All Title Author
Keywords Abstract

Publish in OALib Journal
ISSN: 2333-9721
APC: Only $99


Relative Articles


Sense of Coherence, Self-Disclosure, and Depression in Lung Cancer Patients

DOI: 10.4236/ojmp.2021.101002, PP. 11-26

Keywords: Lung Cancer, Sense of Coherence, Self-Disclosure, Depression, Quantitative Method

Full-Text   Cite this paper   Add to My Lib


This study aimed to investigate the relationship between sense of coherence and depression and the mediating role of self-disclosure in lung cancer patients. Α cross-sectional study was conducted in “Sotiria” Chest Diseases Hospital, Greece, with a sample of 200 lung cancer patients. The administered questionnaires included demographic-medical information, SOC-13, Distress Disclosure Index, and CES-D scale. Analysis was performed by SPSS v.23 and PROCESS. Depression was common (41%) and negatively correlated to SOC (rho = -0.843, df = 198, p < 0.001), while self-disclosure did not mediate this relationship. Hierarchical linear regression analysis showed that patients with weak SOC, disease recurrence, metastases, low income, and receiving therapy in Day clinic had higher levels of depression. In conclusion, a strong SOC represents a protective factor against depression in lung cancer patients. Consequently, there is a need for targeted interventions, which should mainly increase SOC of these patients.


