The Role of Locus of Control and Attributional Style in Coping Strategies and Quality of Life among Iranian Breast Cancer and Colorectal Cancer Patients: A Pilot Study
Background: The influence of various psychological factors and coping mechanisms on quality of life (QOL) in cancer patients has been well established. We evaluated locus of control and attributional styles, and their association with coping styles and quality of life (QOL) among Iranian cancer patients.
Methods: This cross-sectional study was conducted on patients with breast cancer and patients with colorectal cancer in stage I to III. Patients were assessed for demographic and disease characteristics, cancer-related symptoms, locus of control, attributional styles, coping styles, and QOL.
Results: From 140 invited patients, 100 patients participated in the study. Data of 55 patients with breast cancer and 22 patients with colorectal cancer were appropriate and included for analysis (mean age of 47.5 ± 7.9 years, 89.6% female). Factors positively associated with QOL included educational level, internal locus of control, overall hopefulness, and confrontive, optimistic, and self-reliant coping styles (r = 0.228 to 0.426). Factors negatively associated with QOL included age, symptoms severity, overall hopelessness, and fatalistic and emotive coping styles (r = -0.221 to -0.674). Internal locus of control and hopefulness were associated with confrontive/adaptive coping styles (r = 0.226 to 0.381), while external locus of control and hopelessness were associated with evasive/maladaptive coping styles (r = 0.208 to 0.381).
Conclusion: These results indicate that internal locus of control, hopefulness, and positive attributional styles are associated with more adaptive/confrontive coping strategies and better QOL in Iranian cancer patients. Further studies with more comprehensive psychosocial evaluation in a larger sample of cancer patients are warranted.
- Quality of life
- Health locus of control
Al-Azri, M., Al-Awisi, H., & Al-Moundhri, M. (2009). Coping with a diagnosis of breast cancer-literature review and implications for developing countries. Breast J, 15(6), 615-622. doi:TBJ812 [pii];10.1111/j.1524-4741.2009.00812.x [doi]. Retrieved from PM:19686231
Allart, P., Soubeyran, P., & Cousson-Gelie, F. (2013). Are psychosocial factors associated with quality of life in patients with haematological cancer? A critical review of the literature. Psychooncology., 22(2), 241-249. doi:10.1002/pon.3026 [doi]. Retrieved from PM:22287503
Cai, C., Zhou, Z., Yu, L., & Wan, Y. (2011). Predictors of the health-related quality of life of patients who are newly diagnosed with lung cancer in China. Nurs Health Sci, 13(3), 262-268. doi:10.1111/j.1442-2018.2011.00612.x [doi]. Retrieved from PM:21696528
Chung, M. H., Chao, T. Y., Chou, K. R., & Lee, H. L. (2009). Health-promoting lifestyle factors of cancer survivors in Taiwan. Cancer Nurs, 32(3), E8-E14. doi:10.1097/NCC.0b013e318199002b [doi]. Retrieved from PM:19295426
Cimprich, B., Ronis, D. L., & Martinez-Ramos, G. (2002). Age at diagnosis and quality of life in breast cancer survivors. Cancer Pract., 10(2), 85-93. Retrieved from PM:11903273
Cleeland, C. S., Mendoza, T. R., Wang, X. S.,
Chou, C., Harle, M. T., Morrissey, M. et al. (2000). Assessing symptom distress in cancer patients: the
M.D. Anderson Symptom Inventory. Cancer, 89(7), 1634-1646. doi:10.1002/1097-0142(20001001)89:7<1634::AID-CNCR29>3.0.CO;2-V [pii]. Retrieved from PM:11013380
Compas, B. E., Stoll, M. F., Thomsen, A. H., Oppedisano, G., Epping-Jordan, J. E., & Krag, D. N. (1999). Adjustment to breast cancer: age-related differences in coping and emotional distress. Breast Cancer Res Treat., 54(3), 195-203. Retrieved from PM:10445418
Cousson-Gelie, F., Irachabal, S., Bruchon-Schweitzer, M., Dilhuydy, J. M., & Lakdja, F. (2005). Dimensions of cancer locus of control scale as predictors of psychological adjustment and survival in breast cancer patients. Psychol Rep, 97(3), 699-711. Retrieved from PM:16512284
De, V. C., & Vinck, J. (1996). Health locus of control and quality of life in lung cancer patients. Patient.Educ Couns., 28(2), 179-186. doi:0738-3991(96)00897-X [pii]. Retrieved from PM:8852092
Farahani M, Cooper M, & Jin P. (1996). Is locus of control unidimensional or multidimensional? - Data from Persian translations of Rotter's I-E scale and Levenson's I, P, and C scales. Psychol Res, 3(4), 38-62.
Frank-Stromborg, M., Pender, N. J., Walker, S. N., & Sechrist, K. R. (1990). Determinants of health-promoting lifestyle in ambulatory cancer patients. Soc Sci Med, 31(10), 1159-1168. Retrieved from PM:2274804
Health psychology: a textbook. (2007). Ogden J. New York, NY (4th ed.) Open University Press.
