Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of such coping strategies is associated with multiple outcomes, including quality of life, symptoms of depression and anxiety, illness understanding, and end-of-life care. Accumulating data demonstrate that early palliative care, integrated with oncology care, not only improves these key outcomes but also enhances coping in patients with advanced cancer. In addition, trials of home-based palliative care interventions have shown promise for improving the ways that patients and family caregivers cope together and manage problems as a dyad. In this article, we describe the nature and correlates of coping in this population, highlight the role of palliative care to promote effective coping strategies in patients and caregivers, and review evidence supporting the beneficial effects of palliative care on patient coping as well as the mechanisms by which improved coping is associated with better outcomes. We conclude with a discussion of the limitations of the state of science, future directions, and best practices on the basis of available evidence.

中文翻译：

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理解和解决应对在晚期癌症患者姑息治疗中的作用

晚期癌症具有相当大的身体症状和社会心理负担，对患者及其护理人员来说是一种生存威胁和主要压力源。为了应对这种压力，患者及其护理人员使用各种策略来管理疾病和相关症状，例如以问题为中心、以情感为中心、以意义为中心以及精神/宗教应对。使用此类应对策略与多种结果相关，包括生活质量、抑郁和焦虑症状、疾病理解和临终关怀。越来越多的数据表明，早期姑息治疗与肿瘤治疗相结合，不仅可以改善这些关键结果，还可以增强晚期癌症患者的应对能力。此外，以家庭为基础的姑息治疗干预的试验显示出改善患者和家庭护理人员共同应对和管理问题的方式的希望。在本文中，我们描述了该人群应对的性质和相关性，强调了姑息治疗在促进患者和护理人员有效应对策略方面的作用，并回顾了支持姑息治疗对患者应对的有益影响及其机制的证据改善应对与更好的结果相关联。最后，我们根据现有证据讨论科学现状、未来方向和最佳实践的局限性。强调姑息治疗在促进患者和护理人员有效应对策略方面的作用，并审查支持姑息治疗对患者应对的有益影响以及改善应对与更好结果相关的机制的证据。最后，我们根据现有证据讨论科学现状、未来方向和最佳实践的局限性。强调姑息治疗在促进患者和护理人员有效应对策略方面的作用，并审查支持姑息治疗对患者应对的有益影响以及改善应对与更好结果相关的机制的证据。最后，我们根据现有证据讨论科学现状、未来方向和最佳实践的局限性。