Objectives. Head and neck cancer (HNC) patients are at increased risk of psychological distress. Symptoms of distress – including anxiety and depression – have a negative impact on patient’s treatment outcomes and quality of life. Therefore, the aim of the study was to investigate whether stress coping strategies may be important for psychological adjustment (in terms of anxiety and depression), quality of life and health behavior within 12 months after surgical treatment for HNC. Method. It was a 12-month observational study of HNC patients undergoing surgical treatment at Warsaw Cancer Centre – Institute, Poland. Eligibility criteria included a new HNC diagnosis and enrollment for surgical treatment. Data (n= 50) were collected at 48h prior to surgery, 48h after the surgery, 1, 6 and 12 months after the treatment, using the Coping Inventory for Stressful Situations (CISS), the Quality of Life Questionnaire (QLQ C-30), the Hospital Anxiety and Depression Scale (HADS) and the Polish Health Behavior Inventory (IZZ). Results. Stress coping strategies were significantly associated with anxiety and depression, quality of life and health behavior. Task-oriented coping was significantly associated with higher social well-being and general quality of life before the treatment; lower anxiety at 6 and 12 months after the surgery; and with presenting more health behaviors at 12 months after the surgery. Emotion-oriented coping was significantly associated with higher quality of life in terms of physical, cognitive, emotional and social well-being before the surgery; but with higher anxiety before the surgery, 48h and 1 month after; and with higher depression before the surgery, 48h, 1 and 6 months after; and with presenting more health behaviors at 12 months after the treatment. Avoidant coping was significantly associated only with higher quality of life in terms of cognitive, emotional and social well-being before the surgery. Conclusions. All types of coping were associated with higher quality of life before the surgery. However only task-oriented and emotion-oriented coping was associated with anxiety and/or depression and expressing more health behaviors after the treatment. Task-oriented coping seems to be a resource for general well-being, low anxiety and more health behavior, while emotion-oriented coping may hinder patient’s adaptation in terms of expressing higher levels of anxiety and depression before and after the treatment. Assessing HNC patients coping strategies prior to surgery should be considered as a good screening procedure. It is recommended to focus especially of emotion-oriented HNC copers in delivering psycho-oncological support.
Study done in collaboration with J. Lenartowicz, M. Cedzynska and W. Zatonski.