Hope, Coping Style, and Dietary Behaviors of Early and Late Postgastrectomy Stomach Cancer Patients

Stomach cancer is the second leading cause of all cancer deaths worldwide and will increase yearly as the population increases (Lambert, 2000). Psychosocial interventions to promote optimal adaptation to stomach cancer and the special circumstances of gastrectomy should be guided by research on personality characteristics, other psychological factors and the health behaviors which characterize phases of recovery. Although coping styles of gastrectomy patients had been examined in an earlier study, no study had been conducted from a biopsychosocial perspective. In the present study, a group of stomach cancer patients (15) surviving less than five years postsurgery were compared to a group of stomach cancer patients (10) surviving five or more years postsurgery on personality traits of goal-based hope, coping style, knowledge about cancer, quality of life, and health-related behaviors.

Findings revealed that early phase survivors used a predominant coping style of anxious preoccupation, whereas long term survivors used a predominant style of fatalism. Both early and late survivors reported an average quality of life which was positively associated with goal-oriented hope, the coping style fatalism, and negatively associated with the coping style hopelessness/ helplessness. Long term stomach cancer survivors are at special risk for nutrient deficiencies that can lead to severe muscle wasting, osteoporosis and anemia. Both early and late phase patients consumed deficient levels of calcium, and vitamin D and had a substandard status of Body Mass Index (BMI). The strongest predictive factors for time since surgery for this study population of cancer patients were coping styles of anxious preoccupation, fighting spirit, and cognitive avoidance; BMI; and knowledge about cancer. This study was not designed to measure the influence of factors on survival. It provides a description of patients who were in different phases of postgastrectomy surgery and offers suggestions as to how the findings can be used by clinicians to select appropriate interventions.