{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:28:11Z","timestamp":1792106891442,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008963","name":"Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019717","name":"AstraZeneca Espa\u00f1a","doi-asserted-by":"publisher","award":["ES2020\u20101939"],"award-info":[{"award-number":["ES2020\u20101939"]}],"id":[{"id":"10.13039\/100019717","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Uncertainty in the context of advanced cancer diagnosis often incurs significant psychological distress. The aims were to evaluate the incidence of psychological distress upon diagnosis of advanced cancer and to analyze whether the relationship between illness uncertainty and psychological distress can be mediated by coping strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter, prospective, cross\u2010sectional study was conducted in 15 medical oncology departments across Spain. Individuals with unresectable advanced cancer completed questionnaires on uncertainty (Michel Uncertainty of Illness Scale, coping strategies (Mental Adjustment to Cancer, M\u2010MAC), and psychological distress (Brief Symptom Inventory, BSI\u201018) after the diagnostic and treatment appointment and before beginning systemic cancer treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>841 patients eligible for systemic treatment with palliative intent were included between February 2020 and April 2022. A total of 71.7% had clinically significant levels of psychological distress. Univariate analyses identified that the groups with less psychological distress were male (<jats:italic>\u03b7p<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.016), married (<jats:italic>\u03b7p<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.006), and had a better performance status (<jats:italic>\u03b7p<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.007). The most widely used coping strategies were positive attitude and cognitive avoidance. A positive relationship was found between uncertainty, coping strategies, and psychological distress (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Participants who responded with anxious preoccupation suffered more helplessness and psychological distress, while those who responded with cognitive avoidance displayed greater positive attitude and lesser psychological distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with newly diagnosed unresectable advanced cancer frequently experience psychological distress in the face of uncertainty, potentially influenced by coping strategies like cognitive avoidance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.6219","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T09:07:17Z","timestamp":1696410437000},"page":"1694-1701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Coping strategies as mediators of uncertainty and psychological distress in patients with advanced cancer"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1214-6595","authenticated-orcid":false,"given":"Berta","family":"Obispo","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Infanta Leonor  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9837-825X","authenticated-orcid":false,"given":"Patricia","family":"Cruz\u2010Castellanos","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital General Universitario de Ciudad Real  Ciudad Real Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-5830","authenticated-orcid":false,"given":"Ana","family":"Fern\u00e1ndez\u2010Montes","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Complejo Hospitalario Universitario de Ourense \u2013 CHUO  Ourense Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-5766","authenticated-orcid":false,"given":"Sara","family":"Coca\u2010Membribes","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario de Canarias  La Laguna Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9795-8762","authenticated-orcid":false,"given":"Jacobo","family":"Rogado","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Infanta Leonor  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-9059","authenticated-orcid":false,"given":"M\u00f3nica","family":"Anto\u00f1anzas","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7479-8658","authenticated-orcid":false,"given":"Oscar A.","family":"Castillo\u2010Trujillo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Central de Asturias ISPA  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-8809","authenticated-orcid":false,"given":"Helena","family":"L\u00f3pez\u2010Ceballos","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital San Pedro de Alc\u00e1ntara de Caceres  C\u00e1ceres Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5078-139X","authenticated-orcid":false,"given":"Ad\u00e1n","family":"Rodr\u00edguez\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Central de Asturias ISPA  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4592-3813","authenticated-orcid":false,"given":"Paula","family":"Jim\u00e9nez\u2010Fonseca","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Hospital Universitario Central de Asturias ISPA  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-9321","authenticated-orcid":false,"given":"Caterina","family":"Calderon","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychobiology University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm\u201022\u2010162"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547\u20105069.1988.tb00082.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare\u20102013\u2010000482"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010014\u20102243\u2010y"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0285"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547\u20105069.1990.tb00225.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.08.012"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.55.090902.141456"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169071"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5663"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094\u2010021\u201002592\u2010y4"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3155"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000552"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5372"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29120763"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1300\/J077V12N03_03"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2020.06.001"},{"key":"e_1_2_12_19_1","unstructured":"DerogatisLR.Brief Syptoms Inventory (BSI): Administration Scoring and Procedures.3er ed.;1993."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2019.12.001"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0013164404264848"},{"key":"e_1_2_12_22_1","unstructured":"FieldA.Discovering Statistics Using SPSS.3th ed.;2009."},{"key":"e_1_2_12_23_1","first-page":"23","article-title":"Evaluating the fit of structural equation models: tests of significance and descriptive goodness\u2010of\u2010fit measures","volume":"2","author":"Schermelleh\u2010Engel K","year":"2003","journal-title":"Methods Psychol Res Online"},{"key":"e_1_2_12_24_1","volume-title":"Structural Equation Modeling: AMOS Operation and Application","author":"Wu M","year":"2010"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010019\u20106181\u20104"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010016\u20100768\u20102"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2017.12.002"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20777"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000940"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010021\u201006789\u20103"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2018.01.007"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1099\u20101611(200003\/04)9:2<137::aid\u2010pon442>3.0.co;2\u20100"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104741.2010.00964.x"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4864"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp398"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5587"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10390"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010016\u20102964\u2010z"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2010.542814"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1348\/135910705X36749"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.6219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:30:43Z","timestamp":1703604643000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.6219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":39,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1002\/pon.6219"],"URL":"https:\/\/doi.org\/10.1002\/pon.6219","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,3]]},"assertion":[{"value":"2023-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}