Dispositional Optimism and Well-being in Cancer Patients: The Role of Cancer-Related Self-Efficacy

İrem Akıncı, Cansu Akyüz-Yılmaz, Özlem Bozo


Optimistic attitudes of cancer patients are shown as an important personal resource for the psychological and physical adjustment to the illness. Coping styles and appraisals were suggested as indirect pathways through which optimism associates with better functioning in patients. The current study aimed to investigate the role of cancer-specific self-efficacy domains (i.e., coping with cancer-related side effects and stress, maintaining activity and independence, seeking and understanding medical information, and affect regulation and seeking social support) in the association between optimism and physical and psychological (i.e., depressive symptoms) well-being of cancer patients. A cross-sectional study was conducted with 120 patients in Ankara, Turkey. Majority of the participants were female, and about half of them were breast cancer patients. Participants filled a set of self-report questionnaires including Life Orientation Test-Revised, Cancer Behavior Inventory, Multidimensional Quality of Life Scale-Cancer, and Beck Depression Inventory. The data were analyzed separately for physical well-being and depressive symptoms through the bootstrapping method. Of the four self-efficacy domains, maintaining activity and independence accounted for a significant proportion of variance in the optimism-physical well-being and optimism-depressive symptoms relations. Findings highlight the importance of patients' beliefs in their ability to sustain their daily activities for having better physical and psychological well-being during cancer treatment as well as the role of optimism in promoting this particular self-efficacy domain. Interventions are suggested to focus on enhancing cancer patients' self-efficacy in maintaining activity and independence.


Optimism; Cancer-specific self-efficacy; Depressive symptoms; Quality of life.

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Allison, P. J., Guichard, C., & Gilain, L. (2000). A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients. Quality of Life Research, 9(8), 951–960. https://doi.org/10.1023/A:1008931906253

Aspinwall, L. G., Richter, L., & Hoffman III, R. R. (2001). Understanding how optimism works: An examination of optimists' adaptive moderation of belief and behavior. In E. C. Chang (Ed.), Optimism and pessimism: Implications for theory, research, and practice (pp. 217-238). American Psychological Association. https://psycnet.apa.org/doi/10.1037/10385-010

Aydın, G., & Tezer, E. (1991). Relationships among optimism, health problems and academic achievement. Turkish Journal of Psychology, 7(26), 2–9.

Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122-147. https://psycnet.apa.org/doi/10.1037/0003-066X.37.2.122

Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.

Bandura, A. (1999). A social cognitive theory of personality. In L. Pervin & O. John (Ed.), Handbook of Personality (pp. 154-196). Guilford Publications

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004

Beckham, J. C., Burker, E. J., Burker, E. J., Feldman, M. E., & Costakis, M. J. (1997). Self-efficacy and adjustment in cancer patients: a preliminary report. Behavioral Medicine, 23(3), 138–142. https://doi.org/10.1080/08964289709596370

Bidstrup, P. E., Christensen, J., Mertz, B. G., Rottmann, N., Dalton, S. O., & Johansen, C. (2015). Trajectories of distress, anxiety, and depression among women with breast cancer: looking beyond the mean. Acta Oncologica, 54(5), 789–796. https://doi.org/10.3109/0284186X.2014.1002571

Boehmke, M. M., & Dickerson, S. S. (2006). The diagnosis of breast cancer: transition from health to illness. Oncology Nursing Forum, 33(6), 1121–1127. https://doi.org/10.1188/06.onf.1121-1127

Bonacchi, A., Di Miceli, S., Lippi, D., Muraca, M. G., & Miccinesi, G. (2018). Unmet needs of Italian cancer patients in different stages of the disease and care process. Tumori Journal, 104(4), 285-291. https://doi.org/10.5301%2Ftj.5000637

Bower, J. E. (2014). Cancer-related fatigue—mechanisms, risk factors, and treatments. Nature Reviews Clinical Oncology, 11(10), 597-609. https://doi.org/10.1038/nrclinonc.2014.127

