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Coping strategies in early, integrated palliative care

Coping strategies in early, integrated palliative care
Types of coping strategies Descriptions of coping strategies Examples of coping strategies
Cognitive
Self-distraction Direct attention to activities that help shift one's mind away from worries Engage in hobbies, reading, puzzles, games, or work
Cognitive restructuring Identify and dispute irrational or maladaptive thoughts Refute the fear that only full-dose chemotherapy is needed for cancer control
Mindfulness Bring one's attention to experiences in the present moment Practice meditation, yoga
Behavioral
Problem-solving Identify problems, generate solutions, and create an action plan Research clinical trial options
Discuss and document advance care plans; estate plans
Soliciting social support Identify informational, emotional, and practical needs Develop strategies for obtaining needed support from care team, family, and friends
Behavioral activation Identify values and align behaviors Remain engaged with important activities as much as possible, even with the disease
Emotional/physiologic
Physiologic interventions Optimize physiologic state Practice relaxation strategies
Maintain good sleep routines
Exercise when possible
Pace activities and conserve energy as needed
Positive psychology interventions Enhance positive emotions, such as optimism, joy, humor, or gratitude Think about future possibilities
Hope for good things
Help others to laugh
Express appreciation toward others
Flow Fully immerse oneself in an activity with focus, energy, and enjoyment Engage in hobbies, creative projects, music, or work
Existential/spiritual
Religion or spirituality Engage in a religious practice Pray
Attend church services
Build community through helping and being helped Help others and accept help from others
Join community for a common purpose
Life review Reflect on life experiences to develop sense of personal coherence, dignity, and legacy Write letters to loved ones
Complete meaningful tasks
Reconcile relationships
Engage in legacy work or project
Meaning-making Reflect on ways experiences have enhanced personal growth and meaning Consider positive life changes from the illness
Explore new goals and priorities
Acceptance Learn to live with and assent to the situation without attempting to change it Talk with family about the reality of the illness and current goals
Originally published in: Jacobsen J, Kvale E, Rabow M, et al. Helping patients with serious illness live well through the promotion of adaptive coping: a report from the improving outpatient palliative care (IPAL-OP) initiative. J Palliat Med 2014; 17:463. Copyright © 2016 Mary Ann Liebert, Inc. publishers.
Adapted and republished in: Greer JA, Applebaum AJ, Jacobsen JC, et al. Understanding and addressing the role of coping in palliative care for patients with advanced cancer. J Clin Oncol 2020; 38:915. DOI: 10.1200/JCO.19.00013. Copyright © 2020. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
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