Personal and social resources facilitate the adaptation to critical life events. The present study investigates whether general self-efficacy beliefs and received social support elevate cancer patients' physical, emotional, and social well-being directly, or whether these effects are rather mediated by active or meaning-focused coping. Gastrointestinal, colorectal, and lung cancer patients were approached at 1 month and at 6 months after surgery (N=175). Structural equation models indicate that self-efficacy at 1 month after surgery exerted a positive direct effect on all three domains of health-related quality of life at 6 months after surgery, but indirect effects through active and meaning-focused coping were also observed. Initial received support elevated later emotional well-being, but not the other two quality of life domains. This effect was not mediated by coping. Results suggest the development of interventions to increase optimistic self-beliefs and coping skills in tumor-surgery patients.
Subjective age is related to health and to life satisfaction, and adaptation to stressful life events is associated with self-efficacy beliefs and coping. The present study on cancer survivors addressed two objectives: the relationship between felt age and perceived disability and satisfaction with recovery, and the feeding back of felt age on general self-efficacy beliefs and coping strategies. Data were collected one and six months after surgery. Individuals with younger age identities reported lower levels of perceived disability and avoidance-oriented coping and higher levels of satisfaction with recovery, self-efficacy and meaning-focused coping than individuals with older age identities. Individuals with decreased or stable felt age indicated increased meaning-focused coping or avoidance-oriented coping, respectively. Explanations for these associations are discussed.
Two kinds of variables may be differentiated within instruments measuring health-related quality of life (HRQOL). Physical symptoms may be called causal variables because their occurrence can cause a change in HRQOL, but poor HRQOL need not necessarily imply that a patient suffers from these symptoms. Other items can be regarded as indicator variables. They reflect the level of HRQOL and a patient with a poor HRQOL is likely to have low scores on all indicator variables. The aim of this study was to test the relationship of the latent HRQOL construct to items and domains on the EORTC QLQ-C30. Confirmatory factor analysis was performed on EORTC QLQ-C30 data from 205 gastrointestinal cancer patients assessed one month after surgery. Functioning scales were established as variables indicating the level of HRQOL whereas all other subscales and items were established as variables causing a change in HRQOL. The model-data fit was satisfactory. Results support the hypothesis that two kinds of variables may be differentiated within HRQOL instruments. Further research should investigate whether both kinds of variables could be combined into a higher order, aggregate score for HRQOL.
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