Perceived stress and its associated demographic-clinical characteristics
and positive expectations among Chinese cervical, kidney, and bladder
Received: 24 October 2017 / Accepted: 29 January 2018 / Published online: 5 February 2018
Springer-Verlag GmbH Germany, part of Springer Nature 2018
Purpose Positive expectations about personal abilities and future outcomes are important in shaping human behavior and emo-
tion, which may influence the psychological adjustment in cancer patients. We aimed to assess two basic kinds of perceived stress
in Chinese cancer patients and to investigate their associations with demographic-clinical characteristics and positive expectations.
Methods A multi-center, cross-sectional study was conducted in consecutive cervical, kidney, and bladder cancer inpatients from
three general hospitals in Liaoning province from February 2013 to August 2014. A total of 790 patients eligible for this study
completed questionnaires on demographic-clinical variables, optimism, general self-efficacy, perceived global, and cancer-
related stress anonymously. Hierarchical regression analyses were conducted to examine the relationships between optimism,
general self-efficacy, and perceived stress, after controlling for possible covariates.
Results Mean score of perceived global stress was 17.85 (SD 4.43). Mean score of perceived cancer-related stress was 37.15 (SD
12.66); 38.1% of the sample scored 44 and above, 20.1% scored 50 and above. Education, physical activity, cancer stage, and
time since diagnosis were significantly associated with perceived stress. Optimism and general self-efficacy accounted for an
additional variance in perceived global (14.9%) and cancer-related stress (16.9%), and both of them were independent and
protective variables of perceived stress.
Conclusions This study recognized cancer patients at risk for high levels of perceived stress and extended the understanding of
the association between positive expectations and perceived global and cancer-related stress. Enhancing or maintaining optimism
and general self-efficacy might be potential targets for future psychosocial interventions aimed at relieving perceived stress in
Cancer is considered as one of the most stressful life events, and
the stress response could be further initiated by cancer-related
factors. Stress can be conceptualized as life events/stressors or
as perceived stress [1, 2]. The impact of objective life stressor
depends on one’s perceptions of stressfulness, indicating that
stress response to the objective event was cognitively mediated
by the perceptions of stress [1, 3]. The cognitive appraisal of
stressful events emphasizes the importance of evaluating per-
ceived stress in addition to objective stress. Among breast can-
cer patients, the impacts of perceived stress on depressive
symptoms and quality of life were larger than those of objective
stress [1, 4], and perceived stress fully mediated the relationship
between life events and quality of life .
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s00520-018-4081-9) contains supplementary
material, which is available to authorized users.
* Lie Wang
Department of Social Medicine, School of Public Health, China
Medical University, No.77 Puhe Road, Shenyang North New Area,
Shenyang 110122, Liaoning, People’s Republic of China
Supportive Care in Cancer (2018) 26:2303–2312