Problem Solving Style
I was fascinated to read this article about the impact of personal problem solving style on adjustment/adaptation to a diagnosis of breast cancer. Hepner and his colleagues at the University of Missouri adminstered a test to 121 women who were newly post breast surgery and then re-administered it one year later. Here is their summary:
" Multiple hierarchical regressions revealed, after controlling for patient demographics and stage of cancer, that problem-solving style (particularly personal control) was associated with emotional distress, adjustment to chronic illness, and physical function immediately following surgical intervention. In addition, a more positive problem-solving style was associated with less emotional distress, but not a better adaptation to a chronic illness or physical functioning 12 months later; the Personal Control again was the best single predictor of the emotional distress, adding 10% of the variance in predicting this outcome. "
This summary does not detail the styles that were evaluated and we are left to try to understand what constitutes a "positive problem solving style." Although the authors don't describe it, I think we can speculatate that such an approach would entail good information-gathering skills, an ability to filter what information and advice is received (e.g. it is not helpful to listen to every friend's or relative's suggestions re how to make a decision or to read every whack-o diet suggestion that may be give to us) , a personal comfort with making thoughtful decisions in general and then not second-guessing ourselves, and a generally positive outlook on life. Certainly, most of us feel less distressed when we believe that we have more control over our situations and our choices.
Medical care and doctor/patient relationships have come a long way since the days of patenalistic medicine. In some ways, it was simpler to just have your doctor tell you what to do. The choices offered to newly diagnosed woman can be overwhelming and confusing, and it certainly is helpful to have some opinions offered by our doctors. It is impossible for us, for example, to read informed consents for four different clinical trials and make an educated decision re which would be best for our particular situation. No matter how smart and motivated we may be, we (or, at least most of us) are not oncologists or breast surgeons. The key is striking the right balance between patient autonomy and choice and physician input and recommendations.
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