1. Intervention for Cancer Patients: A
Qualitative Study
Dr. Laxmi Vajpeyi
Babu Banarasi Das National Institute of Technology and Management
Lucknow
This Research Paper is a piece of a Project entitled “Intervention for Cancer Patients”, funded by
UGC, New Delhi.
Address: 4/549-550, Vibhav Khand, Email ID: laxmi.vajpeyi@gmail.com
Gomti Nagar, Lucknow.
1

2. ABSTRACT
The present study is conducted on cancer patients suffering from breast or cervix cancer. An
intervention is also planned for the study. In pre intervention condition twenty cancer patients
were administered measures of psychological characteristics of optimism, future orientation,
perceived control, symptom reporting, quality of life and coping strategies. Then those patients
were screened, who scored low on optimism, future orientation and perceived control scale and
using more maladaptive coping strategies. These patients then attended 10 intervention sessions.
Intervention was scheduled for 15 days with 10 sessions. In post test intervention the counseled
patients again completed the psychological measures used in the pre test condition.
The results of quantitative measures and case studies of counseling showed that cancer patients
who believe that they had control over at least some aspects of their illness were better adjusted
to illness, use more active coping strategies and also plan something for near or distant future
than the patients who do not have such beliefs. The intervention sessions indicated that those
patients who enjoyed more social and psychological resources from their family or friends relied
more on active coping such as positive appraisal and seeking guidance and lesson avoidance
coping, especially emotional discharge found that optimistic patients seem to cope in more active
problem oriented way.
It can be concluded on the basis of the findings of the study that psychological dispositions like
having a sense of control, optimism and future oriented outlook along with supportive and caring
2

3. relationships enhances the tendency to effectively and actively manage a deadly chronic disease
like cancer.
KEYWORDS: Cancer, Counseling, Social support, Optimism, Coping, Intervention.
Introduction
Cancer is a set of more than 100 diseases that have several factors in common. All
cancers result from dysfunction in DNA is the part of the cellular programming that controls cell
growth and reproduction. Normally DNA ensures the regular slow production of new cells but in
case of this malfunctioning DNA causes excessively rapid cell growth and proliferation.
Cancerous cells provide no benefit to the body, but harm severely. Uncontrollable cell division
causes cancer. These cells form a visible mass or tumor. This initial tumor is called the “Primary
Tumor” cells from the primary tumor can break off and lodge elsewhere in the body where they
then grow into “Secondary Tumors”. This process is called “Metastasis”. A cancer which has
spread to other organs is called “Metastatic”.
Some species are more vulnerable to some cancer than others because
many cancers are species specific. Many cancers run in families. Recent discoveries implicate
genetic factors in a subset of colon cancer and breast cancer. These facts will help in assessing
the risk status of many individuals. Many things run in families beside genes including diet and
other life style factors that may influence the incidence of a disease.
3

4. Ethnicity is also linked to cancer. For example, in the United States, Anglo men
have a bladed cancer rate twice that of another groups and a relatively high rate of malignant
melanoma. The prostate cancer rate among blacks is higher than the rate for any other cancer in
any other group. Japanese Americans have an especially high rate of stomach cancer, whereas
Chinese Americans have a high rate of liver cancer. Some cancers are culturally linked through
lifestyle. The probability of development of some cancers change with socioeconomic status.
Type C or cancer prone personality characteristics were also suggested by researchers studying
in the field of personality. Cancer prone personality has an individual who is easy going and
acquiescent, repressing emotions that might interfere with smooth social and emotional
functioning. Bahnson (1981) proposed that cancer patients use particular defense mechanisms,
such as denial and repression. The so called Type C or cancer prone personality has been
characterized the muting of negative emotions and the potential for learned helplessness.
Lack or loss of social support has also been proposed to affect the onset and
course of cancer. The absence of a current social support network has been tied to a higher
incidence of cancer. A substantial body of research suggests link among stress, coping and
cancer, individuals who cope with stress by being acquiescent and pleasant and by repressing
negative emotions may be more likely to develop malignancies. Cancer has been tentatively tied
more specifically to problems with social support and to stressful life events. Stress may also
impair DNA repair, when lymphocytes are confronted with an antigen, they typically respond
with increases in cellular DNA and subsequent proliferation. This fact suggests the importance of
the DNA link in the development of cancer.
4

