Indicators of maladaptive emotions in patients with cancer as assessed by oncologists and nurses

The clinical management of patients with cancer by oncologists and nurses needs to differentiate between maladaptive emotions that do require professional mental health care and adaptive emotions that do not require such care. Previous qualitative research identified six symptoms as potential indicators of maladaptive emotions. These included lingering, increasing or extreme emotions, emotions that interfere with daily life or with treatment, and unexplained somatic symptoms. The present study tested the validity of these symptoms as indicators of maladaptive emotions in patients with cancer.

Patients with a solid malignancy were assessed 3 to 7 months after the start of chemo- or immunotherapy. Patients were categorized as experiencing either adaptive or maladaptive emotions, using two reference standards: (a) a psychiatric diagnostic assessment or (b) patient's subjective need for professional mental health care. Oncologists and nurses assessed the presence of the six symptoms, using a checklist. A total count was made of the number of symptoms that were rated as present.

As hypothesized, the total symptom count was statistically significantly greater in patients with maladaptive emotions than in patients with adaptive emotions. This was consistently observed for the ratings by oncologists as well as nurses, and for both reference standards.

The current study confirmed six symptoms assessed by oncologists and nurses as valid indicators of maladaptive emotions in patients with cancer. We recommend assessing these symptoms in the broader context of managing emotional well-being of patients with cancer.