Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

Abstract

This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. 152 patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in selfefficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population.Self-efficacy, or the confidence in one's ability to perform a specific behavior or task (Bandura, 1997), is one factor that has been examined in relation to patient's adjustment to cancer. Selfefficacy for managing pain, symptoms, and function in particular may be critical to a patient's ability to manage the physical and psychological challenges of cancer. For several reasons, lung cancer provides a particularly good model in which to study self-efficacy for pain and symptom control. First, lung cancer is common, being the second leading site of cancer occurrence among both men and women with over 174,000 new cases projected for 2006 (American Cancer Society, 2006). Second, lung cancer poses significant challenges for patients and their caregivers including aggressive medical treatments and an uncertain prognosis. In Address correspondence to: Laura S. Porter, Ph.D., 2200 West Main St, Suite 340, Durham, NC 27705, USA, email: laura.porter@duke.edu, telephone: 919-416-3436, fax: 919-416-3458.. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovere...

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