Emotional distress, locus of control and information preferences among cancer patients

One hundred and nine cancer patients were evaluated with psychological tests which included the Inventory of Current Concerns, Profile of Mood States, Index of Vulnerability Rating Scale, Multidimensional Health Locus of Control Inventory and Information Styles Questionnaire. The purpose of the study was to examine the pattern of relationships between emotional distress, locus of control and information preferences among cancer patients. Patients with high health internal locus of control scores were expected to have less distress and greater information preferences.

The sample of patients in the present study was found to have more concerns, mood disturbance, vulnerability, physical symptoms and wider extent of illness compared to the sample from Weisman and Worden's Omega Project (1977). The present sample was also shown to have less information and participation preferences compared to Cassileth's (1980) survey. The present sample was found to have higher health external, and lower health internal, scores compared to patients with other chronic illnesses, or healthy adults. Reported physical symptoms was the best predictor of emotional distress among medical variables. Medical data predicted less than one-third of the variance in distress.

Patients with more aggressive cancers were found to be more distressed. Distress was high at initial diagnosis and then decreased, confirming Weisman and Worden's (1976) findings, but rose again before the end of the first year postdiagnosis suggesting the "existential crisis" returns for many.

Results indicated that health locus of control and information styles are not significant factors in determining the amount of emotional distress that the cancer patient reports. However, consistent trends and occasional significance showed health internals to have less concerns, mood disturbance, vulnerability, or overall distress, and greater information preferences. High chance patients had greater concerns, vulnerability, composite distress, and lower information preferences.

Elderly patients reported the least information preferences and internal locus of control. The overall pattern of results suggested that health locus of control beliefs may become altered in situations of life-threatening illness; that denial becomes significant, especially among the elderly; and that effectiveness in coping needs to be assessed along with reported distress.