Daily coping with a shortened life expectancy: Development of a daily diary measure for loss and restoration orientation in terminally ill patients with cancer

• Applicant: Dr. Sigrun Vehling
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2015 to 2017
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 284146356

Medical progress has led to an increased number of cancer patients living longer with incurable terminal disease. Being aware of and living with a shortened live expectancy confronts patients with the significant existential challenge of preparing for the reality of death while still engaging in daily life. The Dual Process Modell of Coping with Bereavement predicts a dynamic fluctuation between two coping orientations after unchangeable loss. Extended to loss of the future in terminal cancer, loss oriented coping processes refer to realization of death and grieving for what has become impossible, while restoration oriented coping processes refer to maintaining hope and engaging in worthwhile goals. The study aims to develop a measure for repeated daily assessment of loss and restoration oriented coping processes in patients with terminal cancer in order to investigate their theoretically predicted dynamics in intensive longitudinal studies. Measure development will cover four steps: The first step includes a systematic review of the literature on coping processes described to occur in response to a shortened life expectancy in patients with terminal cancer. Two reviewers will derive categories of coping processes by latent content analysis. In a second step, expert raters will assign derived coping processes to the theoretical categories of loss and restoration orientation in a structured process. Third, a German and English item pool is generated by bilingual translation and expert review in order to yield culturally sensitive concordant versions in both languages. Fourth, a pretest of the initial items by focus interviews in the target sample will result in a reduced first version of the measure for validation in a subsequent daily diary study. The measure will contribute to understand dynamic psychological processes relevant to psychological well-being and health care at the end of life. Specifically, patients' pattern of loss and restoration orientation in daily life may explain psychological adaptation outcomes as well as preferences regarding end-of-life discussions with clinicians and advance care planning, and thus guide interventions to improve end-of-life communication in the setting of terminal cancer.

• DFG Programme: Research Fellowships
• International Connection: Canada
• Host: Professor Dr. Gary Rodin, Ph.D.