Jalowiec A. (2003). The Jalowiec coping scale. In Strickland OL & Dilorio C (Eds.), Measurement of nursing outcomes (pp. 71-97). New York, NY: Springer.
Levenson, H. (1973). Multidimensional locus of control in psychiatric patients. J Consult Clin Psychol, 41(3), 397-404. Retrieved from PM:4803272
Lu, W., Cui, Y., Chen, X., Zheng, Y., Gu, K., Cai, H. et al. (2009). Changes in quality of life among breast cancer patients three years post-diagnosis. Breast Cancer Res Treat., 114(2), 357-369. doi:10.1007/s10549-008-0008-3 [doi]. Retrieved from PM:18409069
Mehnert, A., & Koch, U. (2008). Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psychosom.Res, 64(4), 383-391. doi:S0022-3999(07)00487-4 [pii];10.1016/j.jpsychores.2007.12.005 [doi]. Retrieved from PM:18374737
Montazeri, A., Goshtasebi, A., Vahdaninia, M., & Gandek, B. (2005). The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual.Life Res, 14(3), 875-882. Retrieved from PM:16022079
Moro-Valdezate, D., Buch-Villa, E., Peiro, S., Morales-Monsalve, M. D., Caballero-Garate, A., Martinez-Agullo, A. et al. (2012). Factors associated with health-related quality of life in a cohort of Spanish breast cancer patients. Breast Cancer. doi:10.1007/s12282-012-0402-x [doi]. Retrieved from PM:22926507
Naaman, S. C., Radwan, K., Fergusson, D., &
Johnson, S. (2009). Status of psychological trials in breast cancer patients: a report of three meta-analyses. Psychiatry, 72(1), 50-69. doi:10.1521/psyc.2009.72.1.50 [doi];10.1521/psyc.2009.72.1.50 [pii]. Retrieved from PM:19366294
Naus, M. J., Price, E. C., & Peter, M. P. (2005). The moderating effects of anxiety and breast cancer locus of control on depression. J Health Psychol, 10(5), 687-694. doi:10/5/687 [pii];10.1177/1359105305055324 [doi]. Retrieved from PM:16033790
Peterson C, Semmel A, Von Baeyer C, Abramson LT, Metalsky GI, & Seligman MEP. (1982). The attributional style questionnaire. Cognitive Therapy and Research, 6(3), 287-300.
Pourhoseingholi, M. A., Faghihzadeh, S., Hajizadeh, E., Abadi, A., & Zali, M. R. (2009). Bayesian estimation of colorectal cancer mortality in the presence of misclassification in Iran. Asian Pac.J Cancer Prev, 10(4), 691-694. Retrieved from PM:19827896
Reuter, K., Classen, C. C., Roscoe, J. A., Morrow, G. R., Kirshner, J. J., Rosenbluth, R. et al. (2006). Association of coping style, pain, age and depression with fatigue in women with primary breast cancer. Psychooncology., 15(9), 772-779. doi:10.1002/pon.1012 [doi]. Retrieved from PM:16362999
Schnoll, R. A., Harlow, L. L., Stolbach, L. L., & Brandt, U. (1998). A structural model of the relationships among stage of disease, age, coping, and psychological adjustment in women with breast cancer. Psychooncology., 7(2), 69-77. doi:10.1002/(SICI)1099-1611(199803/04)7:2<69::AID-PON286>3.0.CO;2-8 [doi]. Retrieved from PM:9589505
Shapiro, S. L., Lopez, A. M., Schwartz, G. E., Bootzin, R., Figueredo, A. J., Braden, C. J. et al. (2001). Quality of life and breast cancer: relationship to psychosocial variables. J Clin Psychol, 57(4), 501-519. doi:10.1002/jclp.1026 [pii]. Retrieved from PM:11255204
Sørlie T, & Sexton HC. (2004). Predictors of change in health locus of control following surgical treatment. Personality and Individual Differences, 36(5), 991-1004.
Watson, M., Pruyn, J., Greer, S., & van den Borne, B. (1990). Locus of control and adjustment to cancer. Psychol Rep, 66(1), 39-48. Retrieved from PM:2326428
Weis, F. D., Fitzpatrick, T. R., & Bushfield, S. Y. (2008). Hope, locus of control, and quality of health among elder Latina cancer survivors. Soc Work Health Care, 46(2), 51-70. Retrieved from PM:18192197
Wrightson, K. J., & Wardle, J. (1997). Cultural variation in health locus of control. Ethn.Health, 2(1-2), 13-20. doi:10.1080/13557858.1997.9961811 [doi]. Retrieved from PM:9395585
Yi, M., & Kim, J. (2013). Factors influencing health-promoting behaviors in Korean breast cancer survivors. Eur J Oncol Nurs, 17(2), 138-145. doi:S1462-3889(12)00048-8 [pii];10.1016/j.ejon.2012.05.001 [doi]. Retrieved from PM:22687200