Coping Strategies Among Filipino Cancer Patients Undergoing Radiation Therapy in Two Tertiary Care Hospitals in the Philippines: An Analytical Cross-sectional Study
Authors:   Department of Radiation Oncology, St. Luke’s Medical Center, Republic of the Philippines, Zaldarriaga Jose Ma. , Tangco-Abao Caissa Elvira ,   Department of Radiation Oncology, St. Luke’s Medical Center, Republic of the Philippines, Lopez Manuel Martin ,   Department of Radiation Oncology, St. Luke’s Medical Center, Republic of the Philippines, Magsanoc Juan Martin ,   Department of Radiation Oncology, St. Luke’s Medical Center, Republic of the Philippines, Peña-Camacho Angela ,   Department of Radiation Oncology, St. Luke’s Medical Center, Republic of the Philippines
Published: August 2024

Introduction: The process of coping is central in the lives and experiences of cancer patients. Foreign literature on coping strategies among cancer patients is largely qualitative in nature, in the form of thematic, grounded theory, and phenomenological analyses. Of the quantitative research that has been done, many have found varying degrees of association between certain coping strategies and improved quality of life and decreased emotional distress. However, knowledge on how coping varies and is associated with the patient’s demographics, disease characteristics, among other factors remains in its infancy. This is especially true in the Philippines.
Materials and Methods: Filipino patients more than 18 years of age, with histologically confirmed diagnosis of cancer, receiving radiation therapy at St. Luke’s Medical Center-Quezon City or St. Luke’s Medical Center-Bonifacio Global City from April 2022 to December 2022, were asked to answer the Filipino Coping Strategies Scale (FCSS). The FCSS is a self-administered, 37-item, 4-point scale that measures the degree to which the respondent uses particular coping strategies
categorized into one of nine domains: cognitive reappraisal, social support, problem-solving, religiosity, tolerance, emotional release, overactivity, relaxation and recreation, and substance use.
Results: A total of 210 patients answered the survey. The majority of them were 50 to 80 years old (65.2%), women (56.7%), married (50.5%), Roman Catholic (74.3%), college graduates (66.2%) and had an estimated monthly household income on less than 1700 US dollars (66.2%). Religiosity is the primary coping strategy in this patient population, with a composite score of 3.9214 out of 4 (SD = 0.1688). The second most utilized coping strategy is problem-solving (composite score = 3.6310; SD = 0.3162). The third most common coping strategy is cognitive reappraisal (composite score = 3.5524; SD = 0.4062). This is closely followed by relaxation and recreation (composite score = 3.5343; SD = 0.3734). The fifth most utilized coping strategy is social support (composite score = 3.3140; SD = 0.5790). Calculation of independent samples t-test revealed no statistically significant difference between the coping strategies in terms of hospital (i.e. St. Luke’s Quezon City or St. Luke’s Bonifacio Global City), sex, metastatic status, and intent of radiotherapy. Calculation of analysis of variance (ANOVA) likewise revealed no statistically significant difference in terms of age, marital status, religion, educational attainment, estimated monthly income, primary cancer diagnosis, days elapsed since primary cancer diagnosis, Wong-Baker Faces (WBF) pain rating, and Eastern Cooperative Oncology Group (ECOG) performance status.
Conclusion: The most commonly utilized coping strategies in our patient cohort are religiosity, problem-solving, cognitive reappraisal, relaxation and recreation, and social support, regardless of demographicand disease-related characteristics. To the proponents’ knowledge, our research is the first to study the coping strategies of Filipino cancer patients in a quantitative manner. Doubtless, further research is needed to shed light on this crucial but barely yet untouched aspect of cancer care.