5. Thus, we can say that DNA dysfunction is the major cause of cancer. Some
studies suggest that cancers are related to many factors, like life style, social support and socio-
economic status. Some researchers suggested that Characteristics of Type C or cancer prone
personality is the cause of cancer.
Cancer is the second leading cause of death. However, more than one third of
cancer victims live at least 5 years after their diagnosis, thus creating many rehabilitation issues.
Cancer creates a wide variety of problems including physical disability, family and marital
disruptions, sexual difficulties, self esteem problems, social and recreational disruptions and
general psychological distress.
Cancer takes a substantial toll, both physically and psychologically. The physical
difficulties usually stem from the pain and discomfort cancer can produce, particularly in the
advancing and terminal phase of illness. Difficulties also arise as a consequent of treatment.
Many cancer patients also receive debilitating follow up treatments such as radiation therapy and
chemotherapy. Recent work suggests that patients may also develop conditioned immune
suppression in response to repeated pairings of the hospital, staff and other stimuli with the
immunosuppressive effects of chemotherapy. Psychological problems also arise as a
consequence of cancer, which is one of the most frightening and poorly understood diseases in
our country. Some researchers have mentioned that cancer patients are “Victimized” by family
members and friends. They may be avoided and even isolated by others, whose terror about the
disease and mistaken conceptions make unable to provide badly needed social support.
5

6. Certain coping strategies appear to be helpful in dealing with the problems
related to cancer. Coping through social support, focusing on the positive distancing were all
associated with less emotional distress whereas cancer patients who coped with their cancer
related problems through cognitive and behavioral escape avoidant strategies, showed more
emotional distress. In many ways coping with a diagnosis of a chronic illness is like coping with
any other severely stressful event. The appraisal of a chronic disease as threatening or
challenging leads to the imitation of coping efforts. One notable point is that the coping
strategies identified have few direct action factors like planful problem solving of confronting
coping. This may be because certain chronic illnesses in this case, cancer raise so many
uncontrollable concerns that coping strategies employed favor distraction, avoidance and
emotional regulation. There is also some evidence that those who employ multiple coping
strategies cope better with the stress of chronic disease than those who engage in a predominant
coping style. People have to increase their coping skills to manage the stressful situations. Some
of the coping skills are:
• Ability to relax and remain calm and composed in times of stress.
• Ability to understand the nature of problems and think of possible and feasible
solutions.
• Ability to set realistic objectives and goals and try to achieve them.
• Ability to have more realistic and appropriate attitude, knowledge and change
the behavior as required by the situation.
6

7. • Ability to get the help of family members and others in facing the situation or
the problem.
• Maintain self-esteem and take control of the situation.
To develop these coping skills following suggestions can be made to patients:
Introspection: Every body knows his assets and limitations, his strengths and weaknesses, his
resources in terms of knowledge, money materials. People must feel proud of their assets; they
don’t worrying about their weaknesses and limitations. People should try to improve himself and
reduce their limitations. “Do not compare own self with others who are better than you”.
Cultivate Relationship: Stop criticizing others, stop finding fault with others. Show respect to
elders and love to the youngsters, Cultivate friendship. “Expect not too much from the family
members, friends and colleagues, relatives.”
Role Play in Proper Ways: Each one of us have to play different roles in our family, occupation
and social life.
“Understand the role and responsibilities and make an honest effort to fit into the role as
expected in your community.”
7

