Coping and adjustment in children with cancer: a meta-analytic study

The current meta-analysis assessed the efficacy of coping strategies on psychological and physical adjustment in children with cancer (n = 1230). Coping strategies were operationalized in accordance with two coping taxonomies; the first is based on the general orientation of the child's coping attempts (approach or avoidance), and the second is based upon coping efforts to regulate the stressor and/or feelings of distress attributed to it (problem-focused and emotion-focused). Approach, avoidance, and emotion-focused coping were unrelated to overall adjustment. A small-to-medium but negative association was found between problem-focused coping and adjustment, indicating more use of the strategies that compose this dimension are associated with poorer adjustment. However, homogeneity analyses also indicated significant variation for all of these effect sizes. Follow-up moderator analyses found coping-adjustment relations were both dependent upon time since diagnosis and the particular stressor the child was dealing with during treatment.