Coping and Psychological Distress among Head and Neck Cancer Patients

The psychological distress associated with head and neck cancer patients can result from the life threatening nature of the disease or from the disfigurement and dysfunction associated with the disease. Few studies have described the relationship between the psychological distress and how patients cope with head and neck cancer. Objectives: To investigate how head and neck cancer patients 6-12 months after their diagnosis cope with their disease and how their coping skills are related to their psychological distress (symptoms of anxiety and depression). Methods: We conducted a cross sectional study using the baseline data of 107 head and neck cancer patients in a prospective study. We evaluated coping strategies using the Ways of Coping Checklist (WOCC) and anxiety and depression using The Hospital Anxiety and Depression Scale (HADS). Results: The data analysis revealed that among the participants the mean anxiety rating was 5.1 and the mean depression rating was 4.1 (on scales of 0-21, wherein higher score indicates greater problems). Twenty six patients (24.3%) had high levels of anxiety and 16 patients (15%) had high levels of depressive symptoms (defined by the well recognized cut off point of <8 versus ≥8 on the scales). In addition, results showed that patients used a variety of coping strategies with "problem focused" coping strategy being used most frequently. Subjects with high levels of symptoms of anxiety were more likely to use "seek social support" (P=0.037), "blamed self" (P=0.023), "wishful thinking" (P<0.001) and "avoidance" (P<0.001) coping strategies. Subjects with high depressive symptoms were more likely to use "blamed self" (P=0.003), "wishful thinking" (P<0.001) and "avoidance" (P<0.001) coping strategies. Conclusion: These data suggest that coping strategies in head and neck cancer patients vary according to their level of psychological distress. This research is funded by a grant from the Canadian Institute of Health Research.