Coping Style, Insomnia, and Psychological Distress Among Persons With Gastrointestinal Cancer

Abstract

BackgroundAlthough insomnia has been shown to play an important role in psychological distress among gastrointestinal cancer patients, little is known about the internal mechanisms underlying this relation. Coping styles have been shown to moderate the effect of sleep on emotion, and this moderating effect may be age-dependent.ObjectiveThe aim of this study was to test how age and coping styles moderate the role of insomnia on psychological distress among gastrointestinal cancer patients.MethodsThis was a descriptive cross-sectional study with a convenience sample. A total of 352 patients with gastrointestinal cancer from two tertiary hospitals were recruited to participate in this study. The Kessler Psychological Distress Scale, the Insomnia Severity Index, and the Simplified Coping Style Questionnaire were used to assess patients’ psychological distress, insomnia, and coping styles, respectively. We performed hierarchical multiple regression and Johnson–Neyman statistical analysis to probe the moderating effect of coping styles and age.ResultsThe mean age of the participants was 58.32 years. Nearly half of the participants reported psychological distress, and many reported insomnia. Insomnia was significantly positively associated with psychological distress. Coping styles and age moderated the relationship between insomnia and distress. Specifically, positive coping buffered the effect of insomnia on psychological distress only for subjects aged 34 years and younger; negative coping exacerbated the above relationship in patients aged 68 years and older while weakening the relationship in participants aged 51 years and younger.DiscussionThere are age differences in the moderating role of coping styles on the relationship between insomnia and distress among gastrointestinal cancer patients. This study provides preliminary evidence to inform tailored guidance on coping styles by age groups to attenuate the risk for psychological distress related to insomnia in the cancer population.

Various types of stress and greater use of disengagement coping are associated with worse sleep disturbance in oncology patients undergoing chemotherapy

“…Compared to the Low class, the other two classes reported higher use of most of the disengagement coping strategies (i.e., self‐distraction, venting, behavioural disengagement, self‐blame; Table 4) These types of behaviours aim to avoid or ignore stressors and their related emotional consequences (Kvillemo & Branstrom, 2014). This finding is not unexpected, because previous research found that the use of disengagement coping behaviours was associated with higher levels of sleep disturbance in patients with prostate (Hoyt et al., 2009; Thomas et al., 2010; Trudel‐Fitzgerald et al., 2017), breast (Thomas et al., 2010; Trudel‐Fitzgerald et al., 2017), gastrointestinal (Lv, Zhao, Li, et al., 2022; Trudel‐Fitzgerald et al., 2017), and genitourinary (Trudel‐Fitzgerald et al., 2017) cancers. For example, avoidance of stressors through self‐distraction was associated with increased sleep disturbance in patients with various types of cancer 2 months after enrolment (Trudel‐Fitzgerald et al., 2017).…”

“…While not evaluated in detail in oncology patients with heterogenous types of cancer, and since the mean age for our sample is 57.1 years, one plausible explanation for the association between higher levels of sleep disturbance and a higher use of disengagement coping strategies is age. Compared to older patients, younger patients tend to address symptoms (e.g., sleep disturbance) with more direct actions (e.g., stress reduction) because of their perceptions of a more limited future (Lv, Zhao, Li, et al., 2022). An equally plausible explanation for the increased use of disengagement coping strategies is that oncology patients receiving chemotherapy often experience multiple co‐occurring symptoms.…”

Exploring Patient Centered Perspectives on Suicidal Ideation: A Mixed Methods Investigation in Gastrointestinal Cancer Care

“…The psychological impact of GI cancer, including depressive disorders and suicidal ideation, has been well-documented, with studies highlighting the strong relationship between psychological characteristics and internet use, family burden, household occupancy, age, and emotional support [16]. Furthermore, coping style, insomnia, and psychological distress have been identified as important factors affecting the well-being of individuals with gastrointestinal cancer, emphasizing the need for a holistic approach to address the psychological aspects of this patient population [17]. The prevalence of suicidal ideation in cancer patients, including those with gastrointestinal cancers, has been a subject of research, with studies reporting a higher risk of suicidal ideation in specific cancer subtypes, such as ovarian cancer [18].…”