto the concepts of the Folkman and Greer theoretical model. Qualitative interviews conducted in home settings, 4-12 weeks apart (n = 45) examined coping strategies, why people thought they were effective, and in what circumstances. Interviews were coded and analysed using techniques of constant comparison. RESULTS: Mapping coping strategies clearly onto the problem- or emotion-focused elements of the model proved problematic. Fluctuating symptoms, deterioration over time, and uncertain timescales in advanced cancer produce multiple events simultaneously or in quick succession. This demands not only coping with a single event but also frequent repositioning, often to an earlier point in the coping process. In addition, there is substantial ongoing potential for some degree of distress rather than purely "positive emotion" as the final stage in the process is death with several points of permanent loss of capability in the interim. CONCLUSIONS: The Folkman and Greer theoretical model is helpful in deconstructing the discrete "problem-focused" or "emotion-focused" coping mechanisms participants describe, but its formulation as a linear process with a single, positive, outcome is insufficiently flexible to capture the evolution of coping for people with advanced cancer.
OBJECTIVE: To explore whether the Folkman and Greer theoretical model of appraisal and coping reflects the processes used by people living with advanced cancer. METHODS: Interview data from a longitudinal qualitative study with people with advanced (stage 3 or 4) cancer (n = 26) were mapped onto the concepts of the Folkman and Greer theoretical model. Qualitative interviews conducted in home settings, 4-12 weeks apart (n = 45) examined coping strategies, why people thought they were effective, and in what circumstances. Interviews were coded and analysed using techniques of constant comparison. RESULTS: Mapping coping strategies clearly onto the problem- or emotion-focused elements of the model proved problematic. Fluctuating symptoms, deterioration over time, and uncertain timescales in advanced cancer produce multiple events simultaneously or in quick succession. This demands not only coping with a single event but also frequent repositioning, often to an earlier point in the coping process. In addition, there is substantial ongoing potential for some degree of distress rather than purely "positive emotion" as the final stage in the process is death with several points of permanent loss of capability in the interim. CONCLUSIONS: The Folkman and Greer theoretical model is helpful in deconstructing the discrete "problem-focused" or "emotion-focused" coping mechanisms participants describe, but its formulation as a linear process with a single, positive, outcome is insufficiently flexible to capture the evolution of coping for people with advanced cancer.
Authors: Vanessa L Beesley; David D Smith; Christina M Nagle; Michael Friedlander; Peter Grant; Anna DeFazio; Penelope M Webb Journal: Support Care Cancer Date: 2018-06-12 Impact factor: 3.603
Authors: Hilde M Buiting; Marleen A C van Ark; Otto Dethmers; Emma P E Maats; Jogien A Stoker; Gabe S Sonke Journal: BMJ Open Date: 2019-03-30 Impact factor: 2.692
Authors: Suzanne K Chambers; Melissa K Hyde; Kirstyn Laurie; Melissa Legg; Mark Frydenberg; Ian D Davis; Anthony Lowe; Jeff Dunn Journal: BMJ Open Date: 2018-02-17 Impact factor: 2.692