Assessing the psychological predictors of benefit finding in patients with head and neck cancer.

BACKGROUND: Some individuals are able to gain psychological benefits from illness and adversity, such as a greater sense of purpose and closer relationships, termed 'benefit finding' (BF). The main aim of this study was to explore the extent to which BF is reported in patients with head and neck cancer (HNC). Secondary aims were to establish the relationships between BF, other patient-reported outcomes and predictive factors such as coping strategy and level of optimism. METHODS: This repeat measures study was conducted with 103 newly diagnosed patients with HNC. Self-completion questionnaires were used to assess BF pre-treatment and 6 months after treatment and pre-treatment coping, optimism, quality of life, anxiety and depression. Sixty-eight patients (66%) completed follow-ups. RESULTS: Moderate to high levels of BF were reported. Anxiety, depression and quality of life were not related to BF. Regression models of BF total score and three new factor analysed BF scales indicated that use of emotional support and active coping strategies were predictive of finding more positive consequences. Optimism, living with a partner and higher educational attainment were also found to have a protective effect. The amount of variance in BF explained by these five pre-treatment factors ranged from 32 to 46%. CONCLUSIONS: These findings demonstrate that both dispositional and potentially modifiable factors, in particular optimism and coping strategies, were associated with patients identifying positive consequences of a diagnosis of HNC. To maximise patient's longer-term resilience and adaptation, components of BF, either directly or via coping strategies, could be targeted for intervention.

Associations between quality of life, coping styles, optimism, and anxiety and depression in pretreatment patients with head and neck cancer.

BACKGROUND: Head and neck cancer is often diagnosed at a late stage and consequently radical treatment is necessary. The pretreatment phase is a time of high anxiety and depression for patients. This study aimed to investigate whether anxiety and depression are related to quality of life, coping styles, and dispositional optimism. METHODS: One hundred and three patients were recruited after diagnosis to a questionnaire study. Measures included the Hospital Anxiety and Depression Scale; SF12v2 Health Survey; Brief COPE, and the Revised Life Orientation Test. RESULTS: Quality of life, in particular emotional role explained a large proportion of the variance in pretreatment anxiety and depression. In addition, the use of negative coping styles was related to high anxiety levels and low levels of optimism were related to higher levels of depression. CONCLUSION: There are a small but significant proportion of pretreatment patients that may benefit from individualized support.