Introduction-The Cancer Behavior Inventory-Brief Version (CBI-B), a 12-item measure of self-efficacy for coping with cancer derived from the longer 33-item version (CBI-L), was subjected to psychometric analysis.

Purpose An estimated 30% of cancer patients are expected to experience clinically significant psychological distress during the treatment phase of their disease. Despite significant attention being directed to the mental health needs of individuals undergoing and completing treatment, there is less known about the mental health needs of survivors and the role of potential protective factors in survivorship, such as coping self-efficacy and social support. Method One hundred and twenty-four post-treatment cancer survivors (mean age = 62.23 years, female = 70%, average 9.3 years post-treatment) were asked to complete measures of physical symptoms, coping self-efficacy, social support, and depression as part of a national convenience sample of cancer patients and survivors. Results About 20% of participants possessed scores on the CES-D indicative of clinically-relevant depression. Coping self-efficacy was not only a significant predictor of depression (43% VAC); it also partially mediated the relationship between symptoms and depression. Social support accounted for limited variance and was not a significant predictor of depression in a model containing both social support and coping self-efficacy as predictors. Conclusion A substantial minority of post-treatment survivors reported depression symptomatology. Coping self-efficacy may be an important component of patients’ adjustment and possible target for intervention. These results highlight the ongoing mental health and support needs of cancer survivors.

Results suggest that the CGI is a reliable and valid measure of self-efficacy for caregiving, and indicate the importance of self-efficacy for self-care and for managing difficult communication in successfully navigating the demands of caregiving for terminally ill persons.

Objective Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. Method An uncontrolled, repeated measures design was used. Women (N=32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n=12) or group formats (n=20). On average, participants were middle aged (M=58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2-, 4-, and 7-months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included. Results Distress, anxiety, and negative affect decreased, while positive affect and mental health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety. Conclusions This treatment was feasible to deliver and acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence.

Background Optimal Matching Theory (OMT; [1]) posits that the effects of social support are enhanced when its provision is matched with need for support. We hypothesized that matching received social support with the needs of persons with cancer and cancer survivors would be related to better psychosocial adjustment than a mismatched condition. Method In a cross-sectional design, Sample 1, 171 cancer patients, and Sample 2, 118 cancer survivors, completed measures of emotional and instrumental received support, physical debilitation, and psychological distress. Results The OMT model was confirmed; those needing support (i.e., greater physical debilitation), who did not receive it, experienced more distress than those who needed support and received it. Patients in treatment benefited from the matching of need and provision for both emotional and instrumental support; whereas, survivors only benefited from the matching of emotional support. Conclusions The results suggest that social support is contextualized by the degree of physical impairment and may be somewhat different for cancer patients in treatment compared to cancer survivors. The transition to cancer survivorship may involve a transformation in the need for as well as the type and amount of received social support.

In contrast to the large literature on patients’ coping with an initial diagnosis of cancer, there have been few quantitative or qualitative studies of patients coping with recurrence. A qualitative study was undertaken to aide in the development of a tailored intervention for these patients. Individuals (N=35) receiving follow-up care for recurrent breast or gynecologic cancer at a university-affiliated cancer center participated in an individual or a group interview. Transcripts of interviews were analyzed using a coding format with two areas of emphasis. First, we focused on patients’ emotions, as there is specificity between emotions and the corresponding ways in which individuals choose to manage them. Secondly, we considered the patients’ social environments and relationships, as they too appear key in the adjustment to, and survival from, cancer. Patients identified notable differences in their responses to an initial diagnosis of cancer and their current ones to recurrence, including the following: 1) depressive symptoms being problematic; 2) with the passing years and the women’s own aging, there is shrinkage in the size of social networks; and, 3) additional losses come from social support erosion, arising from a) an intentional distancing by social contacts; b) friends and family not understanding that cancer recurrence is a chronic illness, and/or c) patients’ stemming their support requests across time. The contribution of these findings to the selection of intervention strategies is discussed.

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