Skip to main content
SpringerLink
Log in

Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer

Supportive Care in Cancer volume 26, pages 4133–4142 (2018)Cite this article

Abstract

Objective

Most women with ovarian cancer present with advanced stage disease and face aggressive treatments, recurrence, and possible death, yet little is known about how they cope. Our objective was to identify coping strategies used by women with ovarian cancer and their trajectories of use after diagnosis and to assess if coping trajectories are associated with subsequent anxiety, depression, or quality of life.

Methods

Women with ovarian cancer completed questionnaires including the Brief-COPE, HADS, and FACT at 3, 6, and 9 months after diagnosis and the HADS and FACT at 12 months. Using data from 634 women who completed the 3-month questionnaire, factor analysis was conducted to identify coping strategy clusters. Trajectory modeling was used to assess patterns of coping over time. Associations between coping trajectory from 3 to 9 months and patient-reported outcomes at 12 months were investigated using general linear models.

Results

Three coping strategy clusters were identified. Use of “taking action/positive framing” followed four distinct trajectories over time: low-stable (44%), medium-stable (32%), medium-decreasing (11%), high-stable (12%). Use of “social/emotional support” had four trajectories: low-increasing (7%), low-decreasing (44%), medium-decreasing (40%), and high-stable (8%). Women either “accepted their reality” (26%) or “used some denial” (74%). Women who accepted reality reported significantly less anxiety and depression and better quality of life at 12 months. Women with high-stable use of taking action/positive framing reported less depression. Women with high-stable use of social/emotional support reported better quality of life.

Conclusions

Strategies to assist women with acceptance, action-planning, positive-framing, and maintaining psychosocial support should be considered.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tracey EA, Roder D, Francis J, Zorbas HM, Hacker NF, Bishop J (2009) Reasons for improved survival from ovarian cancer in New South Wales, Australia, between 1980 and 2003: implication for cancer control. Int J Gynecol Cancer 19:591–599

    Article  Google Scholar 

  2. Lockwood-Rayermann S (2006) Survivorship issues in ovarian cancer: a review. Oncol Nurs Forum 33:553–562

    Article  Google Scholar 

  3. Price MA, Butow PN, Costa DSJ, King MT, Aldridge LJ, Fardell JE, DeFazio A, Webb PM (2010) Prevalence and predictors of anxiety and depression in women with invasive ovarian cancer and their caregivers. Med J Aust 193:S52–S57

    PubMed  Google Scholar 

  4. Power J, Brown L, Ritvo P (2008) A qualitative study examining psychosocial distress, coping, and social support across the stages and phases of epithelial ovarian cancer. Health Care Women Int 29:366–383

    Article  Google Scholar 

  5. Mizrahi I, Kaplan G, Milshtein E, Reshef BP, Baruch GB (2008) Coping simultaneously with 2 stressors: immigrants with ovarian cancer. Cancer Nurs 31:126–133

    Article  Google Scholar 

  6. Tuncay T (2014) Coping and quality of life in Turkish women living with ovarian cancer. Asian Pac J Cancer Prev 15:4005–4012

    Article  Google Scholar 

  7. Gilbertson-White S, Campbell G, Ward S, Sherwood P, Donovan H (2017) Coping with pain severity, distress, and consequences in women with ovarian cancer. Cancer Nurs 40:117–123

    Article  Google Scholar 

  8. Canada AL, Parker PA, Basen-Engquist K, de Moor JS, Ramondetta LM (2005) Active coping mediates the association between religion/spirituality and functional well-being in ovarian cancer. Gynecol Oncol 99:S125–S125

    Article  Google Scholar 

  9. Hill EM (2016) Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking. Psychol Health Med 21:551-61

    Article  Google Scholar 

  10. Price MA, Bell ML, Sommeijer DW, Friedlander M, Stockler MR, Defazio A, Webb PM, Butow PN (2013) Physical symptoms, coping styles and quality of life in recurrent ovarian cancer: a prospective population-based study over the last year of life. Gynecol Oncol 130:162–168

    Article  CAS  Google Scholar 

  11. Seibaek L, Blaakaer J, Petersen LK, Hounsgaard L (2013) Ovarian cancer surgery: health and coping during the perioperative period supportive care in cancer. Support Care Cancer 21:575–582

    Article  Google Scholar 

  12. Lazarus RS, Folkman S (1984) Stress appraisal and coping. Springer, New York

    Google Scholar 

  13. Carver CS, Connor-Smith J (2010) Personality and coping. Annu Rev Psychol 61:679–704

    Article  Google Scholar 

  14. Carver CS, Scheier MF, Weintraub JK (1989) Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 56:267–283

    Article  CAS  Google Scholar 

  15. Dunkel-Schetter C, Feinstein LG, Taylor SE, Falke RL (1992) Patterns of coping with cancer. Health Psychol 11:79–87

    Article  CAS  Google Scholar 

  16. Bury M (1982) Chronic illness as biographical disruption. Sociol Health Illn 4:167–182

    Article  CAS  Google Scholar 

  17. Folkman S, Greer S (2000) Promoting psychological well-being in the face of serious illness: when theory, research and practice inform each other. Psycho-Oncology 9:11–19

