Antecedents, Appraisal, Coping Strategies and Psychosocial Adjustment among Cervical Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Mixed-Method Study
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Date
2022-11-01
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Addis Ababa University
Abstract
Despite great developments in diagnostic and treatment modalities for cervical cancer,
overall psychosocial adjustment difficulties lead to poor health outcomes and reduced adherence
to therapy. Accordingly, this study assessed the antecedents, appraisal, coping strategies, and
psychosocial adjustment among cervical cancer patients in Tikur Anbessa Specialized Hospital.
A cross-sectional, mixed-method study design was employed. The quantitative study collected
data from 299 women and analyzed using descriptive, correlation, multiple regression, and path
analysis. The qualitative study collected data through in-depth interviews with 11 women and
analyzed via thematic analysis. The quantitative study revealed that most women experienced
significantly greater psychosocial adjustment difficulties. They appraise their illness as a threat
and harm/loss than a challenge. The result indicated that uncertainty, self-efficacy, presence of
meaning in life, harm/loss and challenge appraisal, problem-focused coping, and emotion-
focused coping strategies were significant predictors of psychosocial adjustment difficulty.
Besides, the mediating role of cognitive appraisal and coping strategies in the association
between antecedents and psychosocial adjustment was partially supported. The qualitative study
findings indicated that women experienced a lack of satisfaction with health care, struggle in
work and daily life, and financial difficulties. Women employed various strategies to cope with
their illness such as accepting, diverting attention, and religiousness. They experienced delays in
seeking medical care because of limited awareness and repeated practice of traditional rituals.
Information and advice from health professionals were the most crucial support need identified.
The integrated study findings show that women’s personal and environmental antecedents
influence their appraisal and coping strategies, and consequently their psychosocial adjustment
with diagnosis and treatment of cervical cancer. Finally, it was recommended that cervical
cancer treatment needs to integrate the psychological and social components of health. Also,
expanding diagnostic and treatment facilities should be considered to help women access timely
and cost-effective care.
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Keywords
Cervical cancer, Appraisal, Coping, Psychosocial adjustment, Tikur Anbessa Specialized Hospital, Ethiopia