Winter 2015 2.indd

Volume 25, Issue 1, WInter 2015 • CanadIan onCology nursIng Journal reVue CanadIenne de soIns InfIrmIers en onCologIe AbstrAct Complex support needs are involved in coping with a diagnosis of melanoma. The purpose of this study was to determine the perceived social support levels and utilization of adaptive and maladaptive coping strategies by Canadian melanoma patients. The impact of social support level on coping strategy utilization was also examined. Social support and coping strategies were assessed using the Medical Outcomes Study Social Support Survey (MOS-SSS) and the 28-item Brief COPE, respectively. Perceived levels of emotional/informational support were significantly lower than affectionate support and positive social interaction. Acceptance, active coping, and use of emotional support were the most frequently utilized coping strategies. Patients with higher perceived levels of social support had significantly higher adaptive coping scores than patients with lower levels of social support. Health care professionals have an important role in promoting awareness of and access to emotional and informational support resources in order to improve perceived social support levels. IntroductIon Melanoma is one of the fastest growing cancers worldwide (Garbe & Leiter, 2009). Many aspects of an individual’s health are influenced by a melanoma diagnosis, including self-identity, body image, well-being, relationships, career opportunities, and finances (Zabora, Brintzenhofeszoc, Curbow, Hooker, & Piantadosi, 2001; Kasparian, McLoone, & Butow, 2009). Approximately 30% of melanoma patients report psychological distress levels indicative of the need for psychological therapy (Kasparian et al., 2009; Zabora et al., 2001; Trask et al., 2001). Social support is the support accessible to an individual through social ties to other individuals, groups and the larger community; it is thought to play a critical role in the psychological adjustment of melanoma patients (Lichtenthal et al., 2003). Devine, Parker, Fouladi, and Cohen (2003) showed that better psychological adjustment one month after treatment was predicted by greater social support and fewer intrusive and avoidant thoughts amongst 53 patients with metastatic melanoma and renal cell cancer. The authors suggest that cognitive processing of a traumatic event may be mediated by available social support, allowing patients to assimilate the cancer experience into their views of the self and the world (Devine et al., 2003; Kasparian et al., 2009). Utilization of adaptive coping strategies, defined as the tendency to react to or deal with problems in a constructive, direct and positive manner (Trapp et al., 2012), is also important for cancer patients, as they experience a range of psychological reactions to and challenges after their diagnosis. Higher appraisal of the subjective ability to cope with melanoma is associated with increased well-being and reduced psychological distress (Hamama-Raz, Solomon, Schachter, & Azizi, 2007). Fawzy (1995) showed that a nursing intervention including coping skills teaching decreased psychological distress levels. Maladaptive strategies are the tendency to react to or deal with problems in an avoidant or unconstructive manner (Trapp et al., 2012). Social support and coping strategies are highly interdependent. For example, how a person copes with a stressful life situation may influence their social network’s readiness or ability to provide support. The individual who uses behavioural disengagement as a coping strategy may withdraw from their friends and family, who may, in return, feel discouraged to offer their help. Conversely, those who actively seek emotional support from their social network encourage its responsiveness (Schreurs & DeRidder, 1997). Health care professionals play an important role in melanoma patient support by assessing psychological and emotional status, providing psychological support, promoting the use of adaptive coping strategies, and educating patients about Investigating coping strategies and social support among Canadian melanoma patients: A survey approach