Coping strategies, psychological distress, and satisfaction with health care among cancer survivors

Background: Coping strategies in cancer patients are crucial to mitigate the associated physical and psychological challenges. The objectives were to examine coping styles among cancer patients, their association with psychological distress and care satisfaction, and the possible mediating role of depression. Methods: A cross-sectional study was conducted among 200 cancer patients attending Minia Oncology Center, Egypt during 2021-2022. Data were collected using an interview questionnaire for demographic characteristics, cancer related-data, as well as Depression Anxiety Stress Scale-21 (DASS-21), Patient satisfaction questionnaire (PSQ-18), and Coping Strategy Scale (the Brief COPE inventory). The conceptual presence and direction of depression as a mediating factor were evaluated using multiple linear regression based on Baron and Kenny’s criteria. Results: The average age of the patients was 41.98±13.41 years and 57% were females. The most frequently reported cancers were breast cancer (28.5%) and colon cancer (20.5%). The overall mean adaptive coping score (2.38±0.55) was higher than the maladaptive score (1.65±0.41). Adaptive coping mechanism was significantly associated with higher educational level and advanced cancer stage (p<0.001). Patient satisfaction was negatively correlated with depression (r=-0.24, p<0.001). Adaptive coping was significantly correlated with patient satisfaction (r=0.54, p< 0.001). Depression partially mediated the effect of patient satisfaction on adaptive coping (p<0.001). Conclusions: Different coping strategies were employed among cancer patients in response to the illness. Adaptive coping was positively associated with patient satisfaction, with depression mediating this relationship. These findings emphasize the importance of addressing psychological well-being of cancer patients to enhance both patient satisfaction and effective coping.