Coping and Perception of Prognosis in Patients With Indolent Non-Hodgkin’s Lymphoma
Author:
Newcomb Richard A12ORCID, Johnson P Connor12, Yang Daniel3, Holmbeck Katherine1, Choe Joanna1, Nabily Anisa1, Lark Porsha1, Dhawale Tejaswini12, Amonoo Hermioni L24, El-Jawahri Areej12ORCID
Affiliation:
1. Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital , Boston, MA , USA 2. Harvard Medical School , Boston, MA , USA 3. Duke University School of Medicine , Durham, NC , USA 4. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute , Boston, MA , USA
Abstract
Abstract
Background
Indolent non-Hodgkin’s lymphomas (iNHL) are a heterogenous group of mostly incurable diseases with prolonged illness courses and prognostic uncertainty. Yet, studies evaluating coping and perception of prognosis are limited.
Methods
We conducted a cross-sectional study of adults newly diagnosed with iNHL in the past 3 months at a single academic center. We assessed quality of life (QOL: Functional Assessment of Cancer Therapy—General), psychological symptoms (Hospital Anxiety and Depression Scale), coping (Brief-COPE), and perception of prognosis (Prognosis Awareness Impact Scale).
Results
We enrolled 70.6% (48/68) of eligible patients. Patients had older age (mean = 66.9,sd = 10.5), were female (60.4%), predominantly identified as White (85.4%), and had at least received a college degree (75%). Chronic lymphocytic leukemia (39.6%) and follicular lymphoma (33.3%) were the most common diagnoses. Overall, 27.1% and 14.6% of patients reported clinically significant anxiety and PTSD symptoms, respectively. Patients highly utilized acceptance (56.2%), seeking emotional support (47.9%), and denial (47.9%) as coping strategies at diagnosis. While 66.7% of patients recalled their oncologist assessment of illness as incurable, only 35.4% reported that the illness is unlikely to be cured. Overall, 45.8% indicated that they were worried about prognosis and 31.2% reported perseverating on their prognosis. Higher emotional coping with prognosis was associated with fewer anxiety (B = −0.6, SE = 0.2, P < .001), depression (B = −0.3, SE = .1, P = .005), and PTSD (B = −1.3, SE = 0.4, P < .001) symptoms and better QOL (B = 1.7, SE = 0.4, P < .001).
Discussion
Patients with iNHL report substantial psychological distress, a diversity of coping strategies, and complex cognitive understanding of their prognosis. Interventions, which address prognostic uncertainty and promote positive emotional coping with prognosis, may ameliorate psychological distress in this population.
Funder
National Cancer Institute
Publisher
Oxford University Press (OUP)
Subject
Cancer Research,Oncology
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