Symptom distress—The concept: Past and present

Nurses assist patients to cope with symptom distress, while physicians are primarily concerned with symptom occurrence in the diagnosis or treatment of disease. Patients' perceptions of abilities to cope with symptom occurrence vary.49,51 Without effective interventions to alter (restrain or produce) their own actions to cope with symptoms, they may withdraw from potentially curative treatments. Self-regulation theory provides a structure for organizing various interventions to reduce distress and facilitate coping. The parallel response to a stressful event includes two responses: the cognitive or objective response and the emotional response (symptom distress). Differentiation of these two responses are critical to understanding treatment of symptom distress. Johnson has shown that sensory information, a cognitive intervention, facilitates the use of an existing repertoire of coping strategies and behaviors.31 The parallel response model provides a structure for further study of symptom distress, sensory information, and other interventions to facilitate coping.Table 1.. An Overview of Selected References to Self-Regulation Theory and the Parallel Processes ModelReferenceBrief Description of the WorkLeventhal et al53Describes use of the model and theusefulness of the model in researchabout women's responses to cancerchemotherapyLeventhal andJohnson51An in-depth review of the theory ofself-regulation, the parallel responsemodel, and the research base forpreparatory information as aninterventionLeventhal et al54Explains and uses the self-regulationtheory parallel response model tosuggest a change in health messagesto focus on how people represent andcope with health problemsNerenz et al29Uses self-regulation model in a study todescribe the factors associated withemotional distress duringchemotherapy, and subsequentdecisions to delay, reduce, or terminatetreatment Table 1.. An Overview of Selected References to Self-Regulation Theory and the Parallel Processes Model