    Article  CAS  Google Scholar 

  18. Roberts D, Calman L, Large P, Appleton L, Grande G, Lloyd-Williams M, Walshe C (2018) A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer’s theoretical model of appraisal and coping. Psycho-Oncology 27:229-235

    Article  Google Scholar 

  19. Carver CS (1997) You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med 4:92–100

    Article  CAS  Google Scholar 

  20. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  CAS  Google Scholar 

  21. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    Article  CAS  Google Scholar 

  22. King MT, Stockler MR, Butow P, O’Connell R, Voysey M, Oza AM, Gillies K, Donovan HS, Mercieca-Bebber R, Martyn J, Sjoquist K, Friedlander ML (2014) Development of the measure of ovarian symptoms and treatment concerns: aiming for optimal measurement of patient-reported symptom benefit with chemotherapy for symptomatic ovarian cancer. Int J Gynecol Cancer 24:865–873

    Article  Google Scholar 

  23. Basen-Engquist K, Bodurka-Bevers D, Fitzgerald M, Webster K, Cella D, Hu S, Gershenson D (2001) Reliability and validity of the functional assessment of cancer therapy-ovarian. J Clin Oncol 19:1809–1817

    Article  CAS  Google Scholar 

  24. Matsunaga M (2010) How to factor-analyze your data right: do’s, don’ts and how-To’s. Int J Psychol Res (Medellin) 3:97–110

    Article  Google Scholar 

  25. Nagin DS, Odgers CL (2010) Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol 6:109–138

    Article  Google Scholar 

  26. Jones BL, Nagin DS (2007) Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociol Methods Res 35:542–571

    Article  Google Scholar 

  27. Jones BL, Nagin DS, Roeder K (2001) A SAS procedure based on mixture models for estimating developmental trajectories. Sociol Methods Res 29:374–393

    Article  Google Scholar 

  28. Christ GH (1991) A model for the development of psychosocial interventions recent results in cancer research Fortschritte Der Krebsforschung Progrès Dans les Recherches Sur Le. Cancer 121:301–312

    CAS  Google Scholar 

  29. Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, Ketcham AS, Moffat FL Jr, Clark KC (1993) How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. J Pers Soc Psychol 65:375–390

    Article  CAS  Google Scholar 

  30. Courtens AM, Stevens FC, Crebolder HF, Philipsen H (1996) Longitudinal study on quality of life and social support in cancer patients. Cancer Nurs 19:162–169

    Article  CAS  Google Scholar 

  31. Price MA, Butow PN, Bell ML, deFazio A, Friedlander M, Fardell JE, Protani MM, Webb PM (2016) Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making? Support Care Cancer 24:2627-34

    Article  Google Scholar 

  32. Manne S (2007) Coping with cancer: findings of research and intervention studies. In: Martz E, Livneh H (eds) Coping with chronic illness and disability. Springer Science and Business Media, New York, pp 191–293

    Chapter  Google Scholar 

  33. Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36:13–34

    Article  Google Scholar 

  34. Hulbert-Williams N, Owen R (2015) Acceptance and commitment therapy (ACT) for cancer patients. In: Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R, Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R (eds) Psycho-oncology, 3rd edn. Oxford University Press, New York, pp 521–525

    Google Scholar 

  35. Australian Institute of Health and Welfare (2012) Gynaecological cancers in Australia: an overview. Australian Institute of Health and Welfare, Canberra

  36. Australian Cancer Network and the National Breast Cancer Centre (2004) Clinical Practice Guidelines for the Management of Women with Epithelial Ovarian Cancer. Camperdown, NSW

Download references

Acknowledgements

We acknowledge the OPAL Study team and all the clinicians and participating institutions who helped make this study possible (see opalstudy.qimrberghofer.edu.au for a complete list). We also thank consumer representatives Karen Livingstone, Hélène O’Neill, and Merran Williams and all the women who took part.

Funding

The OPAL study was funded by the National Health and Medical Research Council (NHMRC) of Australia (GNT1025142, GNT1073898). Collection of additional MOST data was funded by BUPA Health Foundation and the QIMR Berghofer Weekend to End Women’s Cancers 2014. PM Webb was supported by an NHMRC Fellowship (GNT1043134) and A DeFazio is supported by the University of Sydney Cancer Research Fund and the Cancer Institute NSW through the Sydney West Translational Cancer Research Centre.

Author information

Authors and Affiliations

  1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia

    Vanessa L. Beesley, Christina M. Nagle & Penelope M. Webb

  2. Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia

    David D. Smith

  3. School of Public Health, The University of Queensland, Brisbane, Australia

    Christina M. Nagle

  4. Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia

    Michael Friedlander

  5. Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, Australia

    Peter Grant

  6. The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia

    Anna DeFazio

  7. Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia

    Anna DeFazio

Authors
  1. Vanessa L. Beesley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David D. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina M. Nagle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Friedlander
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Grant
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anna DeFazio
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Penelope M. Webb
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the OPAL Study Group

Corresponding author

Correspondence to Vanessa L. Beesley.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Electronic supplementary material

Supplementary Table 1

(DOCX 219 kb)

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beesley, V.L., Smith, D.D., Nagle, C.M. et al. Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer. Support Care Cancer 26, 4133–4142 (2018). https://doi.org/10.1007/s00520-018-4284-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4284-0

Keywords

search

Navigation