[1]  American Cancer Society (2018).
[2]  Cataldo, J.K. and Brodsky, J.L. (2013) Lung Cancer Stigma, Anxiety, Depression and Symptom Severity. Oncology, 85, 33-40.
[3]  Key, G. (2015) Psychiatric Care of Lung Cancer Patients. Cancer Network, 29, 195-197.
[4]  European Lung Foundation (2018)
[5]  Walker, J., Sawhney, A., Hansen, C.H., Symeonides, S., Martin, P., Murray, P. and Sharpe, M. (2013) Treatment of Depression in People with Lung Cancer: A Systematic Review. Lung Cancer, 79, 46-53.
[6]  Rolke, H.B., Bakke, P.S. and Gallefoss, F. (2008) Health Related Quality of Life, Mood Disorders and Coping Abilities in an Unselected Sample of Patients with Primary Lung Cancer. Respiratory Medicine, 102, 1460-1467.
[7]  Hopwood, P. and Stephens, R.J. (2000) Depression in Patients with Lung Cancer: Prevalence and Risk Factors Derived from Quality-of-Life Data. Journal of Clinical Oncology, 18, 893-903.
[8]  Shimizu, K., Nakaya, N., Saito-Nakaya, K., Akechi, T., Yamada, Y., Fujimori, M., Ogawa, A., Fujisawa, D., Goto, K., Iwasaki, M., Tsugane, S. and Uchitomi, Y. (2012) Clinical Biopsychosocial Risk Factors for Depression in Lung Cancer Patients: A Comprehensive Analysis Using Data from the Lung Cancer Database Project. Annals of Oncology, 23, 1973-1979.
[9]  Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C. and Piantadosi, S. (2001) Τhe Prevalence of Psychological Distress by Cancer Site. Psychooncology, 10, 19-28.<19::AID-PON501>3.0.CO;2-6
[10]  Shi, Y., Gu, F., Hou, L.L. and Hu, Y.Q. (2015) Self-Reported Depression among Patients with Non-Small Cell Lung Cancer. Thoracic Cancer, 6, 334-337.
[11]  Margari, N., Karapoulios, D., Getsios, I., Rizou, V., Kostopoulou, S., Balodimou, Chr. and Siagouli, M. (2016) Anxiety and Depression in Lung Cancer Patients. International Journal of Caring Sciences, 9, 308-313.
[12]  Buccheri, G. (1998) Depressive Reactions to Lung Cancer Are Common and Often Followed by a Poor Outcome. European Respiratory Journal, 11, 173-178.
[13]  Mou, Q.Q., Yu, C.H. and Li, J.Y. (2016) Investigation and Analysis for Impact Factors of Distress in Patients with First Diagnosed Lung Cancer. Journal of Peking University, 48, 507-514.
[14]  Abhishekh, H.A., Balaji, A.L. and Mehta, R.M. (2014) Depression in Lung Cancer Patients. Indian Journal of Psychiatry, 56, 307.
[15]  Hung, M.S., Chen, I.C., Lee, C.P., Huang, R.J., Chen, P.C., Tsai, Y.H. and Yang, Y.H. (2017) Incidence and Risk Factors of Depression after Diagnosis of Lung Cancer: A Nationwide Population-Based Study. Medicine (Baltimore), 96, e6864.
[16]  Aass, N., Fosså, S.D., Dahl, A.A. and Moe, T.J. (1997) Prevalence of Anxiety and Depression in Cancer Patients Seen at the Norwegian Radium Hospital. European Journal of Cancer, 33, 1597-604.
[17]  Chapple, A., Ziebland, S. and McPheron, A. (2004) Stigma, Shame and Blame Experienced by Patients with Lung Cancer: Qualitative Study. BMJ, 328, 1470.
[18]  Ignatius, E. and Kokkonen, M. (2007) Factors Contributing to Verbal Self-Disclosure. Nordic Psychology, 59, 362-391.
[19]  Uysal, A., Lee Lin, H. and Kneem, R. (2010) The Role of Need Satisfaction in Self-Concealment and Well-Being. Personality and Social Psychology Bulletin, 36, 187-199.
[20]  Barr, L.K., Kahn, J.H. and Schneider, W.J. (2008) Individual Differences in Emotion Expression: Hierarchical Structure and Relations with Psychological Distress. Journal of Social and Clinical Psychology, 27, 1045-1077.
[21]  Yoo, G.J, Aviv, C., Levine, E.G., Ewing, C. and Au, A. (2010) Emotion Work: Disclosing Cancer. Supportive Care in Cancer, 18, 205-215.
[22]  Munro, H., Scott, S.E., King, A. and Grunfeld, E.A. (2015) Patterns and Predictors of Disclosure of a Diagnosis of Cancer. Psychooncology, 24, 508-514.
[23]  Dagan, M., Sanderman, R., Hoff, C., Jeroen Meijerink, W.J.H., Baas, P., van Haastert, M. and Hagedoorn, M. (2014) The Interplay between Partners’ Responsiveness and Patients’ Need for Emotional Expression in Couples Coping with Cancer. Journal of Behavioral Medicine, 37, 828-838.
[24]  Mc Leod, D.L., Tapp, D.M., Moules, N.J. and Campbell, M.E. (2010) Knowing the Family: Interpretations of Family Nursing in Oncology and Palliative Care. European Journal of Oncology Nursing, 14, 93-100.