Bozo, Ö., Akıncı, İ., & Akyüz, C. (2019). The psychometric properties of cancer behavior inventory as a predictor of quality of life in Turkish cancer patients. Current Psychology, 38(1), 229–238. https://doi.org/10.1007/s12144-017-9609-5

Büyükaşik-Çolak, C., Gündoğdu-Aktürk, E., & Bozo, Ö. (2012). Mediating role of coping in the dispositional optimism–posttraumatic growth relation in breast cancer patients. The Journal of Psychology, 146(5), 471–483. https://doi.org/10.1080/00223980.2012.654520

Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat Jr., Frederick, L., & Clark, K. C. (1993). How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65(2), 375–390. https://psycnet.apa.org/doi/10.1037/10338-005

Carver, C. S. & Scheier, M. F. (2014). Dispositional optimism. Trends in Cognitive Sciences, 18(6), 293-299. https://dx.doi.org/10.1016%2Fj.tics.2014.02.003

Carver, C. S., Scheier, M. F., & Segerstrom, S. C. (2010). Optimism. Clinical Psychological Review, 30, 879–889. https://doi.org/10.1016/j.cpr.2010.01.006

Chang, S., Witteloostuijn, A., & Eden, L. (2010). From the Editors: Common method variance in international business research. Journal of International Business Research, 41, 178-184. https://doi.org/10.1057/jibs.2009.88

Dixon, A. L., & Schertzer, S. M. (2005). Bouncing back: how salesperson optimism and self-efficacy influence attributions and behaviors following failure. Journal of Personal Selling & Sales Management, 25(4), 361–369. https://doi.org/10.1080/08853134.2005.10749070

Drageset, S., Lindstrøm, T. C., & Underlid, K. (2010). Coping with breast cancer: between diagnosis and surgery. Journal of Advanced Nursing, 66(1), 149–158. https://doi.org/10.1111/j.1365-2648.2009.05210.x

Ercolano, E. (2017). Psychosocial concerns in the postoperative oncology patient. Seminars in Oncology Nursing 33(1), 74-79. https://doi.org/10.1016/j.soncn.2016.11.007

Friedman, L. C., Kalidas, M., Elledge, R., Chang, J., Romero, C., Husain, I., Dulay, M. F., & Liscum, K. R. (2006). Optimism, social support and psychosocial functioning among women with breast cancer. PsychoOncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 15(7), 595–603. https://doi.org/10.1002/pon.992

Gustavsson-Lilius, M., Julkunen, J., Keskivaara, P., Lipsanen, J., & Hietanen, P. (2012). Predictors of distress in cancer patients and their partners: The role of optimism in the sense of coherence construct. Psychology & Health, 27(2), 178-195. https://doi.org/10.1080/08870446.2010.484064

Haugland, T., Wahl, A. K., Hofoss, D., & DeVon, H. A. (2016). Association between general self-efficacy, social support, cancer-related stress and physical health-related quality of life: a path model study in patients with neuroendocrine tumors. Health and Quality of Life Outcomes, 14(1), 1–7. https://doi.org/10.1186/s12955-016-0413-y

Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis : A regression-based approach. Guilford Press.

Hickok, J. T., Morrow, G. R., Roscoe, J. A., Mustian, K., & Okunieff, P. (2005). Occurrence, severity, and longitudinal course of twelve common symptoms in 1129 consecutive patients during radiotherapy for cancer. Journal of Pain and Symptom Management, 30(5), 433–442. https://doi.org/10.1016/j.jpainsymman.2005.04.012

Hirai, K., Suzuki, Y., Tsuneto, S., Ikenaga, M., Hosaka, T., & Kashiwagi, T. (2002). A structural model of the relationships among self‐efficacy, psychological adjustment, and physical condition in Japanese advanced cancer patients. PsychoOncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 11(3), 221–229. https://doi.org/10.1002/pon.1735

Hisli, N. (1988). Beck Depresyon Envanteri’nin geçerliği üzerine bir çalışma [A study on the validity of Beck Depression Inventory]. Psikoloji Dergisi, 6, 118–122.

