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The Role of Cognitive Appraisal in Quality of Life Over Time in Patients With Cancer

Theresa A. Kessler
ONF 2020, 47(3), 292-304 DOI: 10.1188/20.ONF.292-304

Objectives: To better understand how personal factors, contextual factors, and cognitive appraisals predict quality of life.

Sample & Setting: 81 patients with a new diagnosis of cancer were recruited from two oncologists’ offices in the midwestern United States.

Methods & Variables: A longitudinal design was used to collect data at three time points: within 1 month of diagnosis, at 6 months after diagnosis, and at 18 months after diagnosis. Data were collected using the Cognitive Appraisal of Health Scale and the Quality of Life Index–Cancer Version III.

Results: Individuals identified a variety of primary appraisals at the same time and more consistently identified their cancer as a challenge rather than a harm/loss or a threat. The greatest variation in appraisals and quality of life occurred about six months after diagnosis. Hierarchical regression analyses demonstrated that age and primary and secondary appraisals explained a significant amount of variance in quality of life at all three time points.

Implications for Nursing: Interventions to improve quality of life for individuals newly diagnosed with cancer are needed and may be more helpful if they target cognitive appraisals. Nurses should assess what matters to the individual; it is important to evaluate how each person appraises a cancer diagnosis so providers can support coping and adjustment from diagnosis through individual treatment trajectories.

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