Denial and helplessness in cancer patients undergoing radiation therapy: Sex differences and implications for prognosis

Abstract

One hundred consecutive outpatients undergoing radiation therapy were prospectively studied using the Locus of Control Inventory designed by Rotter and a questionnaire covering various aspects of diagnosis, implications of disease, and details of therapy. The Locus of Control Inventory, which measures a person's belief that life's important events are controlled by personal effort (internality) as opposed to factors outside of one's control (externality), revealed a significant difference between men and women in this study. Although women were similar to the general healthy population, men expressed a greater sense of control as their radiation therapy progressed. Men were also more likely to characterize their illness as not very serious and to deny knowledge of their correct diagnoses or details of their treatment. With survival determined at two years following the study, it was found that living and deceased women had initially rated the seriousness of their illnesses appropriately, while deceased men had rated their illnesses as significantly less serious than women or surviving men. It is concluded that sexual differences in coping mechanisms may be accentuated by malignancy and men may actively deny their diagnosis and its implications. This amount of denial and sense of personal control in the face of a potentially fatal illness may indicate a need for more supportive clinical intervention for the radiation therapy patient.

Denial and physical outcomes in lung cancer patients, a longitudinal study

“…This finding is concordant with studies among patients with other cancer types and coronary heart disease [54][55][56][57]. Traditionally, men are found to be more focused on work-related issues and women on family and health-related matters [58].…”

The Differential Effect of Perceived Control and Negative Affectivity as a Function of Gender after Coronary Artery By-pass Graft Surgery

“…This proposal is supported by Thompson et al (1998), who found no difference between the genders regarding sense of control over age-related physical changes. However, in the case of cancer, women have been reported to express less control than men do (Leigh et al, 1980;Nolen-Hoeksema et al, 1999). In general, cancer prevalence is similar among both genders, whereas heart diseases are often perceived as men's related diseases.…”

“…For example, differences in personality traits were examined in people from 37 nations, and women scored higher in neuroticism in all nations (Lynn & Martin, 1997). Women cancer patients express less control than men do (Leigh, Ungerer & Percarpio, 1980;NolenHoeksema et al, 1999). Women appear to be more emotionally vulnerable and express more types of negative emotions (Bekker, Croon, & Vermaas, 2002;Senior, Weinman, & Marteau, 2002;Smith & Reise, 1998;Vassend & Skrondal, 1999).…”

Rôle de l’identité sexuée et de l’influence du genre pour l’analyse de l’expérience des soins de support en oncologie

“…Parmi les facteurs comportementaux et environnementaux, certains auteurs soulignent l'impact du style de vie des hommes : consommation d'alcool et de tabac, mauvaises habitudes alimentaires, prises de risque délibérées [3,12,26,48], des conditions de travail plus difficiles [42], un intérêt moins marqué pour l'information sanitaire [4] ou encore le fait que ceux-ci attendraient davantage avant d'avoir recours aux soins [23,36]. Ces comportements à risques pourraient être expliqués par certains facteurs individuels dispositionnels (traits de personnalité) et transactionnels (croyances, stratégies d'ajustement) plus marqués chez les hommes comme le sentiment d'invulnérabilité, la minimisation des risques [23] ou le déni de la maladie [2,9,33].…”