Kolokotroni, P., Anagnostopoulos, F., & Hantzi, A. (2018). The role of optimism, social constraints, coping, and cognitive processing in psychosocial adjustment among breast cancer survivors. Journal of Clinical Psychology in Medical Settings, 25(4), 452-462. https://doi.org/10.1007/s10880-018-9555-x

Kroenke, C. H., Rosner, B., Chen, W. Y., Kawachi, I., Colditz, G. A., & Holmes, M. D. (2004). Functional impact of breast cancer by age at diagnosis. Journal of Clinical Oncology, 22(10), 1849-1856. https://doi.org/10.1200/jco.2004.04.173

Lee, V., Cohen, S. R., Edgar, L., Laizner, A. M., & Gagnon, A. J. (2006). Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy. Social Science & Medicine, 62(12), 3133-3145. https://doi.org/10.1016/j.socscimed.2005.11.041

Luoma, M. L., & Hakamies‐Blomqvist, L. (2004). The meaning of quality of life in patients being treated for advanced breast cancer: a qualitative study. PsychoOncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 13(10), 729–739. https://doi.org/10.1002/pon.788

Magaletta, P. R., & Oliver, J. M. (1999). The hope construct, will, and ways: Their relations with self‐efficacy, optimism, and general well‐being. Journal of Clinical Psychology, 55(5), 539–551. https://doi.org/10.1002/(SICI)1097-4679(199905)55:5%3C539::AID-JCLP2%3E3.0.CO;2-G

Manne, S. L., Ostroff, J. S., Norton, T. R., Fox, K., Grana, G., & Goldstein, L. (2006). Cancer-specific self-efficacy and psychosocial and functional adaptation to early stage breast cancer. Annals of Behavioral Medicine, 31(2), 145-154. https://doi.org/10.1207/s15324796abm3102_6

Mazanec, S. R., Daly, B. J., Douglas, S. L., & Lipson, A. R. (2010). The relationship between optimism and quality of life in newly diagnosed cancer patients. Cancer Nursing, 33(3), 235–243. https://dx.doi.org/10.1097%2FNCC.0b013e3181c7fa80

Merluzzi, T. V., & Martinez Sanchez, M. A. (1997). Assessment of self-efficacy and coping with cancer: development and validation of the cancer behavior inventory. Health Psychology, 16(2), 163–170. https://psycnet.apa.org/doi/10.1037/0278-6133.16.2.163

Merluzzi, T. V., Nairn, R. C., Hegde, K., Martinez Sanchez, M. A., & Dunn, L. (2001). Self‐efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (version 2.0). PsychoOncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 10(3), 206–217. https://doi.org/10.1002/pon.511

Padilla, G. V., Mishel, M. H., & Grant, M. M. (1992). Uncertainty, appraisal and quality of life. Quality of Life Research, 1(3), 155–165. https://doi.org/10.1007/BF00635615

Phan, H. P. (2016). Longitudinal examination of optimism, personal self-efficacy and student well-being: a path analysis. Social Psychology of Education, 19(2), 403-426. https://doi.org/10.1007/s11218-015-9328-4

Pınar, R. (2002). A study on the reliability and validity of the Turkish version of the MQOLS-CA2 in people with cancer. Turkish Journal of Cancer, 10(4), 148–163.

Pirl, W. F. (2004). Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. Journal of the National Cancer Institute Monographs, 2004(32), 32–39. https://doi.org/10.1093/jncimonographs/lgh026

Rahnea-Nita, R. A., Paunica, S., Motofei, C., & Rahnea-Nita, G. (2019). Assessment of anxiety and depression in patients with advanced gynaecological cancer. Mediterranean Journal of Clinical Psychology, 7(2). https://doi.org/10.6092/2282-1619/2019.7.2214

Ramírez-Maestre, C., Esteve, R., & López, A. E. (2012). The role of optimism and pessimism in chronic pain patients adjustment. The Spanish Journal of Psychology, 15(1), 286-294. https://doi.org/10.5209/rev_SJOP.2012.v15.n1.37335

Rand, K. L. (2018). Hope, self-efficacy, and optimism: Conceptual and empirical differences. In M. W. Gallagher & S. J. Lopez (Ed.), The Oxford Handbook of Hope (pp. 45-58). Oxford University Press. 10.1093/oxfordhb/9780199399314.013.4

