Dr. Samantha Serpentini, Psychologist

Background

The evidence for the importance of self-efficacy for coping in the context of oncology and in palliative care is connected to its relationship with not only self-care but also with adjustment and quality of life. Self-efficacy theory has a long history of guiding assessment and interventions in many health domains, including cancer. Generally, greater self-efficacy for coping has been positively associated with adjustment to cancer, quality of life (QOL), positive mood, and treatment seeking and negatively correlated with cancer symptoms. There is an increasing interest in the role of self-efficacy with regard to patients with advanced cancer and those in palliative and supportive care. The challenges that advanced cancer patients may face in palliative care include dealing with severe symptoms of pain and fatigue, and having the functional capacity to manage their lives independently. Also, patients receiving palliative and supportive care may have more basic, proximal and short-term QOL goals involving specific physical and emotional challenges.
From this perspective, the concept of personal self-efficacy for coping represents a key concept in the management of quality of life and the physical and psychological well-being of patients.

Research achievements

Our research provides an integrative picture of the global and multidimensional condition of a representative sample of Italian advanced cancer patients, highlighting the specific cultural differences in the process of adaptation to cancer.
We also contributed to develop high quality measures able to give more objectivity to the global needs of cancer patients and useful in identifying specific self-efficacy goals for coping in structured psychosocial interventions.
In the scenario of modern oncology, it’s crucial to receive information directly from patients about their physical and psychological condition; identifying patients’ problems means having adequate information in order to guide psychosocial interventions towards a more personalized approach to care. In line with the new and emerging models of palliative and supportive care, patients are being encouraged to be active agents in their medical care in terms of negotiating the challenges that they confront.

Conclusions and perspectives

In order to improve clinical practice in oncology and palliative care, it would be useful to identify the specific level of self-efficacy for coping in patients that could be considered clinically critical. This could be an important resource both in the identification of patients’ adaptation process and in structuring specific psychosocial interventions that are personalized and tailored. Because self-efficacy is a specific mutable factor that can be facilitated with specific psychosocial treatments, it can become a focal point of interventions. This research contributes to those new directions.