8. Resource Management: Whether it is time money, materials, every one of us have constraints.
None of us have the luxury of having unlimited resources. “We have to plan, prioritize our
needs and allot time, money and materials accordingly”.
Understand problem and Situation: Before we play action or reaction to the problems, try to
know how and when problem started, who has contributed to it, what are the aggravating factors
and what could be the outcome?
Positive Attitude: Be optimistic and tell yourself that you will succeed; you will be able to
manage and sail through the problems. “Keep trying and keep working.”
Sharing of Failures and Frustrations: Suppressed feelings are painful and make the people
unhappy and uncomfortable. “Ventilation helps the people to feel good and comfortable.”
Relaxation: In between the busy schedule of life, every people try to find a few minutes to relax.
“Look at flowers, plants, trees, birds or children and enjoy the nature’s creation.”
Do Not Be Anxious about Death: Death may strikes us many time but never anxious about
Death because it’s not in our hands. “Be happy and comfortable with what you have.”
Cancer related pain and its associated distress provide a paradigm in which
to apply Counseling schedules for general use with cancer patients and their families. Counseling
is a helping process which by way of talking and discussing helps the client to find solutions and
8

9. feel comfortable. These processes have the potential to reduce isolating dysfunctional and
maladaptive responses that lead to a sense of control and of self efficacy. Increased awareness of
unexamined thoughts feelings and behaviors within the patient, family and health care team
stimulates the potential for the emergence of a true therapeutic alliance. It starts with the first
contact of the client with the counselor. Generally counseling is done in three stages as given
below:
First Stage: Client comes in contact with the counselor. They develop trust and rapport with
each other. The client is helped to talk about his perceived problems and his emotional reactions.
He is assured of help to find solution to his problems.
Second Stage: Understanding the problems, the factors which appear to be the cause, aggravate
or become hurdles in finding solutions for the problems are identified and understood. Reliance
and scientific explanations are worked out.
Third Stage: After knowing the measures taken by the individual to solve the problem and the
results of the same, he is helped to –
i. Work out both short and long term solutions.
ii. Reduce the severity of problems.
iii. Cope with the problems, if no solution is possible.
9

10. Thus, the main goal of counseling is the individual is encouraged to keep
trying to improve his conditions using the available resources and feel comfortable in this
ongoing struggle. With this in view this study tried to counsel cancer patients to use active
coping strategies, inculcate optimism, futurity and sense of control in them. The cancer patients
were make realized through counseling that although they are afflicted with very serious disease
but if they use their resources, e.g., family, friends etc. properly, they actively cope with the
problems arouse by the cancer and perceive quality in life.
Method
Participants
10

11. Fifty female cancer patients from Hanuman Prasad Poddar Cancer Hospital Gorakhpur, suffering
from breast or cervix cancer participated in the study. They were at first or second stage of
cancer. Their mean age was 51.4 years. About 90 percent of the patients were illiterate and came
from rural middle class family background.
Intervention Plan
In pre intervention condition fifty cancer patients were administered measures of psychological
characteristics of optimism, future orientation, perceived control, symptom reporting and coping
strategies. Then those patients were screened, who scored low on optimism, future orientation
and perceived control scale and using more maladaptive coping strategies. These patients then
attended 10 intervention sessions. Intervention was scheduled for 15 days with 10 sessions
according to the following scheme.
Session 1: Forming a good rapport, establishing a working relationship, attempting to show
interest with her problem.
Session 2: After baseline assessment of the LOT, FO, Perceived control the patient was
convinced to take part in intervention.
Session 3: Enlisting the problems in coping (psychological, social, financial and any other) and
emphasis on active coping strategies.
Session 4: Identification of the causes of disease and beliefs of patients.
Session 5: Assessment of the impact of illness on the patient.
Session 6: Focusing on optimism and perceived control.
Session 7: Identifying defense/coping mechanisms.
11

