Coping self-efficacy, perceived helpfulness of coping, and distress: a longitudinal investigation of breast and gynecologic cancer patients undergoing chemotherapy.

ABSTRACT

We examined changes in coping self-efficacy (CSE) pre- and post-chemotherapy and whether these changes predicted depressive symptoms and perceived stress after chemotherapy among women breast and gynecological cancers. We further tested whether perceived helpfulness of coping strategies used during chemotherapy influenced these effects. In a longitudinal design, participants (n = 79) provided data on CSE, depressive symptoms, and perceived stress pre-chemotherapy, post-chemotherapy (~ 4 months later), and at 8 and 12-month follow-up. During chemotherapy, participants completed a one-week daily diary on use and helpfulness of coping strategies in managing side effects. CSE decreased during chemotherapy, returning to baseline levels at follow-up. Higher problem-focused CSE pre- and post-chemotherapy predicted increases in distress among women who appraised their coping strategies as low or average in helpfulness during chemotherapy; problem-focused CSE was unrelated to changes in distress at high levels of perceived helpfulness. Increases in coping self-efficacy without concomitant helpful coping strategies may be markers for poor adjustment post-chemotherapy and identify patients who could benefit from psychosocial services. Combined education and skills-based interventions to align self-efficacy beliefs with coping strategies may reduce psychological burden.