Association between coping strategies and benefit finding in adult cancer patients: a meta-analysis

This study aims to synthesize the available evidence on the association between coping strategies and benefit finding (BF) in adult cancer patients and to investigate the potential moderating effects of cancer type, cancer stage, measurement instrument, study design, and sample size.

Following PRISMA guidelines, this meta-analysis systematically searched international and Chinese databases from inception to August 7, 2025. Eligible studies were observational investigations reporting associations between coping strategies and BF among adult cancer patients. Data were pooled using fixed- or random-effects models in CMA software. Heterogeneity was explored through subgroup analyses and meta-regression.

A total of 26 studies involving 6078 participants were included. Problem-focused coping (including active coping, confrontation, planning, instrumental support, and positive coping) was moderately to strongly associated with BF (r = 0.446, 95% CI: 0.382-0.505). Positive emotion-focused coping (including acceptance, positive reframing, emotional support, humor, and religious coping) showed a moderate positive association with BF (r = 0.340, 95% CI: 0.308-0.370). Negative emotion-focused coping was not significantly associated with BF (r = 0.009, 95% CI: -0.111-0.129), although resignation was negatively associated with BF, whereas avoidance and negative coping showed nonsignificant associations. Self-blame, self-distraction, substance use, and venting were positively associated with certain outcomes, although these findings were based on a limited number of studies. Cancer type and coping assessment instrument (e.g., the culturally adapted MCMQ [Medical Coping Modes Questionnaire]) significantly moderated these associations. Cancer stage also moderated the association between problem-focused coping and BF, with stronger correlations observed in studies including participants across all cancer stages. Study design and sample size were not identified as significant moderators.

Problem-focused coping and positive emotion-focused coping were positively associated with higher levels of BF among cancer patients. These associations varied by cancer type and the measurement instruments used, underscoring the importance of considering individual and contextual factors when interpreting psychosocial outcomes. Routine assessment of coping strategies may help identify patients' psychosocial needs and inform supportive care approaches aimed at fostering positive psychological adjustment throughout the cancer experience.