12. Session 8: Suggesting alternatives/ tips for better coping.
Session 9: Reinforcing/ reinstalling Hope.
Session 10: Consolidation of the cognitive behavioral intervention.
In post test intervention the counseled patients again completed the psychological measures used
in the pre test condition.
Measures
Life orientation test: Scheier and Carver (1985) have developed Life Orientation Test to
measure dispositional optimism. The scale had an internal reliability of 0.76 and test-retest
reliability of 0.79.
Perceived Control Scale: M...Agarwal, A.K.Dalal, D.K.Agarwal and R.K. Agarwal developed
the perceived control scale. The co-efficient alpha for this scale was 0.78.
Future Orientation: A variation of the technique used by Made (1972). This technique was
successfully adopted and used by Agarwal and Tripathi(1979) and Agarwal (1980). The formula
for calculation of proportion for future event is: Total Future Events/ Total Events. The
proportion was converted into arcsine x to get the future orientation score. The internal reliability
of this technique was found high.
12

13. P.G.I. Health Questionnaire: Developed by Verma, Wig and Prasad (1985) this scale consists
of a total of 38 items which were related to physical and psychological distress. Reliability of the
test using retest and split half methods was 0.80 and 0.86 respectively.
Coping Operation Preference Enquiry (COPE): Carver, Scheier and Weintraub (1989)
developed this scale. The retest and split half reliability was found 0.71 and 0.79 respective.
WHO Quality of life: In order assess the quality of life in health care settings in India, this
questionnaire was developed by a team of researchers of World Health Organization (WHO),
namely Saxena, Chandirmani and Bhargava (1998). The original long version of the scale
consists of 100 items related to domains, like Physical Health, Psychological Health, Social
Relationships, level of Independence and Environment. The short version of the scale was used
for the present investigation, which consists of 28 items related to four facets: physical,
psychological, social, and environmental.
Procedure
13

14. This study was conducted with fifty female cancer patients. The research participants were
administered measures in the following order: Personal memorandum, Life orientation test,
Future orientation test, Symptom reporting, Perceived control, Coping scales and Quality of life
Measures appeared in the same manner for all the participants. They were informed about the
purpose of the study. When these patients completed questionnaires they were thanked and
excused. After this baseline assessment the participants were screened and low scorer
participants were convinced to take part in counseling sessions. All 13 low scorer participants
agreed to take part in counseling session. The detail of the 10 session was already given in
research design section. After counseling the post intervention session was done in the same
manner as had been conducted in the pre- intervention.
Results
Findings of the present investigation were presented in two sections. In
the first section the quantitative analysis was presented and in the second section the cases of the
counseled cancer patients were described.
Quantitative analysis: Table 1 shows scores on all the psychological measures of all the 50
cancer patients. The general findings of the study are that psychological dispositions like having
a sense of control, optimism and future oriented outlook along with supportive relationships
14

15. enhances the tendency to effectively and actively manage the chronic disease. These dispositions
can be foster in patients through interventions.
Table 1 show that there were significant mean differences on optimism, perceived control,
symptom reporting, my future, future orientation and quality of life in pre and post test
conditions. Table 2 shows scores on different coping strategies. There were significant mean
differences on Active, Acceptance coping strategies and a significant t on Acceptance coping
strategy. There were no significant mean differences on humor and substance use and
maladaptive coping strategies.
Qualitative analysis: In this section of results the cases of each counseled patient is presents.
The patients were individually intervened for perceiving the brighter side of the adverse event,
looking forward and plan for future and they were encouraged to perceive increased control in
their life during the intervention sessions the counselor tried to emphasize on those psychological
characteristics on which individual patients had low score. Hence, each patient was counseled
according to hr respective need. The detailed description of the counseling sessions of each
patient is given below-
Case study 1: Mrs. Nazma aged, 45 years, illiterate, house wife, is suffering from ovary cancer,
diagnosed 6 months, earlier. The results of her baseline assessment showed that she was losing
hope. Her way of thinking was pessimistic. She thought that nothing would be good in her way.
She doesn’t want to think her future and she feels that everything in her life is uncontrollable.
Then she attended 10 counseling sessions. During the counseling sessions she listens carefully to
the counselor. Now she improves herself and her way of thinking. She used active coping
15

