Life is precious and I'm making the best of it: coping strategies of long-term cancer survivors

Objective: Coping strategies mediate the relationship between challenging situations and their impact on psychosocial outcomes. Many long-term cancer survivors continue to face a range of challenges in their daily lives, yet little is known about how this population copes. The study explored the prevalence and predictors of cancer-specific coping strategies among a heterogeneous sample of long-term cancer survivors. Methods: A population-based cross-sectional sample of 863 adult cancer survivors 5-6 years post-diagnosis completed a pen-and-paper survey. Cancer-specific coping was assessed via the Mini-Mental Adjustment to Cancer (mini-MAC) Scale. Potential predictor variables included patient, disease and treatment characteristics and social support. Results: The most commonly used coping strategies were fatalism and fighting spirit. Of those survivors that used any of the coping strategies assessed, 53% used at least two strategies. Maladaptive coping was commonly predicted by low social support (OR = 1.77 to 2.49) and being a disability pensioner, whereas having ever received chemotherapy widely predicted greater use of all types of coping. A weekly household income of over $1000 a week uniquely predicted not using any mini-MAC coping strategies. Conclusions: Survivors continue to engage in cancer-specific coping strategies many years after diagnosis, albeit to a lesser extent than recent survivor populations. A number of predictors were identified that can alert health workers to long-term survivors at increased risk of maladaptive coping. Given that low social support consistently predicted maladaptive coping responses, interventions aimed at promoting positive coping responses should include strategies to increase access to social support. Copyright (C) 2010 John Wiley & Sons, Ltd.