Appraisals and coping in people living with cancer: a meta-analysis.

The present meta-analysis examined the relationship between primary appraisal dimensions and coping strategies in people with cancer. Primary appraisals were operationalized as appraisals of threat, challenge, and harm/loss. Coping was operationalized according to two coping taxonomies: the first based on coping efforts to manage the stressor itself and/or the distressful feelings associated with it (problem- or emotion-focused coping, respectively) and the second based on the general orientation of the coping efforts (approach or avoidance coping). Appraisals of threat were (counter-intuitively) related to use of problem-focused coping (r=0.20); appraisals of harm and/or loss were related to avoidance coping (r=0.23); and appraisals of challenge were related to both problem-focused (r=0.15) and approach coping (r=0.14). These findings suggest that individuals with cancer who appraise their illness as a threat are likely to use more problem-focused coping strategies. Individuals who appraise their cancer as a harm/loss, however, are likely to use more avoidance coping strategies. And finally, those who appraise their cancer as a challenge are likely to use approach coping strategies. Factors found to moderate the relationship between appraisals and coping included age of the participant, time since diagnosis, and type of cancer.