Learning Objective #1: Describe how personal characteristics, treatment outcomes, and cognitive appraisals explain quality of life at the time of cancer diagnosis

Learning Objective #2: Describe how cognitive appraisals and quality of life change over time in persons newly diagnosed with cancer

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Medical outcomes, such as disease free survival, mortality, symptom management, and cancer relapse rates, have typically been used to evaluate treatment and recovery from cancer. With more successful cancer treatment, measurement outcomes focusing on quantity are becoming insufficient. Comprehensive outcome measurement must evaluate the experience as perceived by the individual living with cancer. Critical to the measurement of this personal experience is the evaluation of an individual's cognitive appraisal and quality of life (QOL). QOL is perceived uniquely by individuals and is an issue of increasing importance to those living with cancer. According to the transactional model of stress and coping, what an individual cognitively appraises about the cancer experience influences QOL and the resulting adaptation to the potentially stressful event. The purpose of this study was to assess cognitive appraisals, treatment outcomes, and the impact of these variables on quality of life over time for individuals facing a new diagnosis of cancer. Data were collected over one year using a repeated measures design. Instruments included: a researcher developed tool to measure treatment related variables, the Cognitive Appraisal of Health Scale, and the Quality of Life Index Cancer Version – III. Subjects were female (71%), married (79%), worked (50%), high school graduates (85%), and aged 23 - 78 years (M = 62). The top cancer diagnoses were breast (39%) and lung (18%); the majority (43%) was treated with chemotherapy initially. Seven variables from the model explained 84% of the variance in QOL scores at initial diagnosis, F(8, 57) = 36.42, p < .000. Multiple cognitive appraisals and QOL changed significantly over time (p < .04). An improved understanding of the cancer experience over time should enhance the health care community's ability to provide adequate care and position the community to improve support for survivors and prevent adverse outcomes.