Mastery and Stress in Patients with Advanced or Recurrent Colorectal Cancer During Treatment: A Multicenter Cross-sectional Study

Abstract

Background: Mastery is a human response of gaining competence in dealing with stress and can be applied to understanding the psychological state of patients with advanced or recurrent colorectal cancer (CRC). Objective: To identify mastery in patients with advanced or recurrent CRC undergoing chemotherapy and examine associations between mastery and the patients’ sociodemographic characteristics, social support, and support from clinical staff. Methods: A self-administered survey was conducted among patients with advanced or recurrent CRC receiving outpatient chemotherapy. Participants completed the Mastery of Stress Instrument, the Multidimensional Scale of Perceived Social Support, support from clinical staff, and sociodemographic characteristics. Results: Of 76 participants, 77.6% had a stress score of ≥58 points, indicating a stress status. They achieved, in descending order, acceptance, certainty, change, and growth among mastery processes. Social support was significantly associated with mastery and all its components, and support from clinical staff was significantly associated with mastery and certainty. Conclusions: Most participants reported a high level of stress, indicating that they need support to deal with stress from a mastery perspective. Implications for Practice: Nurses should assess the stress levels of patients with advanced or recurrent CRC and provide care based on mastery to help patients come to terms with cancer-related stress. Providing emotional and social support is necessary to promote positive change and growth. Foundational: This study framed the need for nursing care for stressed patients in terms of their mastery of advanced or recurrent CRC-specific stress. Social support and clinical staff support are essential for achieving such mastery.