Age, self-efficacy, and change in patients' adjustment to cancer

The purpose of this secondary analysis was to investigate cancer patients' self-care self-efficacy and measures of adjustment over time, as well as the role of self-care self-efficacy with measures of adjustment. The primary study was a longitudinal study of cancer patients and family members' adjustments.

Three hundred seven cancer patients at all stages of cancer completed study instruments on one occasion; 181 completed the instruments 4 months later; and 124, 8 months later. Instruments included the Strategies Used by Patients to Promote Health (SUPPH) to measure self-care self-efficacy, the Functional Assessment of Cancer Treatment (FACT) to measure quality of life, the Profile of Mood States (POMS) to measure patients' mood disturbances, and the Symptom Distress Scale (SDS) to measure patients' concerns.

Using analysis of variance, a series of one-way repeated measures used to investigate changes in cancer patients' self-care self-efficacy and measures of adjustment revealed significant decreases in patients' self-care self-efficacy (P = .01) and quality of life (P = .001) over time. Patients' symptoms and mood disturbances did not significantly change over time. The role of self-care self-efficacy with measures of adjustment was investigated using canonical correlations. For the predictor variables, subscores for coping and enjoying life on the SUPPH showed the strongest loadings, 0.83 and 0.94, respectively. On the dependent variables, the FACT was by far the most important variable, with a loading of 0.92.

Results demonstrate that without intervention, cancer patients' measures of self-efficacy and adjustment decrease over time, and patients' self-efficacy influences their adjustment. Psychosocial interventions have been designed to increase self-efficacy and to enhance adjustment. Longitudinal study of efficacy-enhancing interventions is needed.