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A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer's theoretical model of appraisal and coping

A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer's theoretical model of appraisal and coping
A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer's theoretical model of appraisal and coping
Objective

To explore whether the Folkman and Greer theoretical model of appraisal and coping reflects the processes used by people living with advanced cancer.
Methods

Interview data from a longitudinal qualitative study with people with advanced (stage 3 or 4) cancer (n = 26) were mapped onto the concepts of the Folkman and Greer theoretical model. Qualitative interviews conducted in home settings, 4-12 weeks apart (n = 45) examined coping strategies, why people thought they were effective, and in what circumstances. Interviews were coded and analysed using techniques of constant comparison.
Results

Mapping coping strategies clearly onto the problem- or emotion-focused elements of the model proved problematic. Fluctuating symptoms, deterioration over time, and uncertain timescales in advanced cancer produce multiple events simultaneously or in quick succession. This demands not only coping with a single event but also frequent repositioning, often to an earlier point in the coping process. In addition, there is substantial ongoing potential for some degree of distress rather than purely “positive emotion” as the final stage in the process is death with several points of permanent loss of capability in the interim.
Conclusions

The Folkman and Greer theoretical model is helpful in deconstructing the discrete “problem-focused” or “emotion-focused” coping mechanisms participants describe, but its formulation as a linear process with a single, positive, outcome is insufficiently flexible to capture the evolution of coping for people with advanced cancer.
1057-9249
229–235
Roberts, Diane
69d9278a-f158-4870-903a-970977b40b7c
Calman, Lynn
9ae254eb-74a7-4906-9eb4-62ad99f058c1
Large, Paul
9c9a7349-d018-467e-9f4f-bf240a02e8f5
Appleton, Lynda
971b9244-aa8e-4d81-9f95-18ed4fe755f5
Grande, Gunn
7335911a-ee7f-44cd-924e-c8b3c903fe6c
Lloyd-Williams, Mari
80771f88-6f66-4130-a93c-cf5746db30d9
Walshe, Catherine
2917881f-9a21-4b0d-9453-b112c0041e35
Roberts, Diane
69d9278a-f158-4870-903a-970977b40b7c
Calman, Lynn
9ae254eb-74a7-4906-9eb4-62ad99f058c1
Large, Paul
9c9a7349-d018-467e-9f4f-bf240a02e8f5
Appleton, Lynda
971b9244-aa8e-4d81-9f95-18ed4fe755f5
Grande, Gunn
7335911a-ee7f-44cd-924e-c8b3c903fe6c
Lloyd-Williams, Mari
80771f88-6f66-4130-a93c-cf5746db30d9
Walshe, Catherine
2917881f-9a21-4b0d-9453-b112c0041e35

Roberts, Diane, Calman, Lynn, Large, Paul, Appleton, Lynda, Grande, Gunn, Lloyd-Williams, Mari and Walshe, Catherine (2018) A revised model for coping with advanced cancer. Mapping concepts from a longitudinal qualitative study of patients and carers coping with advanced cancer onto Folkman and Greer's theoretical model of appraisal and coping. Psycho-Oncology, 27 (1), 229–235. (doi:10.1002/pon.4497).

Record type: Article

Abstract

Objective

To explore whether the Folkman and Greer theoretical model of appraisal and coping reflects the processes used by people living with advanced cancer.
Methods

Interview data from a longitudinal qualitative study with people with advanced (stage 3 or 4) cancer (n = 26) were mapped onto the concepts of the Folkman and Greer theoretical model. Qualitative interviews conducted in home settings, 4-12 weeks apart (n = 45) examined coping strategies, why people thought they were effective, and in what circumstances. Interviews were coded and analysed using techniques of constant comparison.
Results

Mapping coping strategies clearly onto the problem- or emotion-focused elements of the model proved problematic. Fluctuating symptoms, deterioration over time, and uncertain timescales in advanced cancer produce multiple events simultaneously or in quick succession. This demands not only coping with a single event but also frequent repositioning, often to an earlier point in the coping process. In addition, there is substantial ongoing potential for some degree of distress rather than purely “positive emotion” as the final stage in the process is death with several points of permanent loss of capability in the interim.
Conclusions

The Folkman and Greer theoretical model is helpful in deconstructing the discrete “problem-focused” or “emotion-focused” coping mechanisms participants describe, but its formulation as a linear process with a single, positive, outcome is insufficiently flexible to capture the evolution of coping for people with advanced cancer.

Text A revised model for coping with advanced REVISED FINAL - Accepted Manuscript
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Text PsychoOncology Supplementary online material - Accepted Manuscript
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Text Folkman and Greer Figure - Accepted Manuscript
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Text Coping with advanced cancer model v2 4.6.17 - Accepted Manuscript
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More information

Accepted/In Press date: 6 July 2017
e-pub ahead of print date: 18 August 2017
Published date: January 2018

Identifiers

Local EPrints ID: 413522
URI: https://eprints.soton.ac.uk/id/eprint/413522
ISSN: 1057-9249
PURE UUID: 05f8d820-74a6-4236-9aa8-ff603281a55b
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017

Catalogue record

Date deposited: 25 Aug 2017 16:31
Last modified: 21 Feb 2018 17:31

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Contributors

Author: Diane Roberts
Author: Lynn Calman ORCID iD
Author: Paul Large
Author: Lynda Appleton
Author: Gunn Grande
Author: Mari Lloyd-Williams
Author: Catherine Walshe

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