The relationship between coping style and psychological distress in people with head and neck cancer: A systematic review

OBJECTIVE: Individuals diagnosed with head and neck cancer (HNC) are at elevated risk of psychological distress and reduced quality of life. This review aimed to systematically examine and critically assess the quality of empirical evidence for associations between coping mechanisms and psychological distress among people with HNC. METHODS: CINAHL, MEDLINE, PsycINFO, EMBASE, and Web of Science were searched. Studies were included if they used reliable and valid measures to investigate the relationship between coping style and psychological distress. Study quality was assessed according to pre-set criteria. RESULTS: Twelve studies (8 cross-sectional and 4 longitudinal designs) involving 1281 patients were reviewed. There was considerable heterogeneity in study samples and coping measures. Moderate-to-large associations between disengagement coping mechanisms (eg, avoidance) and psychological distress were observed. Engagement coping strategies (eg, direct action) were not consistently associated with psychological distress. CONCLUSIONS: Several studies observed a significant relationship between coping styles aimed at disengaging and distancing from cancer and increased psychological distress in people with HNC. To understand directionality of these associations and develop understanding of temporal features of the relationship between coping styles and distress, longitudinal designs could be used. This would enable evidence-based recommendations regarding psychological interventions (eg, encouraging helpful coping strategies) for individuals along their HNC care pathway.