16. strategy to reduce stress. She thought optimistically in stressful situation. She tries to think
brighter side of adverse rent. She understood that how thinking will determines what we feel.
Now she tries to look forward. She has also improved in her perception that things are not totally
uncontrollable. All these changes are seen in post test assessment.
Case study 2: Mrs. Kamrunissa, aged 50 years, a house wife, belongs to the rural area, upper
middle class family, is suffering from uterus cancer. After baseline assessment it was found that
the patient was low scored in optimism and personal control but she had lowest scored in future
orientation. She felt that her life is coming to an end. She had no hope for her future. She said
that her future is in dark. Then she attended 10 counseling sessions. After attending these
sessions she shows some changes in her way of thinking. She says that evens her suffering from
this deadly disease but is not an end of life. Now she recognizes the positive side of events and
thinks optimistically. She tries to make her life beautiful in her limited resources because she
thought pain is the part of life and everybody has their own pains. Now she used active coping
strategy, she believes in God and finds comfort in prayer and meditation. She had suggestions
from others in stressful situation. She was improved on future orientation in post test condition.
Case study 3: Mrs. Dharma Devi, aged 45 years, illiterate, house wife, belongs to middle class
suffering form uterus cancer. After baseline assessment, the results indicate that even she was
low scorer in all measures but she had lowest score on coping scale. She was pessimistic and had
no hope for life. She blamed herself for all that happened to her. She accepted that in her
stressful situation she criticize herself for all her troubles. She thought that she was unable to
control anything, which happened with her. She accepted that her future is not secure. She had
lived a very challenging life but at last her disease defeated her. Even she was surrounded with
16

17. many problems she has co-operated very much in the counseling session. She attended all
counseling sessions. Then she tries to understand that how she changes her way of thinking, her
coping patterns and how it will benefit in her treatment. She was used active coping strategy in
post test condition. She was actively coping in stressful situation. Her way of thinking is
optimistic. She assured herself to make her life peaceful until death.
Case study 4: Mrs. Kamlawati Devi, aged 48 years, house wife, belongs to rural area, suffering
from intestine cancer. Before attending the counseling session she was pessimistic and not
satisfied with her life. She tells to the counselor that she failed in accomplishing her
responsibilities. She accepted that she doesn’t try to make situation better in stressful
circumstances because it is not in her hand. She felt that everything is uncontrollable in her life
and she can’t do anything, she feels very helpless. Then she attended 10 counseling sessions. She
said that hr family members don’t take care of her needs. She thought that her family members
are totally tired of her illness. After attending 10 counseling sessions she felt comfortable but
post test results shows that she had not improved very much.
Case study 5: Mrs. Usha Shukla aged 52 years, illiterate, house wife, from rural background,
suffering from intestine cancer. The pre test condition results shows that the patient scored low
on optimism, coping, personal control but she was lowest score on future orientation. The
patient’s way of thinking is pessimistic. She has no hope for her life. She was tried with her
illness. She can’t control her mental peace. She was always in stressful mind set. She can’t
understand the cause of hr illness. In the counseling sessions she tries to understand what
counselor wants to say. She showed much interest to improve herself. She is a god fearing person
and believes in prayer and meditation. She was used adaptive coping strategy to reduce stress in
17

18. her life. She had emotional support and suggestions from others which helped her to reduce
stress. In post test condition the results showed that she was improved her on future orientation.
Case study 6: Mrs. Manju Rai, aged 45 years, house wife, educated up to intermediate, belongs
to the middle class urban family is suffering from uterus cancer. The results of the baseline
assessment indicated that even the patient scored low on all measures but she had lowest score
on personal control. The patient thought that most of things in her life are uncontrollable. Her
future is bleak. She co-operated in counseling sessions scheduled for 15 days with 10 sessions.
She catches every point very easily and she understands that everything is not peoples under
control. Something is uncontrollable its true but she has not to dwell with it. She is used active
coping strategy but she scored high on positive reframing subscale. After counseling she thought
most of things in optimistic way. She improved herself in post test condition. Many factors are
responsible for her improvement such as, she has very good family support, and she has form
belief in God, prayer and meditation.
Case study7: Mrs. Kamlawati Devi, aged 62 years, illiterate, house wife, belongs to rural middle
class suffering from uterus cancer. The pre test results showed that the patient had low scored on
optimism, personal control and future orientation. She is very neutral about her future. She feels
that future events are not in her hands. Then she attended the counseling sessions. She talked
very freely with the counselor. She told that their family members were tired with her illness;
they do not do-operate and not take care of all her needs. In counseling sessions she listened very
carefully to the counselor and tried to understand that how to change these things to make her
happy. She used adaptive coping strategy and she feels that most of the pain can be managed
18

