Coping with personal goal disturbance in the context of breast cancer: key findings and implications

Abstract

Background: The diagnosis and treatment of breast cancer presents unique challenges and demands that can disrupt or completely block the pursuit of important personal goals. Previous research has documented the use of goal-related coping strategies among cancer patients. This prospective qualitative study sought to gain further insight into the nature of adaptive and maladaptive coping with personal goal disturbance across the six months following surgery for breast cancer. Methods: Semi-structured interviews were conducted with 32 female non-metastatic breast cancer patients at two, four and six months post-surgery. A novel situational assessment method captured goal-specific sources of interference and coping responses over time. Thematic and cross-case analytic techniques were utilised to characterise adaptive and maladaptive response patterns. Findings: Participants exhibited four types of responses to personal goal interference – assimilative coping, accommodative coping, informed waiting, and passive responses. There was evidence of both adaptive (i.e. minimised interference and continued goal pursuit following coping response) and maladaptive (i.e. ongoing interference and blocked goal pursuit following coping response) response patterns over time. Facilitators and barriers to adaptive goal-related coping were also identified. Discussion: The nature and efficacy of coping with personal goal disturbance varied across important personal goals and over time among this sample of breast cancer patients. The novel situational assessment and analysis method afforded insight into adaptive and maladaptive coping responses to concrete instances of goal disturbance. Benefits and challenges of utilising this measurement approach in future investigations of goal-related coping in cancer and other illness contexts will be discussed.