Roth, R. S., Lowery, J. C., Davis, J., & Wilkins, E. G. (2005). Quality of life and affective distress in women seeking immediate versus delayed breast reconstruction after mastectomy for breast cancer. Plastic and Reconstructive Surgery, 116(4), 993-1002. https://doi.org/10.1097/01.prs.0000178395.19992.ca

Robb, C., Lee, A., Jacobsen, P., Dobbin, K. K., & Extermann, M. (2013). Health and personal resources in older patients with cancer undergoing chemotherapy. Journal of Geriatric Oncology, 4(2), 166–173. https://doi.org/10.1016/j.jgo.2012.12.002

Rottmann, N., Dalton, S. O., Christensen, J., Frederiksen, K., & Johansen, C. (2010). Self-efficacy, adjustment style and well-being in breast cancer patients: A longitudinal study. Quality of Life Research, 19(6), 827–836. https://doi.org/10.1007/s11136-010-9653-1

Scharloo, M., Baatenburg de Jong, R. J., Langeveld, T. P., van Velzen‐Verkaik, E., Doorn‐op den Akker, M. M., & Kaptein, A. A. (2005). Quality of life and illness perceptions in patients with recently diagnosed head and neck cancer. Head & Neck: Journal for the Sciences and Specialties of the Head and Neck, 27(10), 857–863. https://doi.org/10.1002/hed.20251

Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67(6), 1063–1078. https://doi.org/10.1037//0022-3514.67.6.1063

Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychology, 4(3), 219–247. https://psycnet.apa.org/doi/10.1037/0278-6133.4.3.219

Sorrenti, L., Arena, J., Mafodda, A. V., & Filippello, P. (2021). Perception of well-being, predisposition to optimism, and quality of life of parents of children with autism apectrum disorder. Mediterranean Journal of Clinical Psychology, 9(2). https://doi.org/10.13129/2282-1619/mjcp-3022

Tan, C., & Tan, L. S. (2014). The role of optimism, self-esteem, academic self-efficacy and gender in high-ability students. The Asia-Pacific Education Researcher, 23(3), 621-633. https://doi.org/10.1007/s40299-013-0134-5

Tegin, B. (1980). Depresyonda bilişsel bozukluklar: Beck modeline göre bir inceleme [Cognitive distortions in Depression: A review considering Beck's model] [Unpublished doctoral dissertation]. Hacettepe University.

Tomai, M., Lauriola, M., & Caputo, A. (2019). Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages?. Mediterranean Journal of Clinical Psychology, 7(1). https://doi.org/10.6092/2282-1619/2019.7.1983

Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet‐Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 65(2), 87–108. https://doi.org/10.3322/caac.21262

Türküm, A. S. (2001). The relationships among coping with stress, optimism, irrational beliefs and attitudes toward seeking psychological help: A study with university students. Anadolu University Journal of Social Sciences, 1, 1-16.

Usher, E. L., & Pajares, F. (2008). Self-efficacy for self-regulated learning: A validation study. Educational and Psychological Measurement, 68(3), 443–463. https://doi.org/10.1177%2F0013164407308475

Williamson, G. M. (1998). The central role of restricted normal activities in adjustment to illness and disability: A model of depressed affect. Rehabilitation Psychology, 43(4), 327–347. https://doi.org/10.1037/0090-5550.43.4.327

Wong, W. S., & Fielding, R. (2007). Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor. Supportive Care in Cancer, 15(11), 1223–1230. https://doi.org/10.1007/s00520-006-0190-y

Wu, L. M., Austin, J., Hamilton, J. G., Valdimarsdottir, H., Isola, L., Rowley, S., Warbet, R. Winkel, G., Redd, W. H., & Rini, C. (2012). Self‐efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well‐being after hematopoietic stem cell transplant. PsychoOncology, 21(11), 1175–1184. https://doi.org/10.1002/pon.2012

DOI: https://doi.org/10.13129/2282-1619/mjcp-3229


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