[25]  Eriksson, M. and Lindström, B. (2006) Antonovsky Sense of Coherence Scale and the Relation with Health: A Systematic Review. Journal of Epidemiology and Community Health, 60, 376-381.
[26]  Antonovsky, A. (1987) Unraveling the Mystery of Health: How People Manage Stress and Stay Well. Jossey-Bass Publishers, San Francisco.
[27]  Antonovsky, A. (1979) Health, Stress and Coping. Jossey-Bass Publishers, San Francisco.
[28]  Super, S., Wagemakers, M.A., Picavet, H.S., Verkoijen, K.T. and Koelen, M.A. (2016) Strengthening Sense of Coherence: Opportunities for Theory Building in Health Promotion. Health Promotion International, 31, 869-878.
[29]  Luutonen, S., Sohlman, B., Salokangas, R.K., Lehtinen, V. and Dowrick, C. (2011) Weak Sense of Coherence Predicts Depression: 1-Year and 9-Year Follow-Ups of the Finnish Outcomes of Depression International Network (ODIN) Sample. Journal of Mental Health, 20, 43-51.
[30]  Sairenchi, T., Haruyama, Y., Ishikawa, Y., Wada, K., Kimura, K. and Muto, T. (2011) Sense of Coherence as a Predictor of Onset of Depression among Japanese Workers: A Cohort Study. BMC Public Health, 11, 205.
[31]  Bruscia, K., Shultis, C., Dennery, K. and Dileo, C. (2008) The Sense of Coherence in Hospitalized Cardiac and Cancer Patients. Journal of Holistic Nursing, 26, 286-294.
[32]  Gustavsson-Lilius, M., Julkunen, J., Keskivaara, P., Lipsanen, J. and Hietanen, P. (2012) Predictors of Distress in Cancer Patients and Their Partners: The Role of Optimism in the Sense of Coherence Construct. Psychology and Health, 27, 178-195.
[33]  Antonovsky, A. (1993) The Structure and Properties of the Sense of Coherence Scale. Social Science and Medicine, 36, 725-733.
[34]  Αnagnostopoulou, T. and Kioseoglou, G. (2002) Sense of Coherence Scale [In Modern Greek]. In: Stalikas, A., Triliva, S. and Roussi, P., Eds., Psychometric Tools in Greece, Ellinika Grammata, Athens, 586.
[35]  Kahn, J. and Hessling, R. (2001) Measuring the Tendency to Conceal Versus Disclose Psychological Distress. Journal of Social and Clinical Psychology, 20, 41-65.
[36]  Kormas, C., Karamali, G. and Anagnostopoulos, F. (2014) Attachment Anxiety, Basic Psychological Needs Satisfaction and Depressive Symptoms in University Students: A Mediation Analysis Approach. International Journal of Psychological Studies, 6, 1-10.
[37]  Radloff, L.S. (1977) The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Medicine, 1, 385-401.
[38]  Fountoulakis, K., Iacovides, A., Kleanthous, S., Samolis, S., Kaprinis, S.G., Sitzoglou, K., Karpinis, G. and Bech, P. (2001) Reliability, Validity and Psychometric Properties of the Greek Translation of the Center for Epidemiological Studies-Depression (CES-D) Scale. BMC Psychiatry, 1, Article No. 3.
[39]  Ηayes, A.F. (2013) An Introduction to Mediation, Moderation and Conditional Process Modeling: A Regression-Based Approach. Guilford Press, New York.
[40]  World Health Organization WHO (2018).;jsessionid=418324ABC51985D64314AC44D3903267?sequence=1
[41]  Drageset, J., Eide, G.E. and Hauge, S. (2016) Symptoms of Depression, Sadness and Sense of Coherence (Coping) among Cognitively Intact Older People with Cancer Living in Nursing Homes—A Mixed-Methods Study. PeerJ, 4, e2096.
[42]  Derlega, V. and Berg, J. (1987) Self-Disclosure. Theory, Research and Practice. Plenum Press, New York.
[43]  Cordes, M.C., Scherwath, A., Ahmad, T., Cole, A.M., Ernst, G., Oppitz, K., Lanfermann, H., Bremer, M. and Steinmann, D. (2014) Distress, Anxiety and Depression in Patients with Brain Metastases before and after Radiotherapy. BMC Cancer, 14, 731.
[44]  Trask, P.C. (2004) Assessment of Depression in Cancer Patients. Journal of the National Cancer Institute. Monographs, 80-92.
[45]  Mosher, C.E., Hanna, N., Jalal, S.I., Fakiris, A.J., Einhorn, L.H., Birdas, T.J., Okereke, I., Kesler, K. and Champion, V.L. (2013) Support Service Use and Interest in Support Services among Lung Cancer Patients. Lung Cancer, 82, 162-167.
[46]  Nowicki, A. (2017) The Importance of Research on the Sense of Coherence and Acceptance of the Disease in Patients Receiving Palliative Care Due to Lung Cancer. Nursing and Palliative Care, 2, 1-2.


comments powered by Disqus

Contact Us


WhatsApp +8615387084133

WeChat 1538708413