Psychosocial adjustment to cancer and its associated factors in patients undergoing chemotherapy: A cross-sectional study

Background: Adjustment to cancer refers to functions adopted by an individual for sustaining health and well-being, and leads to a better life and improved quality of life. Failure to adjust causes anxiety, depression, distress, and behavioral problems. The aim of study was to assess psychosocial adjustment to cancer and its associated factors in patients undergoing chemotherapy. Methods: This cross-sectional study recruited 260 cancer patients undergoing chemotherapy at a hospital center in Kashan, Iran in 2016. Data collection tools included demographic details, Psychological Adjustment to Illness Scale (PAIS), and adherence to religious beliefs (Temple). Samples were selected by convenience sampling method. Data were analyzed in SPSS-16 software using descriptive statistics, Chi-square test, and Pearson’s correlation coefficient. Results: The mean age of participants was 54.76±13.82 years, duration with cancer was 10.11±18.89 months, duration of treatment with chemotherapy was 4.8±6.2 months, and the mean score adjustment was 50.1±17.18. Adjustment was found to be significantly related to education, marital status, financial status, employment, and adherence to religious beliefs, but not to age, duration with cancer, duration of chemotherapy, or place of residence. Patients with no metastasis were better adjusted compared to other groups, with a significant difference from the other groups. Conclusion: More than half of patients had moderate to high levels of adjustment. Patients with poor education, self-employment, no family support, low adherence to religious beliefs, and with metastasis displayed poorer adjustment levels; all of these negatively affected their adjustment to cancer. Thus, patients undergoing chemotherapy need greater family, social, and economic support for adjustment.

Clarifying “meaning” in the context of cancer research: A systematic literature review

Objectives: This article synthesizes the published literature related to the construct of meaning in the adult cancer population.Methods: The databases CancerLit, CINAHL, Medline, PsychINFO, and the Journal of Psychosocial Oncology and PsychoOncology were searched to identify all studies related to meaning. The methodological aspects of all studies are described and the conceptual aspects are summarized only from those studies that met criteria for methodological rigor and validity of findings. The definitions forglobal meaning, appraised meaning,search for meaning, andmeaning as outcomeas proposed by Park and Folkman were used to interpret the findings.Results: Of 44 studies identified, 26 met the criteria for methodological rigor. There is strong empirical and qualitative evidence of a relationship between meaning as an outcome of and psychosocial adjustment to cancer.Significance of results: The qualitative findings are considered useful for the development of psychosocial interventions aimed at helping cancer patients cope with and even derive positive benefit from their experience. However, variations in the conceptual and operational definitions, frequent reliance on homogeneous and convenience sampling, and the lack of experimental designs are considered to be methodological limitations that need to be addressed to advance the study of meaning in the context of cancer.