Coping flexibility and associated factors after gastrectomy in patients with gastric cancer: A cross-sectional multisite study

To elucidate the current state of coping flexibility and associated factors in gastric cancer patients after gastrectomy. A cross-sectional multisite study was conducted with 142 patients with gastric cancer who completed questionnaires on coping flexibility, postgastrectomy dysfunction, health literacy, and perceived social support. Coping flexibility was measured using the Coping Flexibility Scale-Revised, which includes three subscales: Abandonment Coping (i.e., abandoning ineffective coping strategies), Re-Coping (i.e., assessing the process of developing and implementing alternative coping strategies), and Meta-Coping (i.e., monitoring coping flexibility process). Higher scores indicate greater coping flexibility. Descriptive statistics and univariable and multivariable logistic analyses were conducted to examine factors associated with coping flexibility. The mean age of the participants was 72.6 (± 10.5) years. Limited activity due to decreased food consumption was associated with lower scores for Abandonment Coping (odds ratio [OR]: 0.4; P ​= ​0.03; 95% confidence interval [CI], 0.2-0.9) and Re-Coping (OR: 0.3; P ​= ​0.003; 95% CI, 0.1-0.6). Higher levels of communicative health literacy were associated with higher Abandonment Coping scores (OR: 1.1; P ​= ​0.04; 95% CI, 1.0-1.3), and higher levels of critical health literacy were associated with higher Re-Coping scores (OR: 1.2; P ​= ​0.03; 95% CI, 1.0-1.3). Limited activity due to decreased food consumption and limited coping flexibility were significantly associated. Health literacy had an important role in facilitating coping flexibility. Nursing support may be crucial in evaluating coping strategies and developing alternatives based on new information.