19. with appropriate medication. In post test condition she improved on optimism and future
orientation.
Case study 8: Mrs. Poonam Chauhan, 46 years, educated up to 8th, house wife, belongs to rural
middle class family suffering from ovary cancer. After baseline assessment the results showed
that even she scored low on all measures but she had scored lowest on coping. Her thought is
pessimistic and she has no hope for her life. She lives with her problem, her illness and her pain.
She doesn’t want to take any kind of support from others in stressful situations. She is used
acceptance coping strategy in the beginning of counseling sessions and she had not supported to
the counselor but after attending some counseling sessions she changed her attitude towards
counselor. She told that her Husband is unemployed and her economical condition is not good.
She had regret about hospital management and staff. She feels very helpless and hopeless now.
After attending counseling sessions she feel much better and in post test condition although she
improved but because her social support system and economic condition is very weak and this
create hurdle in treatment.
Case study 9: Mrs. Prabhawati Srivastva, aged48 years, belongs to rural middle class family,
illiterate, suffering from uterus cancer. Baseline assessment data reported that the patient scored
low on all measures but she scored lowest on optimism. She felt that her life is coming to an end.
She accepted that her family supported her very much in illness, they take care of all her needs
even that she feel that there is no ray of hope for her life. In stressful situation she is using
adaptive coping strategy. In post test condition she showed some changes in her way of thinking.
She understood that even she is suffering from awesome disease but that is not an end of the life,
19

20. It can be managed by medication. In post test condition she showed certain changes in coping
strategies.
Case study 10: Mrs. Poornima Devi, aged 50 years, house wife, illiterate and from rural
background suffering from uterus cancer. The pre test condition results showed that the patient
was low scored in optimism, coping, future orientation and personal control. She was not
satisfied with her life. She accepted that she don’t try to make situation better in stressful
circumstances. She was used acceptance coping strategy. She thought that she can’t control
things; everything in her life is uncontrollable. In counseling sessions she told that she was tired
of her illness and her family members don’t take care of her. The post test condition results
showed that she had not gained very much from counseling sessions but she said that she regain
the confidence that she can.
Case study 11: Mrs. Gulshan Devi, 65 years, a house wife, illiterate and from urban middle
class family suffering from ovary cancer. The baseline assessment showed that the patients had
low scores on optimism, personal control and future orientation. The patient is pessimistic and
she has no mental peace. She always felt herself in stressful mind-set and she was used adaptive
coping strategy. When she attended all counseling sessions she displayed much interest to
improve herself. In post test condition she improved because she wants so and she improved on
future orientation.
Case study 12: Mrs. Geeta Devi, 45 years, house wife, educated up to intermediate, belongs to
urban middle class family suffering from uterus cancer. The baseline assessment indicated that
the patient had low score on optimism, personal control and future orientation. She realizes that
20

21. she had not fulfilled her liabilities and this makes her restless. She felt very helpless and
dependent. In the counseling sessions she catches every point very easily. In post test condition
she restored hope.
Case study 13: Mrs. Aarti Gupta, 52 years, illiterate, house wife, comes from rural upper middle
class suffering from uterus cancer. Baseline assessment showed that the patient was low scorer
on optimism, personal control and future orientation. She doesn’t hope for the best in stressful
circumstances. She felt that future events are not in her hands. Then she attended the counseling
sessions and after that she showed contentment and she improved on optimism.
Discussion
Once a person is diagnosed as having cancer, the realization that now I have
to live with the disease, push him/her to make many compromises in life. After the diagnosis of
cancer, the patient experiences disorientation, anxiety, fear, loss of control etc. He/ she feel that
now life is slipping of his/ her hands. At this moment many times the patient and their caretakers
need outside help to reconcile the life. Frankl (1963) argued that if illnesses were associated with
the lack of hope, then successful treatment must involve it, restoration.
In the present investigation the researchers tried to restore the hope in the
patients that this is not an end of life. Although these patients do not have many years to love but
they are counseled to live their rest of life successfully, gracefully and with worth.
21

