Coping, quality of life and psychological adjustment in men with testicular canceer : evolving changes across the stages of diagnosis, treatment and follow-up

Testicular cancer, the most prevalent cancer in young men, can have a profound impact on coping and psychological adjustment. These effects were investigated in three groups of men at different stages of the illness. Men at diagnosis (n=16), receiving treatment (n= 18) and those at follow-up (n20) were compared in terms of QoL, psychological well-being and coping strategies used in order to deal with their illness. Participants completed a battery of standardised measures assessing these concepts (affect, satisfaction with life, cancer-related quality of life and coping strategies). Overall, wellbeing was associated with the use of adaptive coping strategies and good quality of life. There was a residual impact on psychosexual functioning and impairment was reported in all three groups at relatively high rates. However, this was unrelated to adjustment. The results showed that at follow up, well-being scores were high, quality of life was perceived to be good and most men used 'adaptive' coping strategies. The diagnosis and treatment groups used more maladaptive coping strategies and had lower well-being scores. Treatment posed the greatest threat to quality of life. Despite the controversy within the literature as to the utility of denial in cancer patients, the present study found that it was associated with lower well-being scores in the diagnosis and treatment groups. With the exception of employment status, contextual factors were not found to have a unique impact upon coping or well-being. However, clinical experience would suggest that these variables should not be ignored. Cross-situational differences in wellbeing and coping were demonstrated. This lends support for the perception of cancer as a dynamic stressor placing different demands on individuals' coping resources and therefore well-being at different stages. The clinical and theoretical implications of these findings are discussed. Limitations of the present study are acknowledged and ideas for future research are presented.