Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: A qualitative study.


Journal

Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347

Informations de publication

Date de publication:
02 2019
Historique:
received: 15 01 2018
revised: 09 04 2018
accepted: 05 06 2018
pubmed: 15 10 2018
medline: 19 11 2019
entrez: 15 10 2018
Statut: ppublish

Résumé

Distress is common among cancer patients and leads to worse postoperative outcomes. Surgeons are often the first physicians to have in-depth conversations with patients about a new colorectal cancer diagnosis; therefore, it is important that these surgeons understand how patients cope with the distress of a diagnosis and how they can help patients manage this distress. Patients with colorectal cancer were recruited from an outpatient surgery clinic. Purposive sampling was used to recruit patients if they were either planning to undergo surgery or had undergone surgery within six months. In-depth, open-ended, individual qualitative interviews were performed. Grounded theory was used to develop themes regarding patients' coping strategies and beliefs regarding the role of the surgeon in helping them cope. Patients described their own internal coping strategies using problem-focused, emotion-focused, and meaning-focused techniques. Patients also reported the importance of their social support network for coping. Patients believed surgeons and their teams should help patients manage the emotional components of their cancer diagnosis and surgical experience, especially if patients were experiencing high levels of distress or had inadequate coping skills. They did not believe surgeons themselves should be primarily responsible for helping them cope. In order for surgeons to guide diagnosis and initial management of distress in colorectal cancer patients undergoing surgery, they should screen patients for distress, identify and strengthen patients' own coping strategies, facilitate a strong social support network, and provide patients with the option to obtain further support from the surgeon's office.

Sections du résumé

BACKGROUND
Distress is common among cancer patients and leads to worse postoperative outcomes. Surgeons are often the first physicians to have in-depth conversations with patients about a new colorectal cancer diagnosis; therefore, it is important that these surgeons understand how patients cope with the distress of a diagnosis and how they can help patients manage this distress.
METHODS
Patients with colorectal cancer were recruited from an outpatient surgery clinic. Purposive sampling was used to recruit patients if they were either planning to undergo surgery or had undergone surgery within six months. In-depth, open-ended, individual qualitative interviews were performed. Grounded theory was used to develop themes regarding patients' coping strategies and beliefs regarding the role of the surgeon in helping them cope.
RESULTS
Patients described their own internal coping strategies using problem-focused, emotion-focused, and meaning-focused techniques. Patients also reported the importance of their social support network for coping. Patients believed surgeons and their teams should help patients manage the emotional components of their cancer diagnosis and surgical experience, especially if patients were experiencing high levels of distress or had inadequate coping skills. They did not believe surgeons themselves should be primarily responsible for helping them cope.
CONCLUSION
In order for surgeons to guide diagnosis and initial management of distress in colorectal cancer patients undergoing surgery, they should screen patients for distress, identify and strengthen patients' own coping strategies, facilitate a strong social support network, and provide patients with the option to obtain further support from the surgeon's office.

Identifiants

pubmed: 30316575
pii: S0039-6060(18)30315-5
doi: 10.1016/j.surg.2018.06.005
pii:
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

461-468

Subventions

Organisme : AHRQ HHS
ID : T32 HS000066
Pays : United States

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

Auteurs

Jonathan S Abelson (JS)

Department of Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY. Electronic address: Jsa9004@med.cornell.edu.

Alanna Chait (A)

Department of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.

Megan Johnson Shen (MJ)

Department of Psychology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.

Mary Charlson (M)

Department of Integrative Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.

Anna Dickerman (A)

Department of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.

Heather Yeo (H)

Department of Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY; Department of Public Health, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY.

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Classifications MeSH