22. A substantial body of researches indicated that optimism is associated
with psychological and physical well-being. Optimism helped to people to cope with stress and
reduce risk of illness. (Carver etal, 1993; Horowitz, Adler&Kegeles, 1988; Scheier&Carver,
1985). In the present study it was also observed that optimistic cancer patients think positively
and tried to see positive aspects of the negative situation, as they also scored higher on the
positive reframing subscale of the cope questionnaire and their doctors also admitted that these
patients co-operate in the treatment and had a better recovery. It was also found that house
women caner patients, who scored higher on pessimism, denied the reality of the situation and
reported feeling that the treatment was hopeless and their condition will not be going to improve.
But when all these patients were counseled to look at the brighter side of the events, those who
already thought of a little bit optimistically modified themselves more than those who were
pessimistic. The findings of the study also showed that the support by different groups-family,
friends, social groups and special support groups are important variable in fighting the diseases
like cancer. Seligman (1991) had cited how social isolation may result in worsening of an illness
and hastening of death. During the counseling sessions, patients repeatedly said that support
from the family members is the key to successful recovery to the disease.
The results of quantitative measures and case studies of counseling showed
that cancer patients who believe that they had control over at least some aspects of their illness
were better adjusted to illness, use more active coping strategies and also plan something for near
or distant future than the patients who do not have such beliefs. When the illness condition was
perceived being modifiable and under one’s control, the recovery from myocardial infraction
was enhanced. (Bar-on, 1987). Having a sense of control make the patients to perceive quality in
22

23. life and judge their life satisfactory and less distress full. In the results it was also noted that
orientation towards future activities and goals was also increased. The motivational aspect of
future orientation is the anticipation of instrumental acts to attain positive and to avoid negative
future developments.
The intervention session indicated that those patients who enjoyed more
social and psychological resources from their family or friends relied more on active coping such
as positive appraisal and seeking guidance and lesson avoidance coping, especially emotional
discharge found that optimistic patients seem to cope in more active problem oriented way.
It can be concluded on the basis of the findings of the study that
psychological dispositions like having a sense of control, optimism and future oriented outlook
along with supportive and caring relationships enhances the tendency to effectively and actively
manage a deadly chronic disease like cancer. Although the cancer patient do not have 10 or 20
years of life but an intervention programs me along with treatment regime may ensure a positive
life with quality and satisfaction and without grudge and regret. Although 10 sessions counseling
has made effective on the patients but there is a need for regular intermittent counseling of these
patients and their family members.
23

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26. Table 1.1
Scores of cancer patients on psychological measures before and after CBT interventions
Measures Pre- Post Intervention t
Intervention
Optimism 24.7 (2.80) 28.3 (4.69) 2.12*
Perceived Control 19.3 (1.84) 21.6 (2.91) 2.13*
Future Orientation 7.51 (1.69) 10.89 (1.80) 2.12*
My future 49.2 (1.41) 54.6 (1.73) 2.08*
Symptom Reporting 9.3 (1.69) 9.6 (1.80) 1.64 26
Quality of life 22.5 (3.68) 26.7 (3.28) 2.27*

27. Table 1.2
Means and SDs of scores on the measures of coping strategies
Coping Strategies Pre- Post-Intervention t
27

28. Intervention
Active Coping 18.3 (3.60) 22.4 (3.74) 2.12*
Acceptance Coping 17.2 (3.60) 22.8 (1.91) 2.07*
Maladaptive Coping 16.3 (2.39) 12.3 (1.74) 2.12*
Note: **p<.01, *p<.05.
28